Member Attestation

CTHCG Clinical Member Attestation 

 

Signing this attestation is a requirement for all clinical healthcare providers to become members of CTHCG. CTHCG is a voluntary group of interdisciplinary health care providers dedicated to providing affirming care and ongoing education in the provision of care to Transgender and other Gender Diverse members of our community and/or their families. All providers listed on the website (cthcg.org) must have signed this attestation and attended at least 2 meetings. Attestations and meeting attendance is reviewed and updated on an annual basis by the membership committee.

 

I, _______________________________________________ am committed to becoming a member of CTHCG and to providing affirming healthcare services to the transgender and gender non-conforming (TGNC**) community. I further understand that as a member I am consenting to being listed in the Charlotte Transgender Healthcare Group (CTHCG) directory of trans-affirming providers and am consenting to my name and practice information to be distributed to the TGNC community of Charlotte, North Carolina and surrounding areas via website, listservs, and in print.  

 

I understand that by signing this, I am confirming the following statements are true, and if found to be false my membership and any associated listings may be revoked:

  1. I am a licensed or license eligible healthcare provider in good standing with my licensing board and fall under HIPAA regulations (and superseded by NC State Law when requirements, standards, or implementation specifications than those imposed by HIPAA)

  2. I currently provide healthcare services to TGNC individuals residing within the greater Charlotte community

  3. I have attended at least 2 CTHCG meetings and am committed to continuing to attend at least 2 of the 11 monthly meetings held annually

  4. I am personally and professionally supportive and dedicated to informing myself on gender identity, gender expression and all TGNC* issues and committed to continuing my education on TGNC healthcare and serving the TGNC community.

    1. I am committed to practicing within my level of competency and will formally assess this competency level* annually

    2. I will not practice outside of my scope of competency and will utilize referral sources as appropriate

  5. I will contribute to my best ability and according to current membership requirements, toward the financial maintenance of the CTHCG website and operating materials that support the accessibility and advocacy efforts of CTHCG

    1. I understand a $25 contribution is suggested to meet the current budget

  6. I  recognize that my membership and any associated listings can be revoked and may not be reinstated without a review for the following reasons:

    1. If I do not uphold my commitments to affirmative TGNC** care as listed above, including attending two meetings annually

    2. If my license is suspended, revoked or other disciplinary action has been taken by my licensing board

    3. If it is determined that I have in any way been detrimental to the TGNC**

*2019 LEVEL OF COMPETENCY SELF-RATING SCALE

The “cultural competence” self-rating system for CTHCG members was designed to assist individuals in the community in locating clinicians who can provide the level of affirming and/or specialized care they are seeking. Please identify your current level of competence in providing services to TGNC clients/patients, by indicating ages served by level. (i.e. some clinicians may have experience meeting the transition needs of youth, adolescents and adults and others may have training limited by developmental stage) Please contact the membership committee with any questions.

_____________Trans-friendly: Defined as open, non-judgmental, and accepting with general knowledge only. These are often general practitioners and providers specializing in other clinical areas, who know a great deal about a variety of presenting issues and can help with many different concerns, but don’t necessarily have a specialty in helping patients with sexuality and gender concerns.

______________Trans-informed: Defined as possessing specific knowledge of minority stress, gender dysphoria and transgender and gender non-conforming (TGNC) identities. These providers have attended training(s) to educate themselves more specifically in order to provide TGNC focused services. These providers have some previous experience providing professional services to TGNC individuals and may often consult with Trans-specialists. 

______________ Trans-specialist: Defined as very experienced and educated regarding transgender and gender non-conforming (TGNC) patients. They are knowledgeable about various aspects of minority stress, transition considerations, and can adequately assess informed consent to provide referrals or provide the relevant transition-related care.  They have previously provided professional services to multiple TGNC individuals and may provide consultation, mentorship or supervision to trans-informed, trans-friendly and other trans-specialist providers. They are committed to ongoing TGNC professional development opportunities and often are members of professional organizations centered on TGNC care to remain informed on the latest research and clinical considerations.

Community Disclaimers

Please note that inclusion in this list does not mean endorsement by the Charlotte Transgender Healthcare Group or its members.

  • If a provider is not listed here, it does not mean that they are transphobic. We may have missed them in our outreach efforts or they may choose not to be listed.

  • Inclusion here does not guarantee that the provider is completely knowledgeable or competent in all matters of transgender-related health care, but means simply that they signed a statement that they are “personally and professionally supportive and dedicated to informing myself on gender identity, gender expression and transgender* issues” as stated above.

  • We do not do background checks on the health care providers listed here and therefore can make no representation about their licensing, accreditation, or other professional qualifications. You may wish to check such information with the state licensing boards and/or professional organizations that serve the area where the provider practices.

  • Our provider directory provider listings are only for personal use. They may not be used for soliciting, marketing, or canvassing purposes.

  • No one has paid a fee to participate in our provider directory, and we do not receive any payment from practitioners who are listed.

Adapted from the Missouri Transgender Health Network http://www.transgenderhealthnetwork.org and Minnesota Transgender Health Coalition: http://www.mntranshealth.com

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