Master's Research Project

A web-based, visual resource guide on the primary health care of trans and gender-diverse clients.

Image of desktop design of trans primary care website homepage

Trans Primary Care Guide

Committee Members:

Primary Supervisor
Prof. Shelley Wall, Biomedical Communications, University of Toronto
Committee member:
Prof. Jodie Jenkinson, Biomedical Communications, University of Toronto
Content Supervisors:
Donna Turner, Communications Coordinator, Rainbow Health Ontario
Jordan Zaitzow, Trans Health Connection, Rainbow Health Ontario
Content experts:
Dr. Amy Bourns, Sherbourne Health Centre
Dr. Ed Kucharski, Sherbourne Health Centre

The health care gap

An initial literature review and resource audit into the current state of trans health care revealed a shockingly high lack of care for this marginalized population. Trans-sensitive care practices are rarely incorporated into medical and nursing school curricula while continuing medical education opportunities are limited and often restricted by time, place, and instructor availability. Hence, many primary care providers are currently uncomfortable with, and avoid treating, trans clients because they perceive their own knowledge to be inadequate to meet their clients’ needs.

Understanding the target audience

By attending Rainbow Health Ontario's Trans Health Connection training workshops, I was able to consult with primary care and service providers and figure out the barriers, misconceptions and questions they have encountered.
User personas were then developed in order to explore the potential users' abilities, needs and motivations.

Figuring out a solution

The purpose of the project was to develop a web-based, visual guide that:
  1. Increases primary care providers’ knowledge and confidence in welcoming trans and gender-diverse clients into their day-to-day practice by enriching the medical and non-medical discourse with visualizations that can help professionals relate to the material at hand.
  2. Offers primary care providers timely, non-sequential access to essential guidelines and protocols on the management of new and existing trans clients, including assessment of readiness for hormone therapy, risk assessment and mitigation, monitoring strategies for hormonal dosages & formulations and long-term preventive care
  3. Helps to decentralize trans expertise out of Sherbourne Health Centre and Toronto in order to reach care providers in remote locations across the province of Ontario.

Iterative design

Based on information from published Standards of Care, Guidelines and Protocols and the advisory committee, the information was organized.


Detailed wireframes were developed in order to structure the content for desktop, tablet and mobile access.

Exploration of an interactive visual map to navigate therapy options

Since existing online training resources were mostly restricted to linear narratives and lacked visual communication the goal for the new web-based framework was to show the multitude of different medical and non-medical transition options sought by trans individuals. Initial ideas included many version of an interactive "care map" that simulates Sherbourne Health Centre’s individualized, client-centred approach to trans care. Static, interactive and animated prototypes were developed in order to test this framework.

Research design & Evaluations

Prototypes developed throughout the project were evaluated through a community-based research design strategy:
  1. Formative evaluations of draft illustrations with trans and gender-diverse participants.
  2. Usability testing with students in the Biomedical Communications program.
  3. Summative evaluations of sections of a web-based prototype with primary care provider. (currently still in progress)
Participant reponses from the formative and summative evaluations have informed the redesign of the illustrations and website design.

Research dissemination

Poster Presentation at the Rainbow Health Ontario Conference 2016 and UTM Graduate Research Colloqium
Poster Presentation at the Association of Medical Illustrators Conference - Vesalian Scholar Poster Presentations

Design decisions

Illustrations and interactive visualizations were redesigned based on participant responses from the formative and summative evaluations. Below are examples of visualizations to enrich the medical discourse and to help health care providers learn how to provide care in a trans-competent manner:

A resource targeted at primary care providers

An example of an interactive illustration that to addresses common fears and misconceptions around the provision of hormone therapy.

Illustrated cultural competency skills

Potential clinical encounters and conversations between the provider and client are illustrated in order for physicians/RNs to learn how to approach conversations in a respectful, supportive manner.

Interactive graphics and timelines

Physical effects of hormone therapy are visualized in order to better understand what to expect from hormone therapy regimens.