Toadhenge Consulting: Healthcare Organizational Score Card

  • Welcome to the Healthcare Organizational Score Card!

    Before we dive in, we’ll ask for your name and email to have your results sent to you. If you’re not comfortable sharing your email, no worries—you can download a PDF version of the scorecard anytime at www.askmissjai.com.

    Throughout this score card the phrase "Transgender and Non-Binary, and Intersex" is used. This is because Transgender and Non-Binary are gender identities and Intersex refers to a sex assigned at birth. Though not all Intersex people identify as Transgender or Non-Binary, many health equity challenges overlap for gender-expansive people and intersex people. 


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  • STAFF TRAINING

  • At least 20% of our staff receive ongoing annual training on Transgender and Non-Binary, and Intersex (TGNBI) health topics from external subject matter experts (based on number of FTEs at the facility).*
  • Our organization incorporates recommendations from TGNBI health trainings into all levels of the organization (e.g., direct service, management, c-suite).*
  • Our annual training on TGNBI health includes topics such as: barriers to care, practice documenting gender identity demographic data, health needs for TGNBI patient populations, and creating a welcoming clinical environment for TGNBI patients.*
  • Our new hire training clearly states that our non-discrimination policy (including prohibiting discrimination for gender identity and gender expression), emphasizes confidentiality of TGNBI status in accordance with HIPAA protections, and provides scenarios for gender-affirming policy implementation.*
  • All patients are asked their names and pronouns, which are used consistently within our organization by all staff regardless of legal name and gender marker.*

  • ORGANIZATIONAL POLICY

  • Policies for our organization have been developed or revised to include Transgender and Non-Binary, and Intersex (TGNBI) considerations (example policies include: non-discrimination, dress code, gender transition in the workplace, pronoun/name use, patient rights, restroom use, public accommodations, and treatment of Intersex children).*
  • Our organizational policies include religious directives that prevent access to medically necessary treatments for TGNBI patients.*
  • Sexual Orientation and Gender Identity data is consistently collected for all patients and our organization has a plan in place to analyze this data to anticipate and respond to patient health needs.*
  • Our employee health insurance plans include mental health benefits, gender-affirming hormone therapy, puberty blockers for dependents, gender-affirming surgery, and associated gender-affirming laboratory and medical visits.*
  • Our employees are provided with an LGBTQ+ benefits guide that includes TGNBI benefit descriptions, or they have access to a benefits concierge service with an LGBTQ+ specialty.*
  • Our organization has a written organizational plan to address health disparities among TGNBI patients and outlines at least three procedures to eliminate bias and insensitivity toward TGNBI patients within the organization.*

  • COMMUNITY ENGAGEMENT

  • Educational brochures or print materials specifically addressing health topics affecting Transgender and Non-Binary, and Intersex (TGNBI) people have been created and distributed by our organization, separate from general marketing materials.*
  • Our organization uses inclusive marketing or advertising to actively engage TGNBI patients. TGNBI content or images are included in organic social media posts at least once a year and support is provided for one or more TGNBI-related events or initiatives in our service area.*
  • Our organization’s website includes educational TGNBI-related health information and/or links to TGNBI health education or service resources from outside organizations within our service area.*
  • We frequently collaborate with external TGNBI organizations and community leaders to assess and address TGNBI health needs and concerns within our service area.*
  • We have a community advisory committee focused on TGNBI patient care that is involved in supporting health equity work within the organization.*

  • ORGANIZATIONAL STRUCTURE

  • We offer Transgender and Non-Binary, and Intersex-related clinical services (gender-affirming hormone replacement therapy and surgeries) alongside a dedicated patient navigation/advocacy program specifically for TGNBI patients.*
  • We promote TGNBI-knowledgeable and friendly providers to interested patients and we have a confidential referral mechanism available to the public for TGNBI-specific referrals.*
  • Our electronic health record system captures two-step gender identity, an organ (anatomical) inventory, and current name/pronouns AND prominently displays name and pronouns for staff at appropriate stages of the clinical workflow.*
  • Our HR information system captures voluntary gender identity data, and our anonymous employee engagement surveys allow staff to identify as TGNBI and include TGNBI-related concerns.*
  • Our organization’s patient satisfaction surveys allow TGNBI identification includes TGNBI-related questions, and patient feedback is analyzed for TGNBI health needs.*

  • ORGANIZATIONAL LEADERSHIP

  • Our organization has an LGBTQ+ employee resource group that receives annual funding specifically to support Transgender and Non-Binary, and Intersex (TGNBI) related initiatives and activities.*
  • TGNBI employees are provided resources and encouraged to join leadership development initiatives, including coaching or mentorship, to support their professional growth into visible leadership roles.*
  • Openly TGNBI colleagues serve in high-level, visible leadership roles within our organization.*
  • TGNBI leadership is actively involved in decision-making processes related to TGNBI health equity and our broader organizational health equity initiatives.*
  • Our leadership teams receive coaching on how to support TGNBI employees in the workplace including how to navigate gender transition in the workplace, conflict management and de-escalation, and advocating as a supervisor.*
  • Should be Empty: