Kathmandu (Pahichan) September 13 – In late 2017 and early 2018 we conducted an online survey open to individuals and organisations who had ordered the Passport. The survey was shared by directly emailing people who had ordered the Passport and results were collected anonymously. We sought to capture an understanding of how the Passport is being used and to assess if improvements could be made.

The Passport is a tool to support clear communication between people and organisations on topics related to their genders, bodies and relationships. This information is critical in a wide variety of settings, including health care, ageing & aged care, police, law, housing and education. The Passport is a multipurpose tool designed to promote the best possible care for people who have historically faced mistreatment or exclusion on the basis of their genders, bodies or relationships.

The National LGBTI Health Alliance developed the Passport based on requests and feedback from community and organisations and in collaboration with our members and LGBTI people. People told us about the situations they faced when important aspects of their genders, bodies or relationships were not understood or included in their care.

Organisations told us they found it difficult to know how to ask about sensitive information in ways that were respectful and inclusive. They were seeking a better way to meet people’s needs. This feedback highlighted the need for a multipurpose and user-friendly tool. The Alliance designed this tool (the Passport) to help people to get quality care, and to help organisations to achieve better inclusive practice.

In general, individual Passport holders have predominantly used them in clinical settings or with other allied health services. Passport holders have indicated that the tool has been helpful and well received by service providers and health professionals. The majority of individual respondents are happy with the current version and will use it again in the future. Key suggestions include a digital copy and having the ability to make amendments or additions or limit the information in different circumstances.

Organisations that ordered Passports had mostly used them as a resource to help educate their teams or to share them with people accessing their services. Respondents reported some difficultly about how and where to store the information in the Passport and how to use it within their current systems. This supports the need to raise awareness of inclusive practise and documentation within services and a need for guidance and education around good processes. This also highlights the benefits to individuals in holding a Passport where services may not have adequate systems in place for, or knowledge about sensitively engaging with, people who have diverse genders, bodies or relationships.

Individuals who ordered a Passport

• Most responds where aged between 25-54 with 24.9% aged 55 or older.
• Most people lived in QLD, VIC or SA. There were no respondents from ACT or TAS.
• 50% of Passport holders are experiencing mental illness.
• 35.7% live with a disability.
• 32.2% are experiencing a chronic health condition.
• 32.2% are living in a rural or remote setting.
• 14.3% identified as Aboriginal or Torres Strait Islander.
• 7.2% identified as Culturally and Linguistically diverse.

Where it was used

• 80% reported using the Passport in a clinical setting such as with their GP or at a hospital and 40% used their Passport at an allied or mental health service. Other key places the Passport was used include workplaces and with police.
• 100% retained the Passport, showing it to others but keeping the physical Passport on their person.
• 80% had a positive reaction from service/ health care providers to the Passport. There was only 1 report of a person having a negative experience.
• When the Passport was not used the key reasons indicated were that it was not needed, people were either comfortable discussing their personal information or that some individuals did not wish to disclose all their information in a particular setting.

Most useful features

• 100% reported the Passport was useful or helpful.
• Individuals did not have to explain themselves multiple times to multiple people.
• Having their information noted on a record.
• Having all their information available and easy to refer to.
• Having personal choices listed, such as who contact and who not to contact in an emergency.
• Sharing the information with a trusted person to be able to advocate on behalf of the Passport holder, should they be unable to.
• Lowered concerns about who could make choices on their behalf and more confident about their own choices being followed.
• Able to provide required information to police.
• Using it in a public setting, such as waiting room and still retaining privacy (written information vs vocal).

How it could be improved

• Having removable/ or insert-able pages for amendments and to choose the amount of information shared in different settings.
• A digital copy that can be stored with medical or other service records.
• More extensive details on end-of-life and afterlife planning.
• Clearer labelling on the front cover for health professionals to identify its significance in an emergency.
• Removing the front page to protect privacy.
• The vast majority of responses indicated no change was required.

Where to from here 

Silver Rainbow will review the feedback in the survey and look at ways to implement key recommendations into future versions of the Passport. This will include consideration of whether to extend the end of life planning section or look at the development of a separate tool. Given the overall satisfaction with the Passport, we will maintain the current version for the immediate future.

We will develop guidance materials for organisations on how to sensitively use the Passport and how it can effectively fit in with their systems and processes. This will include tips and recommendations around questions to ask, how to complete each section and storage of the information.

Individuals can order a Passport for free, this includes people who may already have a Passport but require a new one for updates or amendments. Organisations can purchase Passports in packs of 10, prices vary according to income.

Whilst this tool was created by the Silver Rainbow Ageing & Aged Care Project, it has useful applications across many sectors, age groups and environments.

Passport orders are available on our website. This resource is highly valued and appreciated by current Passport holders, we encourage you to share this information with your colleagues, networks, friends and family. A downloadable & printable sample can be found here.

If you have further questions or comments about the Passport, contact [email protected] or call Heath on (02) 8568 1106.