Formulated in November 2021
Revised in November 2022
Revised in November 2023

To eliminate barriers in health screening for transgender persons in the “PwC Health
Insurance Society’s Contracted Medical Institutions,” health screening institutions withtransgender support are indicated with a six-color rainbow mark. The criteria for attaching
this mark are as follows.

PwC Health Insurance Society Criteria for Health Screening Institutions
with Transgender Support
All of the conditions in items 1. to 14. below must be met regarding individual
response to examinees who wish to receive support and examination as agender that differs from the gender indicated on the health insurance cardand Individual Number card (hereinafter simply referred to as “examinee”).

(Response to prior consultation)
1. In the event of consultation by telephone or email from an examinee who
has an appointment or is considering making an appointment, thefollowing response can be made.
❑ Give a specific explanation and make an individual response regarding
items 2. to 14. of these Criteria.
(Privacy of name [designation])
2. At reception on the day of examination, with due consideration of the1following, reconfirm as necessary the matters confirmed in the priorconsultation.
❑ Ensure that privacy-related contents are as inaudible as possible to people
in the vicinity.
3. In the waiting area for the examination, when calling the examinee toinform them about the next check-up, etc., one of the following ways canbe used.
❑ Call using number.
❑ Call using alias.
❑ Call using the surname only.
❑ Approach the examinee and speak directly to them (but not in a loud voice).
❑ There is a guidance system using a tool such as a tablet terminal, callingapp, or buzzer, making it unnecessary to call the examinee’s name.
4. When confirming the examinee’s name before examination at the place ofexamination, either of the following ways can be used.
❑ Confirming using an alias.
❑ Confirming using the actual name (name on the health insurance card)but taking care that it is as inaudible as possible to people in the vicinity.
(Privacy when using facilities and equipment)
5. Regarding use of changing rooms, one of the following responses can beused.
❑ When there are separate changing rooms for men and women, thechanging room the examinee wishes to use can be chosen.
❑ Time can be taken into account (allocate a time when there are no otherusers).
❑ Space can be taken into account (a location as far away as possible fromother users/using a private room/other responses).
6. Regarding use of washrooms, one of the following responses can be used.
❑ When there are separate washrooms for men and women, the washroom2the examinee wishes to use can be chosen.
❑ The examinee can be directed to a shared washroom.
❑ The examinee can be directed to a washroom where privacy can easily beprotected (e.g. a washroom on a floor not being used on that day).
7. Regarding equipment such as examination clothes and slippers, either ofthe following will apply.
❑ There is no distinction between men and women based on color, etc.
❑ There is a distinction between men and women, but the examinee may
wear those of the gender of their choice. (However, it may not be possible
to respond, for example, when there is no size for that gender which fits
the examinee.)
8. When a waiting area is used, either of the following will apply.
❑ If there are separate waiting areas for men and women, the facility of theexaminee’s choice can be used.
❑ There is a waiting area with no segregation between men and women(shared waiting room).
(General operations on the day of examination)
9. The contents of the responses confirmed with the examinee in the priorconsultation is conveyed to the following persons in charge.
❑ The person in charge of reception, person in charge of floor guidance, andperson in charge of allocating the order of examination.
❑ (If there is an examination) The doctor in charge, laboratory technician,and nurse or other examination assistant.
❑ (If there is a consultation) The doctor in charge, nurse or other person incharge.
(Gynecological examination or other gender-specific examination)
10. Regarding ease of receiving a gynecological examination, etc., all of thefollowing responses can be made.
3❑ Gynecological examinations can be received not only on days ofexamination for women but on days when both men and women canreceive health checkups.
❑ If the examinee is undergoing hormone administration or surgery
regarding a transgender female (male to female, etc. transgender person),if the examinee so wishes, certain gynecological examinations, such asbreast cancer screening or a thyroid function test, can be provided.
❑ If the examinee wishes to receive a male-specific examination, such as aprostate examination, regarding a transgender female (male to female, etc.
transgender person), consideration can be taken so that it is not obvious
to others that a male-specific examination is being conducted.
11. If the examinee so wishes, either of the following considerations can betaken so that it is not clear to people in the vicinity that the examinee isreceiving a gynecological examination, etc.
❑ Consideration of space (spatial separation from other users by having theexaminee wait to be called for gynecological examination in a waiting areathat is not specifically used for gynecological examination, such as ashared waiting room, outpatient waiting room, or private room)❑ Consideration of time (separation in time from other users by having theexaminee receive examination first or last on the day of examination,
providing a slight time gap between users before and after, etc.)
12. Regarding the medical interview, etc. for a gynecological examination,etc., either of the following will apply.
❑ The examination method is fixed and cannot be changed on the day, but it
can be explained to the examinee at the time of appointment and at themedical interview.
❑ There is room for choice regarding the examination method (use or nonuse of echo, etc.) and this can be discussed with the doctor in charge on theday of examination.

413. Regarding the place of gynecological examination, either of the following
will apply.
❑ There is little concern about attracting attention at the time of moving tothe gynecological examination area (it is close to other examination rooms,
a shared waiting room is nearby, the patient route can be adjusted, etc.)❑ The gynecological examination area is separate from other examination
areas and there is a risk of being noticed in the course of moving to thisarea, but when necessary a guide, etc. will accompany the examinee whenmoving.
(Consultation)
14. When a stethoscope is to be used on the chest, the following response canbe made.
❑ It can be explained before the examination whether the stethoscope will
be placed over the examination gown, directly onto the chest without
removing the gown or, because it is of great importance from the viewpointof treatment, directly onto the chest after removing the gown.

Points to note
(1) Assumptions regarding appointments
If the examinee wants an individual response, they should conduct anindividual consultation with the health screening institution in advance bytelephone or email. If no prior consultation has been made, the healthscreening institution may not be able to respond as indicated. The healthscreening institution will strictly manage the contents of consultation as
private information.
(2) Assumptions regarding medical interview and examination
The doctors and laboratory technicians involved in health checks do notnecessarily have any knowledge of the health issues particular to transgender5persons, such as hormone treatment and surgical procedures. Regarding
health check results that may be impacted by hormone treatment or surgicalprocedures, such as blood sample reference values (e.g. Hb, Ht, lipids, uricacid, CK, eGFR, etc.), the examinee should consult their own doctor orspecialist doctor and receive their separate comments.
(3) Matters desirable (but not mandatory) for health screening institutions
It is clearly indicated in some way (on website or at reception, waiting room,etc.) that all examinees will be treated impartially and without prejudice
regardless of sexuality, such as sexual orientation or sexual identity. In
addition, all staff are taught basic knowledge regarding LGBT and that it istheir basic duty as healthcare professionals to treat all examinees impartiallyand without prejudice.

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