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1.0 Business Description & Vision
1.1 Our Vision
Our Vision is to support the trans-gender community by providing a well-referenced digital resource library, moderated discussion forum and a concierge service that allows candidates to access surgical and travel services as required.
1.2 What we do
First and foremost this is a for-profit business, but does actively pursue larger stakeholder objectives that are non-direct revenue seeking in nature.
Despite this, the business has an underlying and sustainable business model driven by a motive to bring about a positive return on the shareholders equity (and time) investment. Naturally through this mutually beneficial relationship with our associated partners their own person business interests are exposed to greater opportunities.
The business is by in large a service provider operating in two distinct but intuitively related areas as discussed below;
1.2.1 An information Resource Center (generally non-revenue generating)
o Individuals
§ Experiencing gender identity issues of some description;
§ Identified as transsexual or intersexual;
§ Undergoing some stage of the transition process.
o Families
§ This is primarily through helping them understand general concepts and terminology (which is often complex and poorly comprehended). General education and
§ If required, referrals to other resources such as professional services.
In terms of the sources of this information, we rely on existing online forums where transgender and people transitioning frequently discuss their experience, review doctors and local physicians, and discuss the general experience of undergoing (and importantly recovering) such an involved procedure. For example, Susan’s Place Transgender Resources, (2015) is probably the largest of these forums, with a membership of over 28,000 individuals.
Appendix Item 11 refers to a message from the Moderator of this forum and outlines corporate sponsorship available to the website. This would help us make use of the forum through prominent advertising.
At the same time we would answer member questions and post articles of interest to fascilitate dialogue and raise awareness of our resource centre and its services.
The scope of our reporting in this area will be limited in breath, given this reports specific focus on the sales, operations and revenue generating aspects; however, additional reporting could be warranted, given the mounting areas of research that supports the stance of those firms who have a ambitions beyond solely their profit center. In return for taking a genuinely strong stance on potentially risky social issues (Transgender rights being a case in point) such firms actually experience greater firm value compared to their less righteous competitors (Weinzimmer &
Esken, 2016)
Concierge Care Services is a service platform that coordinates the activities of its partners to meet the customers needs. Customers engage with the company to seek information regarding assistance in receiving information about gender-disphoria and gender reassignment surgery.
The strengths of the relationships the company has with its partner organizations, the growing acceptance and accessibility to affordable surgical options such as in Thailand provide for an environment that can foster the development of this business.
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Furthermore, this business commits its coordinated endeavor to foster the community aspect of the organization by the provision of a medically curated forum, where real patients can share their experiences and interactions with;
• Hospitals
• Surgeons
• Endocrinologists
• Gynecologists
• Psychologists and Psychiatrists
Our own forum, would include content that we may have already psoted on the Susan’s Forum, however it would also include stories and our own material that for editorial reasons may not be allowed on Susan’s. In that sense the two can be considered differentiated, but complimentary.
This community aspect is further enhanced by the company’s commitment to devote 20% of its post tax profits to our preferred outreach organizations. To be posted annually.
Examples of such would include the previously mentioned paid membership/
Sponsorship of Susan’s
1.2.2 A Concierge Care Service (the revenue generating aspect) to,
Primarily the target consists of groups of individuals previously identified, who can be broadly categorized as non-traditionally gender conforming (inter- or trans-sexual), and in many cases are interested in a surgical and/ or depending on previous contact with practitioners clinical consultation.
In short, due to prohibitive home country costs (sometimes stemming from a lack of access to public or private health care benefits and less experienced (or too busy) local practitioners many patients turn to strategic foreign destinations to undergo such operations. That is where the value proposition of our offering is derived.
The various professional service providers that we would typically work to serve our patients are explained in depth in the 2nd & 4th sections of this report.
2.0 Concierge Care Services (Defining the Markets)
The market, whilst being quite specific to individuals interested in gender reassignment and related surgical procedures can be segmented along a number of lines.
2.1 Australian patients
o Pre-operative Australian transgender men
§ This includes full reassignment surgical procedures o Post-operative Australian transgender men;
§ Seeking related procedures to compliment their existing transitory operation
2.2 International (predominantly ‘Western) Patients o Pre-operative international transgender men
§ This includes full reassignment surgical procedures o Post-operative International transgender men;
§ Seeking related procedures to compliment their existing transitory operations
• Facial Feminization
• Voice box surgery
• Hair transplants/ grafts 2.3 Female to Male Patients
o Anecdotal research suggests this segment is 1/10th of which Yanhee Hospital has indicated that the majority of inquiries directly from Japan via an agent.
o Our focus on this segmentation is going to be held off until the planned system under the name of GenderRe is proved successful, with the associated media coverage. At which point it will be spun off as a unique brand “Bodyline-Menz”
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3.0 Industry Analysis
The medical tourism industry, particularly for Australian patients is well developed, with multiple local and international firms offering essentially every procedure imaginable, including of course GRS and related procedures.
However there is really no single player in the market who is so solely devoted to this area of medicine, let alone providing as robust of a community and psychiatric support network for patients.
Competitively, domestic surgeons in Australia cannot match the offerings of Thai doctors on most measures including;
• Price
• Level of post operative care
• Experience of practitioners
Our recent experiences with patient further point towards the competitiveness of our business model, with Natinoal Health Insurance (Medicare in Australia) not covering the procedure.
3.1 SWOT Analysis
The ‘SWOT’ Analysis below is a study we have conducted to identify our firms Internal Strengths (& weaknesses) as well as the External Opportunities and threats, specifically;
• Strengths: characteristics of the business or project that give it an advantage over others
• Weaknesses: characteristics of the business that place the business or project at a disadvantage relative to others
• Opportunities: elements in the environment that the business or project could exploit to its advantage
• Threats: elements in the environment that could cause trouble for the business or project
With it’s history being obscure (although widely credited to the great management consultant, Albert Humphrey, a house name at Standford, MIT & Harvard and both academic & business practice seldom aligning, this framework it widely regarded
as a useful tool help a firm evaluates itself and the market in which it operates to understand the relative strategic fit.
Helpful Harmful
Internal Origin
Strengths
• Lean organizational Structure and low fixed costs.
• Relevant experience of partners and passion for the industry.
• Media exposure to support launch from patient 1’s show on Channel 9
• Media contacts in Australia (access to Channel 9 & SBS)
Weaknesses
• Privately funded (low cash reserves); limited reach advertising budget.
• Limited prior customer testimonials
• ‘Busyness’ of partners
• Preparedness to respond to a surge in customers (maintaining level of service)
• Understanding cultural sensitivities when translating business model
External Origin
Opportunities
• No other strong direct competitors
• Growing awareness and acceptance of industry
• Exclusive agreement with Yanhee Hospital & taking over the international SRS devison
• Australian Department of Human Services allowing
patients to access
superannuation fund to pay for surgery
• Opportunity to market in different markets
Threats
• Low barriers to entry, room for competitors to enter and undercut market share
• Market size (potential growth but always limited)
• Independent patients going directly to clinics
• Exchange rate fluctuations make doing business less predictable and creates exposure to currency risk
• Litigation (minimized through previously discussed mechanisms)
3.2 Competition
As previously mentioned in the SWOT and initial industry analysis there are no specialized/ direct competitors with this company. However competition is seen from companies such as
• Other medical tourism agencies and concierge service providers. Their number is large and geographic dispersion high. Example of which include Estica Thailand;
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o http://www.transgendersurgerythailand.com/contact-us- transgender-surgery-sex-change-operation-sex-reassignment-thailand-bangkok
• Hospitals & Surgeons actively who market their services directly;
o In Thailand
§ Kamal Hospital (Bangkok)
§ Piyavate Hospital (Bangkok)
§ Samitivej Srinakarin Hospital (Bangkok)
o Other locations
§ Numerous spread globally 3.3 Five Forces Framework
3.4 Industry Potential
After using these tools to analyze the industry in general we can look at some more specific quantitative data to exam it’s size and market potential.
Statistically speaking, stimates surrounding the prevalence of transsexualism vary from source to source, however indicatively, however the Amsterdam Gender Dysphoria Clinic
(van Kesteren & Henk Asscheman, 1997) has over four has treated roughly 95% of Dutch transsexual clients, and it suggests a prevalence of 1: 10,000 among assigned males and 1: 30,000 among assigned females.
A 2008 study of the number of New Zealand passport holders who changed the sex on their passport estimated that 1:3,639 birth-assigned males and 1: 22,714 birth-assigned females were transsexual (Veale, 2008).
The variance between these figures is not high and in terms of being able to reach these individuals, through our contact and sponsorship with Susans network we will have access to an already educated and engaged community of more than 20,000 who could be potential customers. This does not include the very engaged, private groups that Fran Hirst is involved in.
4.0 GenderRe Brand Positioning & Value Proposition
(Strategyzer AG, 2017)
This model is an adaption of Osterwelder’s (2004) strategization modelling technique, particularly useful for the application of a lean startup. It has helped our
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firm to better understand our value proposition and given the level of infancy, build on that through our core competancies. However it’s limitations have meant that I have included further industry and internal/external frameworks to compare the company aginst competeitors, both local and international given the globally competitive environment we operate in.
With specific reference to the above business marketing canvas (typically used to explain the business plan and make adaptive changes accordingly) we can begin to understand each of the business elements. The center showing the value position offered and how Operations (Left) and Sales/ Marketing (right) create this. The associated revenues and costs are represented accordingly.
The specifics of each service will be outlined and discussed in detail in proceeding sections, as will the financials in Section 5.
Trading as; “GenderRe” via www.GenderRe.com.
4.1 Service Offering
Concierge Care Services is in essence a service platform that coordinates the activities of its partners to formulate a customized package, tailored to individual needs. The relative partners who provide these individual services are outlined below;
4.1.1 Key Partnerships
These partnerships describe the key relationships that the company has with its related parties. Memorandums of Understanding (MOU’s) and/or associated contracts are located in the appendix as noted.
Bodyline Patient Care (Australia) Limited
o Initial patient/ doctor consultation at hospital
o Care & Custodial Services in Country
§ Attending and arranging meeting with doctors and hospitals
§ Post operative care
• During hospital stay (to ensure that standards and patient comfort is being upheld)
• 2 weeks of monitoring (as needed) following discharge from hospital in Thailand.
§ Assistance in keeping patients local physicians informed of the process (endocrinologists, general practitioners, gynecologists, psychiatrists etc)
o Travel (all as per the level of standard/ budget of the patient)
§ Accommodation
§ Flights
§ Transport
o Staff training in Thailand
§ This particularly concerns the operators of the call center desk that will we be running out of the international department at the hospital.
§ A full time nurse is currently being interviewed to oversee all the care patients will receive.
Trading through;
www.bodyline.com.au
Yahnee International Hospital (Thailand)
• Primary provider of surgical procedures
• Source of international patients through our dedicated staff at their international office and control of their phone lines.
o Australia, New Zealand, USA & Canada
• MTF surgeries performed by Dr Greetchart Poonsirisikit
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Website contact;
www.yahnee.net
Dr Zachariah Turner (Australia)
o Company consultative Physician
o Doctor responsible for providing follow-up with (Australian) patients up to 6 moths from returning to Australia
o Source of publicity and media for the company through existing contacts with the large Australian TV broadcast media
o Bio on
§ https://www.drzac.co/projects/
Dr Diana Hamilton (Australia)
o Psychiatrist responsible for screening patient inquiries using the Harry Benjamin protocol
o Source of patient referrals from,
§ Her practice in Queensland, Australia
§ Her network of professionals globally.
o Advisor on potential areas of liability and best work practices and auditor of surgical providers to ensure compliance with SRS international framework (Harry Benjamin Protocol)
o Support for families before surgery and also following return to Australia.
o Bio on
§ http://www.drdianahamilton.com.au
Ms Yumiko Kigoshi (Japan/ Australia)- (ADACREST Consulting Pty Ltd)
o Well experienced in proving medical (largely cosmetic surgical) concierge procedures to patients both western and in Japan.
o Well connected with Dr Ito in Nagoya, a pioneer in HARG Therapy (Penetrative injection Therapy of Carbonic Acid gas jet), which may prove a popular choice for hair regrowth among interested patients.
o Whilst Ms Kigoshi’s primary input will be in the “Menz” area further along, she is currently referring a second MTF patient.
AVOXI
• Telecom Services for;
o USA o UK o Australia o Canada o New Zealand
Drew Lambert (Australia) (Didcomms Pty LTD)
Consultant publicist. With particular experience with bookings from the Australian Woman’s Day Magazine, SBS News Media Network and Bauer Media.
David Clune (Australia)
Is an experienced social media manager, and advises GenderRe for content creation and html optimization for promotional purposes.
He has kindly offered his services pro-bono.
Partner resumes, profiles and accreditations available via personal website or upon request.
4.1.2 Key Activities
Concierge
The underlying concept behind our business model is the provision of a concierge service that is the linking of our partners and management of the interaction between them to ensure every patients experience is as smooth as possible.
The importance of this service to non-native Thais and those who are less experienced in international travel (let alone medical tourism) is clearer communication with non-native English speakers, access to discount and taking on the burden of scheduling appointments and offering a variety of
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options. This is particularly important in a market where substitutes are available.
Similarly, to have dedicated staff with experience and compassion towards these unique patients aides in the overall customer experience.
Customer Relations
The success of many businesses, especially related to elective surgery and travel can be determined by how the customer views their relationship/ experience with the company. Whilst the day to day care of patients and organizing of hospital visits and accommodation etc is provided by our partner; Bodyline Patient Care Pty LTD.
Through GenderRe’s ERP & CRM system we can check to see if our partners are fulfilling deadlines and following SOP’s to meet the expectations of our company and the patients expected level of service.
The enhancement in the customer relationship and value added by employing patient care specialists is contrasted by the alternative recovery situation had a patient gone directly to a hospital. They would either have to care for themselves in a private hotel or apartment, or incur additional costs by spending an additional two weeks in hospital (non an ideal place to convalesce, particularly when Thailand offer such comfortable lodgings).
Community Engagement
As previously introduced, GenderRe, as being a part of a wider community, commits itself to supporting the LGBTQI community at large, our chosen partners for providing monetary support include;
• Victoria LGBTGI Support Network
• Rainbow Youth (Australia)
• More to be announced
4.1.3 Key Resources
Desk at Yahnee Hospital
Through negotiation with Dr Ismael Naypa, head of the international department of Yahnee Hospital, GenderRe gained unprecedented access to the existing resources of the hospital. Allowing us to choose an existing member of their staff to be trained
by Bodyline for the exclusive purpose of taking calls related to SRS as a representative of GenderRe.
This relationship is currently limited to calls originating from Australia, New Zealand, The UK, USA and Canada. But with the continued success of the relationship and proven increase in throughput (inquiry conversion) due to more well trained staff, our psychiatric network and premium care service along with media publicity we would expect this to be extended to more European locales.
This agreement was reached with Yahnee on Tuesday 11th July 2017, formal MOU just awaiting legal review before final cosigning.
Appendix item 7 is copy of confirmed points.
Human Capital
Janese Ritchie
Of Bodyline (Australia) brings along 15 years of experience in navigating the medical tourism industry in Thailand, having spent this time negotiating with hospitals and providing patient care, along with her sister Judith Remar (a licensed Chaplain).
The knowledge is extremely tacit and is arguably not transferable i.e. is difficult to transfer from one person to another but instead is learnt through experience.
As previously mentioned, Bodyline Patientcare LTD is a partner of GenderRe and their services are contracted.
Dr Zachariah Turner
A registered General Practicing doctor, with a specialization in cosmetic and aesthetic medicine, with regular appearances on Australia’s Channel 10 Morning show he brings a breath of experience and exposure that the company can leverage to its advantage.
Beyond his own personal involvement in medicine in Australia, Dr Zac has been referring patients to for general procedures through Bodyline and can be considered as both an ambassador for and advisor to GenderRe.
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A registered Nurse and trans advocate who underwent her surgery more than 30 years ago is excited to moderate our online forums and also collaborate on future areas such as patient care and liaising with key allies in the LGBT community.
In the future Fran would like to take over all the patient care and initial interaction for customers.
Technical Assets & Infrastructure
The operation of linking all these key partners and organizations is built upon a system consisting of contractual obligations, formalized SOP’s and an interactive (cloud-based) Customer Service & Enterprise Resource planning tool provided by Work (etc), Australia.
The ERP (Enterprise Resource Planning) & CRM (Customer Relationship Management system is cloud based, allowing the users (with appropriate permissions) to follow the input and throughput of customer details and follow the evolving stages of the relationship. Follows patients from the initial inquiry onwards, presenting a system of balances and checks to ensure procedure is followed and customers are always attended to. Similarly from an ERP perspective when patients are being cared for in Thailand the associated careers needed and organization of transfers and relevant travel needs can be monitored and where necessary additional resources deployed.
The technical suite allows for restrictions based access to the data and workflow monitoring between the previously mentioned key partners. This is particularly important, not only given the value of a database as a resource (and the importance of capitalising upon that data) but also given the nature of each partner’s geographical dispersion and the importance of remaining responsive to customer needs and changing working environments.
5.0 Sales, Marketing & Customer Centric Areas
The marketing and sales strategy of the firm is multi-dimensional in relies on
The marketing and sales strategy of the firm is multi-dimensional in relies on