International Transgender Day of Visibility, celebrated on March 31st, is a time to recognise the resilience of transgender and gender-diverse individuals. 

The NHS is committed to providing inclusive and respectful healthcare for all,  and this includes transgender patients who may have specific healthcare needs. Here’s what GP Practices need to know to effectively support staff and patients in primary care.

The term "transgender" is generally preferred by transgender people as an umbrella term encompassing various gender identities that may not align with societal expectations. For instance, someone might feel like they're not exclusively male or female, identify differently than their assigned birth sex, or not identify with any gender at all. It's important to remember that gender goes beyond physical anatomy – we all express ourselves through gendered traits and behaviours. However, due to the diversity within the transgender community, there's no single rule for disclosing this aspect of one's identity.

Unfortunately, the reality for many transgender people is one of fear and discrimination. Reports of transphobic hate crimes in 2023 went up by 11%, with statistics from Galop indicating that 1 in 4 trans individuals have faced threats or violence in 2020. Employment opportunities are limited, with 1 in 3 employers refusing to hire transgender people. The mental health toll is significant, with nearly half of transgender people attempting suicide at some point. Even access to healthcare can be a challenge, as some trans children face legal battles to obtain medication.

Current UK Legislation (as of March 2024)

Equality Act 2010: This act protects transgender people from discrimination in healthcare settings. It ensures they receive the same quality of care as anyone else, including in the workplace or in the provision of goods and services.

A person does not need to be under medical supervision to be protected by the Act. For example, someone assigned as male at birth who decides to live as a woman, but does not consult a doctor or undergo any medical procedures, would be protected. The Act also protects people associated with them, including family members as well as others who are perceived to be transgender.

Gender Recognition Act 2004: This act allows transgender people to gain legal recognition in their acquired gender. They can apply for and get a Gender Recognition Certificate to legally change their gender, get an updated birth certificate, marry/civil partnership in their gender, and have their gender recorded on their death certificate.

Why do Practices need a Transgender Policy?

The NHS recognises that transgender people can face challenges in accessing healthcare due to a lack of awareness or unconscious bias.  Having the relevant guidance will help GP Practices address these issues by:

• Ensuring staff training: Up-to-date training equips healthcare professionals to provide sensitive and competent care, respecting a patient's gender identity and using their preferred pronouns.
• Promoting respectful language: A clear understanding of terminology like "gender dysphoria" and "gender identity" fosters open communication.
• Creating a welcoming environment: Practices can implement procedures to ensure patient privacy regarding their transgender status.

These measures aim to create a safe space where transgender patients feel comfortable discussing their health needs.

How your GP Practice can Support Transgender Patients

Create a Welcoming Environment

• Display posters or signage indicating the practice's commitment to inclusive healthcare.
• Train reception staff to ask about preferred names and pronouns upon arrival.
• Offer single-sex toilets or gender-neutral facilities where possible.

Respect Patient Identity

• Update patient records with their chosen name and title upon request. No proof of medical transition is required.
• Use the patient's preferred pronouns during consultations and correspondence.
• Ensure staff are familiar with transgender terminology to avoid confusion.

Maintain Patient Privacy

• Treat all discussions about gender identity with sensitivity and confidentiality.
• Obtain informed consent before sharing any information related to a patient's transgender status unless legally required.

Provide Appropriate Care

• General healthcare needs of transgender patients are no different from the general population.
• Be aware of potential mental health concerns related to gender dysphoria.
• If a patient expresses an interest in transitioning, explain the referral process to specialist gender identity services.

Stay Up-to-Date

• Encourage staff to participate in ongoing training on transgender healthcare best practices.
• Maintain a list of relevant resources and support groups for transgender patients.

Remember: Every transgender person's journey is unique. By following these tips and adhering to the NHS transgender policy, GP practices can create a more inclusive and supportive environment for transgender patients, ensuring they receive the healthcare they deserve.

Celebrating Visibility

The NHS Equality and Diversity Framework includes resources and guidance to support transgender patients. The International Transgender Day of Visibility is a celebration of transgender people and their contributions to society. By recognising the needs of transgender patients and providing appropriate care, primary care services contribute to the NHS creating a healthcare system that is truly inclusive. 

Subscribers to FPM Core can access the Transgender Patient Policy and the Transgender Equality Policy (for staff). To find out how to subscribe, click here.