Monty's thoughts

The blog of Monty Moncrieff
London Friend Chief Executive

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9 January 2013: #TransDocFail

If you were under any doubts of the reach of social media in connecting minority communities yesterday Twitter provided a remarkable illustration . It started with a simple hash tag - #TransDocFail - which invited trans people to share their experiences of accessing healthcare. What ensued was a miserable catalogue of difficulties, indignities and intrusions in accessing not only gender identity services but throughout engagement with the medical professions for entirely unrelated health needs.
 
The deluge is part of a collective online reaction by many trans people following reporting in Sunday's Guardian of ongoing investigations into the practice of Dr Richard Curtis, a private gender specialist in London. The article alleges a string of actions by the doctor that fall short of international standards. Supporters of the doctor cite his practice as being progressive and humane, and one blogger has set out how she see most of the alleged actions as within the internationally recognised WPATH Standards of Care.
 
Of course, trans people reporting negative experiences of health care is nothing new. 2007's groundbreaking research for Engendered Penalties found 1 in 5 GPs unwilling to help with referrals to gender services. The Government Equalities Office's own polling for their Transgender Action Plan identified health as by far the biggest concern for trans people. Last year new research into trans mental health made very uneasy reading with many respondents reporting worsening well-being after receiving poor care.
 
Encouragingly Engendered Penalties also found that 60% of GPs wanted to help but felt they lacked the information to do so. It's worth highlighting that both the Department of Health and the NHS have produced a range of resources to assist healthcare professionals and commissioners to ensure trans inclusion in care. Many of these are linked below, with updated guidance due from DH before the end of March, and the long-awaited UK Standards of Care which could soon be with us. It's important that medical professionals are made aware of such resources as they provide a benchmark for good practice - and crucially how to avoid negative outcomes. It's understandable that many of the million plus staff working for the NHS may not have had experience of supporting trans people but with such resources available it's not acceptable to not strive to understand their needs and offer them a positive experience of care.
 

New arrangements for gender identity treatment

The NHS restructuring is bringing some significant changes for trans people from April, particularly in the provision of gender identity treatments. Provision will be centrally commissioned by the NHS Commissioning Board as a specialised service. This may eradicate the 'post-code lottery' of myriad different local and regional policies, which have placed differing restrictions on care pathways and limited the choice of provider. However there are still concerns that services may still fall short of the international WPATH Standards. Final consultations on the policy and service specifications to be implemented in April are currently open for response until.25th January. London Friend will be responding as part of the National LGB&T Partnership.
 
As a member of the National LGB&T Partnership, and as a provider partner with cliniQ London Friend is supporting Trans Health Matters, a major national conference on trans health and well-being, on March 12th. The conference will examine access to trans health care, not only gender identity treatment, and explore practical ways that healthcare practitioners, commissioners and trans patients and campaigners can work in concord locally and nationally to improve health outcomes for all trans people.

Monty
 

Some Department of Health and NHS Trans Resources

Trans: A Practical Guide for the NHS

Transgender Guide for NHS Acute Hospital Trusts

NHS Choices Gender Dysphoria

NHS Choices – Live Well: Transgender Health

Living My Life

Bereavement: a guide for transsexual, transgender people and their loved ones

Transgender experiences: information and support

A guide to hormone therapy for trans people

An introduction to working with transgender people: information and support for health and social care staff



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