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GPs poor at treating transgender patients

MPs want full review of NHS services for transgender people

Adrian O'Dowd

Thursday, 14 January 2016

The NHS and some GPs in particular are extremely poor at dealing with and treating transgender people, concludes a report published today by the House of Commons women and equalities committee.

Overall, the report says there is still a long way to go to ensure equality for transgender people, despite welcome progress, in many areas including healthcare, legislation, and the criminal justice system.

There were “serious deficiencies in the quality and capacity of NHS gender identity services”, said MPs who called for a “root-and-branch review” of the NHS's treatment of transgender people.

MPs said the NHS was failing in its legal duty under the Equality Act 2010 and trans people had significant problems in using general NHS services, often because of lack of knowledge and understanding by staff.

GPs in particular often lacked an understanding of trans identities, the diagnosis of gender dysphoria, and their own role in prescribing hormone treatment, said MPs.

They called for an in-depth review of these issues to be completed within the next six months.

The report quotes Dr James Barrett, president of the British Association of Gender Identity Specialists as saying during the inquiry that led to the report: “The casual, sometimes unthinking trans-phobia of primary care, accident and emergency services and inpatient surgical admissions continue[s] to be striking.

“A matter of serious day-to-day importance at a primary care level is the persistent refusal of some general practitioners to even make referrals to gender identity clinics.”

Another witness for the inquiry Dr John Dean, chair of the NHS National Clinical Reference Group for Gender Identity Services, is quoted in the report saying: “My experience, working with GPs and secondary care physicians, is that, overall, people working in the service try to be empathic; they are certainly sympathetic, but they lack a great deal of background knowledge about gender incongruence and dysphoria.

“It is something that is not covered in any detail in medical training.”

The RCGP also gave evidence to the inquiry and agreed that GPs were “overall empathetic but that their knowledge of how to best support transgender patients could be improved”.

To help fill this gap, the college had launched an online training module on gender variance in July of last year.

The committee’s report makes more than 30 recommendations in a wide range of policy areas.

It calls on the government to take action to ensure full equality for trans people, emphasising the need to update existing legislation, provide better services, especially in the NHS, and improve confidence in the criminal justice system.

The government should agree a new strategy for transgender equality to be delivered with full cross-departmental support within the next six months, said MPs, to tackle the many issues that remained unaddressed.

Committee chair Maria Miller said: “Although Britain leads the world in recognising lesbian, gay and bisexual rights, we are still failing trans people in so many ways. Our report challenges attitudes towards trans people and calls for them to be treated equally and fairly.”

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