NHS England’s health conference and LGBTQ+ experiences of health and care
Healthwatch England (HWE) attended NHS England’s (NHSE) LGBT Health Conference to hear updates from the Health and Social Care Secretary, NHS England, and other speakers.
Recent Healthwatch research was referenced by Wes Streeting and the NHSE as evidence of poor care for LGBT+ people that the NHS needs to improve.
HWE shared a summary of the key announcements and updates:
- More than 40,000 people are on a waiting list for a gender dysphoria clinic, with an average wait of five years, delegates were told. Wes Streeting said the NHS had "to do more to help people suffering long waits" and he relayed the story of meeting a transwomen at a Pride event in his Redbridge constituency who told him she had flown to Turkey for the treatment she hadn’t be able to get on the NHS. The health secretary announced £125,00 for a pilot scheme in the South West of England that would offer people information and support such as digital mental health care, while they wait.
- Wes Streeting has not yet received findings of the independent review of adult gender clinics led by Dr David Levy.
- The health secretary said Healthwatch findings that only 53% of trans and nonbinary people rated their GP surgery as good, compared to 74% of the general population, was evidence of inequalities that the NHS needed to be overcome. He also cited disparities from research by other bodies on hate crime, sexual violence and mental health.
- Wes Streeting said his decision to ban prescribing of puberty blockers to children "did not sit easily" with him, especially after meeting young trans people and their parents. But he stood by his decision to follow the clinical evidence. He also defended the delayed start to a clinical trial into puberty blockers in children, while the ethical governance of the research was finalised.
- Alluding to debates on single-sex toilets and services, Wes Streeting said he didn’t want trans people walking into health services feeling fear and that he believed "we can find a way through" to deliver trans-inclusive facilities as well as uphold sex-based rights to privacy and dignity. The Equality and Human Rights Commission has sent a draft statutory code of practice to the equalities minister, but it has not yet been approved.
- More than 400 individual pieces of evidence have been submitted to the NHSE review of LGBT+ health care, led by Dr Michael Brady. Emerging themes including barriers to access, discrimination, mental health disparities, training needs, inclusive practices, and intersectionality. Engagement events will be held over the next two months, including with LGBT+ and VCSE organisations. IT will be sent to government by the end of December.
- More than 800 trans men and non-binary people with a cervix have opted into cervical screening since April, NHSE said. From that date, the IT system changed to allow people with male gender markers on their GP record to be added onto the national screening database to receive automatic invitations. NHSE referred to our recent research showing that record changes and IT problems can cause eligible people to miss out on screening. NHSE is urging GP practices and sexual health clinics to proactively seek out people who they think will want to opt in. Health professionals have to complete an opt-in form after ideally having a face to face discussion with the person. The opt in form cautions patients that if they have changed their NHS number as a part of a gender marker change, then any previous screening test results will not have been transferred to their new record, and the onus will be on them to tell the screener if they’ve ever had concerning results previously.
Trans and non-binary peoples' experiences of GPs in Gloucestershire
Read our report: Trans and non-binary peoples' experience of accessing GPs in Gloucestershire
What did we find?
- Delays for gender specialist appointments meant more than a third of respondents had been waiting for over three years for an initial consultation.
- A key reason for not changing gender marker was named as the perceived difficulty of the process.
- 86.7% of respondents have had their name change accepted and utilised by GPS and other surgery staff. However, there was less successful uptake in the use of appropriate pronouns.
- There is a lack of awareness training for GPs and surgery staff.
- Communication issues, such as misgendering, leads to trans and non-binary individuals not feeling listened to by their GPs.
- People felt that the management of multiple health issues by GPs was impacted by the perceived complexity of Trans care.
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With regard to respondents’ confidence in using a GP surgery for general healthcare needs as a trans and/or non-binary person, 63.3% of respondents stated they were not confident.
Photo credit: The Gender Spectrum Collection