Gender Reassignment Case Study

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Summary of report content

This project involved a longitudinal case study made up of ten interviews with an individual who was undergoing gender reassignment. At key points during the reassignment pathway between March 2017 and September 2020 the individual was asked about the highs and lows of their experience, their treatment by health care professionals and recommendations on how the service could be improved.

The report documents a number of positive experiences from the individual which include the encouraging and supportive approach from health and social care professionals, networks of support, a shared decision-making approach and the involvement of the individual in the transition process. The time restrictions associated with the process were identified as a key area where improvements could be made to reduce the anxiety experienced by those experiencing the gender reassignment process and use of future provisions. In addition, improved knowledge of the costs involved with transitioning should be a key consideration of health and social care provisions.

The report makes 4 recommendations.

  1. Primary care for individuals undergoing gender transition should be provided by one named person throughout the process. It is essential for such persons to be fully trained on trans issues and provides compassionate care.
  2. Primary and specialist care providers must ensure that individuals who are considering gender transition are given detailed medical advice. Further consideration should be given to explain practical advice and support on allied matters such as lifestyle changes due to uptake of hormones, impact on cost of living.
  3. Individuals undertaking gender transition should be provided detailed information in format other than just verbal consultation explaining in detail all the clinical steps and surgical processes that person will have to undergo so they can engage with shared decision making
  4. During the periods of waiting times between procedures and treatments it is essential that individuals received continuous and compassionate support from primary care, and specialist services keep them fully informed of timelines.

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General details

Report title 
Gender Reassignment Case Study
Local Healthwatch 
Healthwatch Nottingham City
Healthwatch Nottinghamshire
Date of publication 
Friday, 30 April, 2021
Date evidence capture began 
Wednesday, 1 March, 2017
Date evidence capture finished 
Wednesday, 30 September, 2020
Key themes 
Consent to care and treatment
Information providing
Integration of services
Lifestyle and wellbeing
Staff attitudes
Staff training
Waiting times and lists for treatment
Other information of note about this report 

Methodology and approach

Was the work undertaken at the request of another organisation? 
What type of organisation requested the work 
Primary research method used 
Structured interview
Unstructured Interview
User stories
If an Enter and View methodology was applied, was the visit announced or unannounced? 

Details of health and care services included in the report

Primary care services 
GP practice
Secondary care services 
General surgery
Community services 

Details of people who shared their views

Number of people who shared their views 
Does the information include public's views? 
Not applicable
Does the information include carer's, friend's or relative's views? 
Not applicable
Does the information include staff's views? 
Not applicable
What was the main sentiment of the people who shared their views? 

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.