Trans Health, Care and Wellbeing

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Summary of report content

Between April and December 2017 225 Trans and Non-Binary people from Bath and North East Somerset, Bristol, North Somerset, South Gloucestershire, Swindon, Wiltshire and other areas in the South West took part in an online survey, interviews and focus groups. Participants were recruited, through a range of methods, including social, community and support groups; online and through social media.

Trans people face a significant amount of hostility in society, and the health care system is a contributing factor. Trans people have very poor mental health compared to the rest of the population. Over seven in ten people were receiving medical help for anxiety or depression, 57% had self-harmed, 70% had suicidal thoughts and feelings and 41% had planned suicide. Two in five had received addiction support.

Over half had been referred to a Gender Identity Clinic.  Some had gone to private services, largely because NHS waiting times were too long.  Over half had to wait up to a year to be seen by a Gender Identity Clinic, and a quarter between a year and three years. Over three in ten were still waiting for their first appointment at the time of responding to the survey. Not all trans and non-binary patients want/need the same type of medical treatment including: hormone therapy, gender surgery, breast reduction or augmentation. Most people reported that that their medical transition had taken/would take up to 4 years.

One in five people said they felt unsafe as a trans or non-binary person in their local area.  Three in five said they had felt discriminated against because of their gender identity.  Most had been called names in the street. 

One in three had felt discriminated against when accessing health care services, including by their GP. Trans people often have to rely on word of mouth to find sympathetic health care professionals. Those Trans people who live in small, isolated and rural communities often have few choices available.

The report contains 19 recommendations about training, anti-discrimination policies in healthcare, specialist support, access to treatment, further research and challenging transphobia.

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General details

Report title 
Trans Health, Care and Wellbeing
Local Healthwatch 
Healthwatch Bath and North East Somerset
Healthwatch Bristol
Healthwatch North Somerset
Healthwatch South Gloucestershire
Healthwatch Swindon
Healthwatch Wiltshire
Date of publication 
Tuesday, 27 April, 2021
Date evidence capture began 
Saturday, 1 April, 2017
Date evidence capture finished 
Sunday, 31 December, 2017
Key themes 
Communication between staff and patients
Cost of services
Health inequalities
Holistic support
Lifestyle and wellbeing
Patient records
Service delivery organisation and staffing
Staff attitudes
Staff training
Waiting times and lists for treatment

Methodology and approach

Was the work undertaken at the request of another organisation? 
Primary research method used 
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
Mental health services 
Community mental health team (CMHT)
Psychiatry / mental health (other services)
Community services 
Community based services for people who misuse substances

Details of people who shared their views

Number of people who shared their views 
Age group 
Non binary
Sexual orientation 
Not known
Other population characteristics 
People who misuse drugs
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Does the information include staff's views? 
What was the main sentiment of the people who shared their views? 

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Does the information contain a response from a provider? 
Is there evidence of impact in the report? 
Is there evidence of impact external to the report? 
Not known

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.