Focus on transgender equality highlights poor experience of trans people in daily lives
The Chair of the NHS England Gender Identity Task and Finish Group reflects on a new top-level report on transgender issues:
Welcome to my latest blog on gender identity services.
I want to say something about the report of the Women and Equalities Select Committee on Transgender Equality, and to update on discussions with the adult Gender Identity Clinics about capacity and waiting times. I also want to talk about the work we are doing with Health Education England on developing the workforce of the future.
The Government will be making a formal response to the Women and Equalities Select Committee, including the recommendations in relation to health. Ahead of that, I thought it would be helpful to share some personal reflections, in my role as Chair of the NHS England Gender Identity Task and Finish Group.
Firstly, I very much welcome the initiative by the Women and Equalities Select Committee to focus on transgender equality for their first inquiry. This has brought a great deal of Parliamentary and media attention to the challenges which the trans community face in their daily lives, including huge difficulties in getting prompt access to supportive specialist and general health services.
The report lays bare the poor experience of many people, and rightly highlights the unacceptable delays in getting NHS treatment.
As part of my oral evidence to the inquiry, I acknowledged that the current waiting times are far too long, and confirmed that we are working with the gender identity clinics (GICs) and the surgical providers to build capacity and to reduce these waits.
At the end of last year, NHS England asked the seven GICs to submit proposals for increasing their capacity and new ways of working, to reduce the length of time that people wait to be seen. We also asked the GICs to make proposals about the support they could provide to people before they have their first appointment with the clinic.
All seven GICS have sent in their plans, which we are reviewing ahead of a meeting at the end of this month with all of the providers. Following this, NHS England will agree with each of the GICs the level of additional investment from the start of the new financial year on 1 April 2016.
Alongside the discussions with the adult services, we are also looking at the additional capacity required for the children and young people’s service run by the Tavistock and Portman NHS Foundation Trust. And 2016/17 will be year two of a planned increase in funding for the providers of genital surgery.
All of the clinics have reported that one of the difficulties they face is workforce – the lack of suitably trained staff to take on the specialist roles which are being created in nursing, medicine, psychology and other professions. This issue has also been picked up in the Committee’s report.
NHS England is now working with Health Education England to look at the curriculum and training for post-graduate doctors, and awareness training that could be made available to staff across the NHS. These discussions are at an early stage, but I am hopeful that this will make a big difference to ensuring that we have the workforce we need for the future to deliver the improved services we all want to see.
Finally, we will be holding the next of our symposiums on gender issues at the start of March. At this meeting, I envisage that NHS England and Health Education England will jointly describe the work that is needed to develop a credible workforce and training strategy, with a specific focus on the help that we need from other public sector organisations and professional bodies.
I hope this blog is helpful. As always, I welcome your comments and feedback.
Will Huxter
Will Huxter is Regional Director of Specialised Commissioning (London) at NHS England and currently chair of the NHS England Gender Task & Finish Group.
Prior to joining NHS England in June 2014, Will worked in a range of commissioning roles within the NHS, and for five years at an NHS Trust.
He has also spent eight years working in the voluntary sector.
5 comments
How about a radical suggestion?
I carried out a survey a while back and approx half of all M2F patients would opt for FFS over GCS as they feel that it would greatly lessen the dypshoria to the point that they could live with it. It would also help people in being able to work as they would feel more confident in themselves.
Doing this would reduce the immediate strain on surgeons specialising in GCS and also the resultant bottleneck which is occurring in the process at this time. There are surgeons specialising in FFS who have spare capacity.
Just a thought for you to consider. Radical – yes; would it work – yes (according to the data I have collected).
Your last blog did not show any comments.
i would like to ask, again, what support is being offered to GPs to help them in prescribing specialist drugs.
Currently there is a vague recommendation from the GIC, with no resource from the CCG, that GPs prescribe and monitor drugs of which they have no real experience.
This becomes a nightmare when our patients have finished their transition and wish to remain on specialist medication but do not wish to remain under the GIC.
The various documents produced by NHSE are a complete abrogation of responsibility and not fit for purpose.
Once again I call upon the transgender community to insist that prescribing and monitoring is taken up by NHSE as a vital issue and not dropped into the ‘too hard to sort out’ long grass
In the meantime we wait, over 15 months for me so far and not a jot of support. If cancer patients had to wait as long there would be a national outcry. As always there may or may not be a possible solution sometime in the never never. How about an urgent circular to all GPs telling them where they can get support and telling them that they must prescribe hormones and monitor patients, and refer to secondary treatment such as hair removal via laser or electrolysis and speech therapy, My last GP point blank refused any support whatsoever and never bothered to reply to a letter I sent him. Having worked all my life, and served my country as a soldier I feel completely let down by the NHS.
I am a retired Gp , I am a a transwoman and have worked as a clinical teacher at Southampton for 26 years as well as being a principal in general practice for 29 years. I am a diversity role model and attend educational workshops in secondary schools.
In view of your comments about postgraduate training I would be very willing to help if such a role appears !, do you have any suggestions?
as someone who is currently using the Nottingham gender clinic service ,i would like to say that one of the biggest ways you might shorten waiting times is for the clinic to stop insisting that you have to wait 18 months minimum in the REAL LIFE EXPERIENCE before recommending srs surgery for those who know what they want , how can waiting an additional 18 months from diagnosis help you caop with surgery ?. if i had a cancer of some sort i would not be told that i have to wait 18 months before i can have any surgery so i can prepare for it this just makes no sense to me, especially since they said after my 4th appointment that they know and i know what i want. i also think that it is wrong for them to make you stop self medicating for 6 months after diagnosis before putting you on cross sex hormones, going back through male puberty at my age was absolutely awful,and then i had to rego female puberty again when they started me on hormones, this is very hard on anyone going through it once and especially when you are older. now it seems to me you have way to many people on hold in the system who are not receiving any support but are just having to wait , just to keep there 18 month time frame which my specialist there told me its 18 months because its always been 18 months , no real reason other that that.it also seems if you are going to have to wait the additional 18 months for surgery they could at least use the time constructively and provide donor site hair removal in that time, as the first time you see the surgeon you will then get put on hold again while you get this done, come on NHS its not rocket science to cut waiting time stop putting people on hold for no reason other that historical waiting times.