Parliamentary report on transgender equality finds serious deficiencies in health treatment of trans people and gender identity services

This article is more than 4 years old

This article is more than 4 years old

Britain has a long way to go to ensure equality for transgender people, according to the first report on the issue produced by a UK parliamentary committee, which said the NHS is letting down the trans community.

The cross-party parliamentary inquiry on the issue was scathing about the health service, which it said was failing in its legal duty in providing equal access to services.

The report on transgender equality stated: “GPs too often lack understanding and in some cases this leads to appropriate care not being provided.” It called for a root-and-branch review of the health service’s treatment of transgender people by the summer.

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The report called on the government to produce a new strategy for full transgender equality within six months, warning that an existing plan issued in 2011 remains “largely unimplemented”.

The reported concluded there was overwhelming evidence of serious deficiencies in the quality and capacity of NHS gender identity services, particularly in waiting times for first appointments and surgery – with recent reports indicating waiting times of between two and three years for access to some of the adult clinics.

Witnesses who had provided evidence to the parliamentary committee on women and equalities reported how trans people face significant difficulties when accessing general NHS services.



Jess Bradley of Action for Trans Health, a campaign group seeking to improve trans people’s access to healthcare, said that in the NHS there was a lack of understanding and lack of cultural competency around trans issues.

Bradley said: “We do see a lot of trans people being denied treatment. You find a lot of trans people are passed from pillar to post.”

Specifically addressing GPs, Bradley said: “A lot of GPs deny healthcare to trans people illegally, based on the fact that they do not agree with the choices that they [trans patients] have made.”

James Barrett, president of the British Association of Gender Identity Specialists (BAGIS), a group of health professionals and scientists, said: “The casual, sometimes unthinking transphobia of primary care, accident and emergency services and inpatient surgical admissions continue[s] to be striking.”

NHS England acknowledged the criticism, and wrote to the committee about how historically transgender and non-binary people have reported poor experience of engagement, with the group becoming “hidden”.

The health service said it had now established a transgender and non-binary network with over 150 members, while workshops on the issue had been held.

After receiving 250 witness statements and five oral sessions, the report listed 30 recommendations for change to improve services for trans people, in a wide range of policy areas.

As many as 650,000 people in the UK are “gender incongruent to some degree”, and the report stated the transphobia experienced by some of these individuals had serious results. The report said it is believed that around one third of transgender adults and half of young people attempt suicide.

Maria Miller, the committee chairwoman, said: “Our report challenges attitudes towards trans people, calling for them to be treated equally and fairly. Media coverage of transgender issues has improved a great deal in recent years, but it still tends to focus on transgender celebrities.

“There is a stark contrast with the day-to-day experiences of many ordinary individual trans people, who still endure routine hostility and discrimination,.”

Among the recommendations, the report called for a reduction from 18 to 16 in the age limit for obtaining official recognition of a new gender without parents’ consent; mandatory training for police officers on transphobic hate crimes; and an end to the “outing” of transgender people in court cases.

There are calls in the report for an introduction of the option to record gender as “X” in a passport as well as moving towards non-gendering official records – with gender only noted where it is relevant.

The report also tackled the issue of language that is used, stating there should be the replacement of the terms “gender reassignment” and “transsexual” with “gender identity” in equality legislation.

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There were also calls for tougher action on “unacceptable” levels of bullying in universities and further education colleges, including gender identity awareness training for all staff, as well as making sports organisations aware that exclusion of transgender players on grounds of safety or fair competition is rarely justified.

The inquiry had heard evidence that numbers of children and teenagers coming out as transgender have increased fourfold over the past five years, and that as many as 1,000 young people have transitioned to a new gender with the support of their parents.



As a result, consideration should be given to quicker provision of puberty-blocking drugs – which delay the onset of adulthood to give young people more time to consider whether they want to press ahead with gender reassignment before they develop adult sexual characteristics – and cross-sex hormone treatments, said the report.

But the committee stopped short of backing calls for official recognition of changed gender for children aged under 16, warning the government should consider possible risks before taking this step.

Jackie Driver, lead director for lesbian, gay, bisexual and transgender (LGBT) issues at the Equality and Human Rights Commission, said: “We welcome today’s landmark report on transgender equality. Despite the marked progress that has been made towards achieving equality for trans people, prejudice and barriers still remain.”

The Gender Recognition Act 2004, which the report says is now outdated, for the first time allowed trans people – who identify with a different gender to the one assigned to them at birth – to be legally recognised in their new gender. The Equality Act 2010 made it illegal to discriminate against trans people.