RCN survey of nurses points to inadequate training, with only a fifth saying workforce has relevant training and experience

UK nurses are failing to meet the needs of transgender patients and feel they lack training and experience to treat the growing number of trans people seeking medical treatment in relation to their gender identity, according to research.

A survey of more than 1,200 nursing staff across the UK found 87% of those nurses who have directly cared for a trans patient felt unprepared to meet the patient’s needs.



The survey, which was conducted by the Royal College of Nursing, also found that 76% have encountered trans people during their healthcare work and 56% had cared for trans people directly.

Just one-fifth of all nurses surveyed said they thought the nursing workforce had the skills to care for trans adults and children, while 76% said more training for all healthcare staff was needed.

The survey comes after the Guardian revealed there has been a steep increase in the number of trans people referred to all 14 gender identity clinics around the country, with a number of clinics experiencing increases of several hundred per cent.

The Guardian found that healthcare options for trans people at specialist gender identity clinics were inadequate, with an average waiting time of nine months for a first appointment for adults and some patients waiting up to four years for a first appointment.

Trans people also reported they often encounter medical staff who did not know how to engage with them, such as GPs having laughed at them when they said they wanted to transition, having their feelings dismissed as “just going through a phase”and being repeatedly misgendered - referred to by their birth sex, not the sex they identify with.



Kirsty Cass, a trans woman who has worked as a nurse for the last two years, says she has encountered prejudice and misunderstanding from healthcare professionals, most of which involved her being misgendered.

In one instance, several years after she had undergone gender reassignment surgery, she went to her local hospital for a biopsy on a lump on her ear. After the procedure, the porters wheeled her to a male ward and tried to make her stay there.

“To say I was upset was an understatement,” said Cass. “I was inconsolable, I was sobbing my heart out.”

Much of the problem, she added, had to do with a lack of training of medical staff, some thing was that was also identified as a point of concern by nurses in the RCN survey. Just 1% of respondents said their pre-registration training dealt with the treatment of trans patients and 78% said they had no training on the subject.

Louie Stafford, the trans programme coordinator for the LGBT Foundation, said he was unsurprised by the survey results.

“Gender identity issues are considered a speciality field, so unless you’re practising in that field, it’s unlikely you’ll have any training or any guidance. It’s great that the RCN are trying to shine a light on this from the medical perspective, there’s an urgency for academic medical institutions to consider the curriculum and the content that they’re teaching and put some awareness training in there.”

Wendy Irwin, RCN diversity and equalities coordinator, said the college was pushing for training regarding the treatment of trans people to become a mandatory part of pre-registration nursing training as well as part of continuing professional development.

“I think nurses are increasingly aware of the gap in their knowledge,” she said. “All nurses have a deep and personal desire to deliver the absolutely best care for all their patients, what they’re looking for is how to do that.”