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Even conservative estimates suggest that around 0.5% of the population of the UK are trans or non-binary. That’s 325,000 people, and the actual number is likely to be much higher. In comparison, there are a little over 54,000 GPs working in the UK. We can see from these numbers that it’s highly likely that all healthcare professionals (HCPs) will have contact with transgender and non-binary people, even if they don’t realise it.

For healthcare professionals working with trans and non-binary people, it’s important to understand that a person’s anatomy does not always represent their gender. At all stages of diagnosis, investigation, and management, HCPs should understand that for some patients some or all of their primary and secondary sex characteristics are not always congruent with their gender identity.

What does this mean?
Gender transition can be roughly divided into social and medical categories, with medical in turn being broadly comprised of hormonal and surgical interventions. Not all transgender people want the same thing from transition, and the transition process can be very gradual. For instance, a trans woman might only want to socially transition (for instance, by using female pronouns) but may not want any hormonal or surgical treatments. Some trans people are unable to pursue medical transition for unrelated health reasons. Whatever kind of transition a person wants and however far along they are, it doesn’t make their gender more or less valid. A trans man is still a trans man, regardless of what medical interventions – if any – he undergoes.

This means that trans and non-binary patients may not present with an appearance or anatomy corresponding to their gender marker, or a mixture of congruent and incongruent features. For example, a person might present with an outwardly masculine appearance but require care relating to their uterus, ovaries, or vagina. Another person might have both breasts and a penis and testes, and require care relating to any of these.

 

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When a patient explains their transgender or gender-diverse identity, HCPs should acknowledge this and provide appropriate care that is respectful of the patient’s identity and healthcare needs.

This should include:

  • All HCP and admin staff using the correct pronouns, name, and title when addressing and referring to their patients. If in doubt, ask quietly and politely.
  • Helping patients ensure that their NHS details are in line with their correct name, title, and gender marker
  • Asking patients how they would like to refer to their anatomy, and what kind of care they need.

 

If you’re a healthcare professional and you want advice about working with trans and non-binary people, you can find lots of great information in our Medical Hub. If you want to share your story of accessing healthcare, you can leave a comment below or reach out to us on Facebook, Twitter, or Instagram.