Accessing gender-affirming healthcare as a trans person is difficult as it is. However, having to access the same healthcare as a trans and disabled person comes with additional obstacles.

A recent survey published in the PubMed Central found that disabled trans people are almost ‘three times more likely’ to report at least one unmet healthcare need compared to disabled cis people. The research also highlighted how people with disabilities deal with additional unmet medical needs in comparison to people without any disabilities, highlighting that disabled trans people are even less likely to receive the healthcare they need due to their gender identity and disability.

Regarding access to a doctor, the survey data suggested that trans people with disabilities were significantly less able to see a healthcare professional as needed compared to cisgender disabled patients. This was also the case for transgender disabled people accessing medication, as they were ‘three times more likely to report an inability’ to get the correct prescription for the medication they required. While there have been improvements in addressing the unmet medical needs of cisgender disabled people, there has not been the same effort to improve access to healthcare for all disabled people who hold multiple marginalised identities.

We interviewed Gianni, a member of the team at GenderGP, to talk about his own experience as a trans man and a wheelchair user. He is currently finishing his PhD researching how trans clinicians and patients navigate healthcare as both disabled and trans people. Through his research, he is also exploring how trans and neurodivergent people access gender-affirming healthcare and the difficulties that come with it. Gianni explained ‘the work that GenderGP does is incredibly important for so many trans patients’, while acknowledging that there is not the same access for all trans people, whether that is due to race, gender or disability.

Part of GenderGP’s job is to ensure that patients can see themselves represented in GenderGP’s staff members, particularly those involved in face-to-face practice, including ensuring the representation of neurodivergent people within the team. Gianni recently hired someone who can use sign language, more specifically British Sign Language (BSL), as a vast majority of our patients are based in the UK. Gianni explains “I was personally affected by the lack of accessibility for disabled trans people, and I wanted to make sure that we as a progressive company were accessible for people who are hearing impaired”. There have been several Information gathering Sessions (IGS) in BSL at GenderGP so far, with many more to come.

The inclusion of team members with intersectional identities or who are able to use sign language can help many deaf and hard of hearing trans people when accessing gender-affirming healthcare through GenderGP’s services. Gianni confirmed that it is a “completely different hurdle” when you are trans and disabled, and intersectional work is the only way to ensure that all trans users’ needs are met. This is especially important given the general lack of access to healthcare for disabled people.

For instance, the Office for National Statistics (ONS) found that in the UK disabled people were affected significantly more by the COVID-19 pandemic compared to non-disabled people. The pandemic affected not only their mental but also their physical health. The ONS report also revealed that 40% of people with disabilities found it more difficult to access healthcare for issues not relating to covid. Research has demonstrated that within the past couple of years, since the start of the pandemic, disabled people’s overall well-being has seriously declined, thus, highlighting the importance of GenderGP’s dedication to the trans and disabled community.

Regarding his own personal experience, Gianni expressed how he is “proud to be a trans disabled man”. Gianni also explored the differences between his experience as a ‘passing’ trans man and other transgender people, and that he has been less likely to encounter certain obstacles that trans individuals who do not adhere to cis people’s prejudices of what a man or a woman should look like have to face. However, once he had his accident and had to access healthcare for medical reasons separate from his gender identity, new obstacles started to arise. He had to navigate healthcare again as a trans man.

‘When you have to navigate healthcare again, you have to keep coming out again and again.’

“Reentering healthcare settings was like opening an old wound”, Gianni said. One aspect that was particularly difficult to navigate, he realised, was how incapable many healthcare professionals are at dealing with a person who is both trans and disabled. When he had to have spinal surgery, a painful period was made all the worse when his doctors were confused about whether to put him in the male or female ward. Ultimately the doctors decided to put him in the male ward, but the simple fact that those providing his care were so unaware of such an elementary matter made for a difficult and distressing situation. This experience further fuelled him in his work in making “disabled trans people really visible”.

It is clear that disabled trans people face additional obstacles due to their intersecting identities. Through Gianni’s experience, it has also become evident that we have to remember how much of an afterthought the disabled trans population is within wider healthcare and how much harder it is for them to access gender-affirming treatment compared to able-bodied trans patients. GenderGP is driven and ready to make gender-affirming healthcare more accessible for disabled trans people everywhere.