Engaging Trans People in Their Healthcare

Engaging Trans People in Their Healthcare

The Equality Act 2010 introduced a Public Sector Equality Duties (PSED) for nine protected characteristics, of which gender reassignment is one. This duty, under section 149 of the act, means that public sector bodies, i.e. the NHS and Local Government can be held legally accountable if they do not apply the law or give ‘due regard’ to individuals who fall under the nine protected groups in the planning and delivery of services.  In health provision, the NHS have statutory duties they must adhere to when they procure/commission new services or make changes to existing services.  Of equal importance is how the NHS communicates with patients, carers and communities, how they communicate, listen to, treat and engage with their staff and how they hold their providers to account to ensure service are inclusive, personal, fair and equitable to meet the needs of these nine protected groups.

The term transgender people/trans people are ‘umbrella’ terms used to describe a diverse group of individuals who find that their gender identity is different to that assigned to them at birth. Trans people, groups and communities have been and continue to be marginalised and experience many disadvantages pertaining to equality of access to healthcare services.  Particularly in relation to participating in shaping services, unlike their lesbian, gay and bisexual (LGB) counterparts. It is understandable that this continued marginalisation makes these groups even harder to reach. In addition, they experience the some of the greatest health inequalities in comparison to other identified groups. The causes of these health inequalities are diverse and complex, and include lifestyle factors (smoking, nutrition, exercise etc) and also wider determinants such as poverty, housing, education etc. Their health inequalities may be affected by their access to healthcare and there are particular concerns about continued ‘institutional ageism’ in society and health. Furthermore, LBT women have a higher prevalence of conditions and barriers experienced by LGBT people in general. This is highlighted by the statistics; 18% of lesbian and bisexual women have never had a cervical screening compared with 7% of women in general.

We wish to engage with trans people in order to:

  • Ensure that local services can be shaped and improved for these individuals
  • Create a greater visibility and awareness of services used by trans people
  • Raise awareness of trans issues through a relationship of constructive communication and trust
  • Support trans groups
  • Increase confidence and improve communication between public bodies and trans people and groups

The first steps of communicating and engaging with trans people is educating professionals who will be participating in the process. This ensures that those carrying out the engagement have a good understanding of the relevant legislation and concerns. In addition, education includes informing individuals of the correct open, inclusive and gender-neutral language to use. Your communication should create a space that is safe, open, positive, transparent and non-judgemental, whether that be spoken or written. When drafting written communications such as posters or other resources, ensure that this language is used alongside inclusive imagery. This targeted information is particularly important to those who are hardest to reach or further marginalised – e.g. women of colour, women of faith, disabled women, migrant women etc.

For any communication and engagement with trans people it is important to work with people and organisations with trans expertise who can input into the process. We will work alongside you to suggest the most inclusive ways of organising any form of engagement or consultation and give advice on the use of appropriate language around gender identity and how to encourage trans people to get involved.

Through this engagement we aim for:

  • Better health outcomes for all and fewer health inequalities
  • Improved patient access and experience
  • Empowered, engaged and included patients and staff
  • Inclusive leadership at all levels

There are a number of methods of engagement that can be followed. The use of an anonymous survey, allows those who do not feel comfortable publicly disclosing their gender identity to be involved. Consultation events allow you to gain a deeper and more detailed insight from trans people. However, in these cases we would recommend providing a safe and accessible changing space, enabling trans people to attend and express their gender identity in the way that they feel most comfortable. Another method of engagement is through trans groups, conversely, many are small and may not have a diverse membership, so we would recommend engaging with an assorted range of national and local groups and individuals.

Ideally using a combination of methods will give you a combination of evidence from individual views to a representation of the trans group as a community. In order to obtain a full and inclusive evidence base you need to ensure that you obtain the views of a variety of trans people, as their needs and priorities may often depend on a number of different factors.

If you want further information or need advice on engaging transgender people, please contact us for a chat.


At H2A we provide a solution focussed approach to transformational change delivered with integrity, transparency and reliability.  We offer a valued service in patient and public engagement, citizen empowerment, campaign development and management, all aspects of communications and disruptive organisational development.

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