3. Fair care for trans people (resolution)

Cumbria Branch

That this meeting of RCN Congress asks Council to lobby for consistent and equitable care for trans patients.

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Progress reports

Council Committee: Diversity
Council decsion: New work
Council member/other member/stakeholder involvement: Tracey Budding, Anne Wells
Staff contact: steve.jamieson@rcn.org.uk

The new Diversity Committee met for the first time on 1 October 2010 and this piece of work is one of its first priorities. It was agreed that a communications strategy was needed to support joint working with a wide-range of stakeholders working in this area, to use case studies to raise awareness of the difference consistent and equitable care can make, and to ensure that current legislation is complied with.

A task and finish group is in the process of being set up, and the deadline for applications to join the group is 9 May 2011. The task and finish group will:

Find out about joining a task and finish group.

The Government's White Paper on the NHS is likely to have a significant impact on the consistent and equitable care of trans patients, and this will be monitored as the situation progresses.

Debate report

Rachael Ridley from the Cumbria Branch, proposer of this resolution, began the debate by highlighting that trans people continue to experience discrimination in health care and that although social attitudes have moved on, progress remains slow. She stated that the trans community is marginalised and faces inadequate service provision.

Densie Elgie, Tees Valley Branch stated that as nurses “we are champions of health care and we cannot afford to overlook patients’ needs”. She went on to say that “all patients have a right to dignity, sensitivity and respect”.

David Jones from the Greater Bristol Branch referred to the stigma that trans people remain subjected to and asked Congress “unless we act professionally, how can we be trusted to give honest, good care?”

David Baker from the Bradford and Airedale Branch was saddened that this resolution was necessary and urged Congress to “show we support dignity, vote for this resolution”.

Sue McBean, RCN Older Peoples Forum said that after 37 years in nursing she knew little about the trans journey and said “how can we deliver the care needed if we have no experience or training on this issue?” She concluded by calling for the introduction of awareness raising education.

Vote

For:   355 (86.59%) 
Against: 55 (13.41%)
Abstain 58

Background

Existing legislation provides a degree of protection against discrimination for trans people in the areas of employment and access to goods, facilities and services (including health) and for their legal recognition as men and women in their acquired gender.

The Gender Equality Duty builds upon this requirement and means that NHS organisations should factor in the needs of trans people in the development of gender equality schemes, and be proactive in promoting their equality. Such activities are likely to take the form of promoting equality in employment, the development of public health policy, as well as commissioning and generic health care provision.

However, research carried out by the Department of Health suggests that a large number of trans people are refused NHS treatment. According to the results of a survey carried out in 2007:

The survey also found that little improvement had been made in funding gender recognition treatments or in waiting times over the last 15 years.

In 2008 Press for Change and TransGender Europe published a joint study – Transgender Eurostudy: legal survey and focus on the transgender experience of health care (TransGender Europe and ILGA Europe, 2008c) - which revealed trans people experience differing levels of care and access to treatment throughout the European Union and recommended that EU states should provide gender reassignment treatment without excessive restrictions being imposed.

The picture across the UK is varied. For example, the Scottish Transgender Alliance published a review of the health care experiences of trans people; sexual health services were praised whilst mental health and out-of-hours care were amongst those that were cited as needing improvement. However, there is less information and research on the direct health care experiences of trans people across Northern Ireland and Wales.

The RCN has established links with organisations such as the Gender Trust and the Gender Identity Research and Education Society (GIRES). A member of the RCN LGBT network participated in the RCN Political Leadership Programme in 2008-9, undertaking an innovative piece of work which focused on nursing-led interventions within health care. This work was featured at the World Professional Association for Transgender Health conference in May 2009.

References and further reading
Department of Health (2007) Reducing health inequalities for lesbian, gay, bisexual and trans people:  briefings for health and social care staff, London: DH
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_078347

Department of Health (2008a) Trans: a practical guide for the NHS, London: DH.
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_089941

Department of Health (2008b) NHS funding processes and waiting times for adult service-users: trans wellbeing and healthcare, London: DH.
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_082956 

TransGender Europe and ILGA Europe (2008) Transgender Europe: legal survey and focus on the transgender experience of health care, Vienna?: Transgender Europe
www.tgeu.org/node/100