Abstract
BackgroundTrans and gender-diverse people face multiple barriers within health care. Primary care practitioners are key to providing health care to trans and gender-diverse people but they often lack training in, and understanding of, trans identities and healthcare options. Few studies have examined health professionals’ understanding of the barriers that exist in health care for trans and gender-diverse people.AimTo map out barriers to providing good-quality health care to trans and gender-diverse people, and explore ways to address them.Design and settingA qualitative interview study involving 20 health professionals working with young trans and gender-diverse people.MethodParticipants were recruited through purposive and snowball sampling. Data were generated using semi-structured qualitative interviews. A thematic analysis involved coding and categorising data using NVivo (version 12) software and further conceptual analysis in which developing themes were identified.ResultsFour barrier domains to good-quality care for trans and gender-diverse people were identified: structural (related to lack of guidelines, long waiting times, and shortage of specialist centres); educational (based on lack of training on trans health); cultural and social (reflecting negative attitudes towards trans people); and technical (related to information systems and technology).ConclusionThere is an urgent need to address the barriers trans and gender-diverse people face in health care. Structural-level solutions include health policy, professional education, and standards; at the practice level, GPs can act as potential drivers of change in addressing the cultural and technical barriers to better meet the needs of their trans and gender-diverse patients.
Highlights
Trans and gender-diverse people in the UK have varied and distinct health and care needs.[1,2] Trans is used here as an abbreviation of transgender to denote a person who feels their sex/gender assigned at birth does not match their sense of self
There is an urgent need to address the barriers trans and gender-diverse people face in health care
Structural-level solutions include health policy, professional education, and standards; at the practice level, GPs can act as potential drivers of change in addressing the cultural and technical barriers to better meet the needs of their trans and gender-diverse patients
Summary
Trans and gender-diverse people in the UK have varied and distinct health and care needs.[1,2] Trans is used here as an abbreviation of transgender to denote a person who feels their sex/gender assigned at birth does not match their sense of self. There are several avenues through which trans people gain access to specialist health care; the current established entry point remains through primary care and being referred to specialist services by a GP.[2] In the UK, the NHS provides specialist trans health care for adults and children. In England, adult specialist care is provided by one of seven gender identity clinics. For those aged
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