Some doctors have an “appalling level of ignorance about transgender people”, a trans support group has claimed.
A survey of the care of transgender patients conducted by Spirit Level found there was “confusion and lack of confidence” in how GPs should be caring for transgender patients in the region. NHS Cheshire and Merseyside bosses today said the survey's findings only represent “a small sample of responses”.
Out of the GP practices to respond, 70% had no one specifically trained in transgender care and 90% said they would not offer any care but would refer patients to gender identity clinics where waiting times for a first appointment can, in some occasions, be three or four years, it is claimed.
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Lily Hunt, chair of Spirit Level, said: “Many doctors couldn't be bothered to respond to the survey. Of those that did - with a few exceptions - most had no real knowledge of the kinds of care transgender people need."
The Liverpool-based support group claims the survey revealed that “doctors are not being trained in how to care for transgender patients and are undoubtedly putting lives at risk as a result”. Of the 85 listed GP practices in Liverpool, only 10 responded.
One GP practice, which answered the survey anonymously, said many of their clinicians “feel that our personal and religious beliefs are being ignored and discriminated (against) within current legislation”. The GP practice added: “Legislation should allow a clinician conscientious objection to prescribing hormones and referring for treatment without being made to feel they are discriminating a transgender person as this is not the case. Rather it refers to particular personal and religious beliefs that conflict deeply with getting actively involved in the transgender change process.”
A spokesperson for NHS Cheshire and Merseyside said NHS GPs follow national British Medical Association (BMA) guidance.
The spokesperson added: “GPs will always provide general medical care to all of their registered patients irrespective of gender reassignment or any other recognised protected characteristic. While these survey findings only represent a small sample of responses, we always welcome the opportunity to understand specific experiences of care in more detail and will continue to work with people across Cheshire and Merseyside to help improve care.”
Ms Hunt emphasised the importance of caring for trans patients, especially considering “high levels of depression, self-harm and suicide” within the community.
She added: “A more holistic, person-centred approach to treating trans patients such as offering fast-tracked therapy and Cognitive Behaviour Therapy to explore gender identity, referring patients to local support groups or a simple course of cheap and safe hormones for trans men or trans women could help alleviate distressing symptoms.”
Investment in such services locally to improve access would also "ease pressure on other clinical services provided by the NHS", according to Ms Hunt.
She said: “Lack of knowledge and training drive a reluctance to offer care, leaving trans people in limbo and at risk. Because of this, desperate trans people will often self-medicate, putting their health at risk. Some doctors also don't want to provide such care for political or religious reasons.
"A half-day training in trans care for all doctors and adherence to the guidance issued by the BMA to doctors would revolutionise primary care of trans people in Liverpool.”
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