We are encouraging trans people to engage in NHS England’s survey. We do so with caveats, our reasoning is explained on this page.
On 13th December 2024 NHS England published a survey for people that have used NHS gender clinics in the past 5 years, current and former NHS gender clinic staff and (bizarrely) the family and friends that have used NHS gender clinics in the past 5 years. TransActual, and other trans and/or LGBTQ+ organisations, were asked to feed back on a draft of the survey.
The short answer is:
- Much of the feedback we gave NHS England’s review team about the survey was acted on.
- We expressed concerns about language around ‘fully transitioned’ and ‘partly transitioned’ and the framing as ‘detransitioned’ as being rather unnuanced. They listened to this feedback and changed the wording.
- Questions about regret and detransition are included in the survey. We know that rates detransition and transition-related regret are hugely exaggerated by those campaigning to restrict trans people’s access to care. This makes these questions uncomfortable to read. A tiny minority of people do detransition or regret some parts of their transition – the survey questions about regret and detransition have the potential to provide more evidence that detransition and regret are incredibly rare.
- There is a survey for friends and family members of people that are being cared for by an NHS gender clinic, or who have been cared for by an NHS gender clinic in the past. We questioned the purpose of that survey and were not given an answer. We highlighted that many trans people are estranged from their families and/or lose friends when they transition – and this is often because the family member(s) or ‘friends’ don’t approve of the person transitioning.
With that in mind, we told NHS England that, if they insist on surveying friends and family members, that they ask those respondents whether or not their friend or family member would agree with the response that they had given. Essentially, asking if the person is responding with views that differ significantly from the views of their friend or family member.
We are incredibly disappointed that NHS England did not make any amendments to the friends and family members survey. It will now not be possible for the team analysing the survey to identify whether or not the person completing the survey is acting against the wishes of their friend of family member.
We are glad that the team responsible for the survey responded to the majority of our feedback. However, we remain of the opinion that questions around detransition and regret – which have already been demonstrated to be rare – have clearly been included to placate those who are campaigning to make it harder for trans people of all ages to medically transition.
At TransActual we value all members of the trans community and recognize that some people will need support from a friend or family member to complete the survey. However, the friend or family member can support them to fill out the survey – there is no need for a survey specifically for friends and family. Many trans people become estranged from family members and from ‘friends’ – often because the family members or ‘friends’ disapprove of the person’s transition. With that in mind, some family members or former friends may have a very different view on the care provided by NHS gender clinics. The responses of people that have been disowned because of their lack of support for a family member or ‘friend’ should not be used to inform the review of transition related care. Asking family members about the care of adults infantilises trans people, implying that our views alone are not sufficient to inform a review of the care we receive. We are adults and our views on the services that we access, along with the views of clinicians working in the services, should be the ones that matter.
TransActual, our colleagues in other trans and/or LGBTQ+ organisations, and trans people have completed consultation after consultation, survey after survey, and have time and again had our views ignored. Many of those consultations were box ticking exercises and have not resulted in improvements to our healthcare, safety or dignity. The stakeholder consultation into the puberty blocker ban is a prime example of this. The majority of people responding to the consultation said that a permanent ban on puberty blockers would be a bad idea and would carry unacceptable risks. The Government decided to indefinitely ban them anyway.
So with that in mind, it would be tempting to not engage with this new NHS England survey. It would be tempting for TransActual to discourage people from filling it in. But we are going to engage and we do want you to respond to the survey and to encourage your friends and family members to respond too.
Think about it this way. If we and you, and our friends and family don’t respond to the survey, the only people completing it will be those campaigning to take our care away. If the data only shows the views of the tiny minority of people that regret transitioning, or of friends and family members who would have stopped the trans person in their lives from transitioning if they could, then the report into the survey will definitely be used to restrict our access to care.
If, however, we do take part in the survey, our views will be collected. This data, the data that represents the experiences of most trans people, will have to be included somewhere in the survey report. So, even if the report is flawed or its findings ignored, we will at least be able to highlight that. And if we are actually listened to, there is a chance that our experiences could influence improvements to NHS transition-related care. That’s a big ‘if’ and a big ‘could’, but we know that if we don’t take part in the survey, our views will definitely not be heard and our experiences will definitely not impact care.
For TransActual, the risks associated with not taking part in the survey are far higher than trans people spending 20 minutes of their time to complete the survey.
We’d like to make it very clear: when the survey report comes out we will be scrutinising it, just as we did The Cass Report. If there is any evidence that trans people’s responses have been misrepresented or downplayed, we will be challenging it. If we think that any data has been omitted or there has been any misconduct, we will submit FOIs, get to the truth. If the evidence is ignored, we will be asking why and will look at all possible avenues to hold NHS England to account.
Complete the survey honestly. If you’re able to, talk to your friends and family about the survey and ask them to complete it, based on a conversation you’ve had with them about your experiences.
The closing date for the survey is Sunday 19th January 2025.
Complete it at: https://nhs.welcomesyourfeedback.net/s/93arah
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