Trans Inclusive Hospital Care

This resource was created thanks to funding by The TRANSforming Futures Partnership in partnership with The National Lottery Community Fund.

Important note

The information in this resource was published in 2024 and reflected our understanding at that time of NHS guidance.

NHS England have recently released new guidance on Privacy, dignity and safety in hospital accommodation. Together with Trans+ Solidarity Alliance, we have released a joint statement about the new guidance. The information in this resource will be updated soon to reflect this new NHS England guidance.

This resource is designed to help healthcare professionals and providers follow good practice in relation to providing trans-inclusive care within a hospital setting.

Use this resource in the way that works best for you. Whether you read it all in one go or dip in out is entirely up to you – there’s a menu lower down the page to choose different sections.

If you find that we’ve used a word or phrase unfamiliar to you, take a look in the Glossary and/or the Medical transition: an overview for healthcare professionals section of this resource.

Trans Inclusive Hospital Care was reviewed by a number of healthcare professionals prior to publication. It is designed to support healthcare professionals and providers, but it is not a substitute for or replacement of clinical expertise.

Trans people in the UK face multiple barriers to accessing NHS healthcare, which can lead to poorer health outcomes.

TransActual’s Trans Lives Survey 2021 found that 70% of trans people had experienced transphobic discrimination when accessing non-transition related healthcare. 83% of non-binary respondents to the Trans Lives Survey 2021 had been discriminated against on this basis when accessing healthcare. Disabled trans people, Black trans people and trans People of Colour were more likely to have experienced transphobic discrimination than the wider trans population.

Trans people regularly report that doctors blame unrelated symptoms on matters relating to them being trans or to their medical transition. This is so common that the term ‘trans broken arm syndrome’ is used to describe it.

When healthcare staff lack confidence in working in a trans inclusive way, this can impact trans people’s experiences at appointments and during hospital stays. TransActual’s Trans Inclusive Healthcare? Trans people’s experiences accessing healthcare in the UK report (2024) found many examples of this. One person told us:

“A lot of time when I go into NHS appointments they can see that I’m trans. There’s a lot of hesitation and sort of attitude of like, well this person is trans, we have to treat them differently because we don’t want to upset them. You see that reflected in doctors not wanting to have to deal with you because they think it can get complex.”

These sorts of experience can lead to trans people avoiding seeking healthcare or putting it off until their condition deteriorates. This acts to perpetuate healthcare inequalities for trans people.

Everybody should be able to access hospital care that’s appropriate to their needs and trans people are no exception. We know that many of the issues faced by trans people when accessing healthcare are because staff lack the training, resources and confidence to work in a trans inclusive way. There’s a perception that it’s complicated to care for trans patients. In reality, trans inclusive hospital care is really not as complex or challenging as many perceive it to be. At its heart is simply good patient-centred care.

“The perfect experience would be to just exist in the world as a human being who just happens to be trans accessing health services.”

from Trans Inclusive Healthcare? Trans people’s experiences accessing healthcare in the UK (2024)

Contents

  1. What does the law say about trans inclusive hospital care?
  2. Expect inclusive practice: policies and processes
  3. It starts at home: communication makes a difference
  4. Little things make a big difference: the hospital environment
  5. Unique, like everyone else: patient-centred care
  6. Ask, don’t assume: things to avoid
  7. Get it right: names, pronouns and record keeping
  8. Keep it relevant: asking trans people about their bodies
  9. Maintain confidentiality: when to tell others a patient is trans
  10. Be aware of the impact of our previous experiences: trans people, mental health, and wellbeing
  11. Keep your patient comfortable: inpatient stays
  12. Dignity in an emergency: trans patients in A&E
  13. Top tips
  14. Medical transition: an overview for healthcare professionals
  15. Other useful resources
  16. Glossary
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