32 | Nursing in Practice | Summer 2023
EQUALITY
How can we be more
inclusive towards transgender patients ?
Nurse lecturer Claire Blake gives her perspective on ensuring the best healthcare for transgender patients in primary care , drawn from her experience of working within sexual health and at a private transgender healthcare clinic
Let ’ s start at the beginning . Who are transgender people ? A transgender – or trans – person is anyone who ’ s gender is different from the gender they were thought to have at birth . The last UK census in 2021 showed there were then 262,000 people identifying as trans or non-binary . 1 However , the true number may be larger than that .
Some people think being trans or non-binary is a new ‘ trend ’, but the first people to undergo hormone treatment and surgeries did so many decades ago . In the 1940s , Michael Dillion became the first trans man in the world to transition from female to male . Christine Jorgensen , a trans woman in the US , started gender reassignment surgery in 1951 , the same year that Roberta Elizabeth Marshall Cowell became the first British trans woman to undergo surgery . 2
Some people – including some working in primary care – may have a judgmental opinion on transgender people , but of course trans people are human beings , with families , jobs and hobbies just like everyone else , and should be treated accordingly .
In our profession specifically , for trans people to receive the best standards of health and social care , nurses and other clinicians must be properly informed . This will help remove barriers to care and communication , and to address health inequalities for this group of patients .
Unfortunately , social and broadcast media rarely offer a positive or realistic representation of trans communities . It is important for us all to do our own research so that we can be suitably prepared for our next consultation or visit with a transgender person .
The importance of being informed I first became passionate about education around transgender patients and transgender health as a general practice nurse in March 2021 . I had my first trans patient sitting in front of me in a consultation and realised I had no training or awareness of the hormones the patient was receiving and how this treatment affects the body , or about the experiences of trans patients within our healthcare system .
I spent the next couple of years researching everything that I could find on the subject , and then set up webinars to help educate other healthcare professionals . I then started working in a private transgender healthcare company as a nurse , in order to gain more experience and knowledge around the transition process and to try to make a difference .
Claire Blake and her husband George Blake , a transgender man , offer education on transgender health online , at www . gc-health . uk
I have worked at the company for more than a year now , alongside teaching .
Why is this important ? Because every patient , regardless of their gender , sexuality , race or ethnicity deserves the same standard of treatment . Unfortunately , there is evidence of a lot of discrimination and inequality faced by trans patients . The authors of LGBT in Britain – Trans Report found that 41 % of staff within healthcare services lacked knowledge of transgender healthcare needs . 3 A Dutch ‘ chart study ’ in 2020 showed suicide rates were higher in transgender people than among the general population . 4 It is so important that we get it right for our trans patients and help them in the same way as we would anyone else . It could make a huge difference to them – and it could even save a life . Note also that ‘ gender reassignment ’ is among the protected characteristics in the Equality Act ( 2010 ) 5 , and this also covers people who have not yet had hormone treatment or surgery . Regardless of our own opinions , we must all be mindful when speaking on this publicly to