Brighton and Hove CCG is working to support improvements to trans peoples' experience of healthcare. We are providing support and resources to help patients talk to clinicians about their gender identity, and to improve clinicians' expertise in caring for trans patients. You can find resources for clinicians here.
Cancer screening for trans patients
You can find information about cancer screening for trans patients here.
Five things to know before you speak to your GP
Please see the table below for useful advice on talking to a GP about gender identity, written for this page by a local Brighton and Hove patient.
1. There’s no one way to be trans and no one way to transition
In early life, some trans patients don’t immediately identify as trans, because on the rare occasions they have seen trans people in the media they always seemed so different from themselves. Even positive representations of trans people often seem to tell the same old story of being ‘born in the wrong body’ – words that some trans people never use to describe their own experience.
It’s important to know that ‘trans’ doesn’t mean any one thing – gender, gender identity and gender expression are all really personal for trans people just as much as they are for anyone else. People want different things, have different experiences and priorities and ‘trans’ will mean different things to different people.
When you go to see your doctor you don’t have to fit a set mould of ‘what a trans person should want’ or ‘what a trans person should look like’ and you shouldn’t have to pretend to be someone you’re not. Their job is to help you identify and access the care you need to live your best life, or to refer you to someone else who can. That might be hormones, surgery, therapies, information, any combination of those things or something else entirely.
2. You’re entitled to your privacy
Curiosity can get the better of people sometimes - people can ask lots of questions. Other times, staff may not know how to deal with certain administrative issues around transition and can be under the false impression that trans people need to ‘prove’ themselves by disclosing highly personal information.
When the trans patient is in a medical environment, they can sometimes feel embarrassed, a little intimidated, and often feel like they need to answer all of the questions someone is asking. If someone asks you an inappropriate, personal question that’s not related to your care, you do not have to answer it. You have every right to say ‘I don’t think that’s relevant’ or ‘I don’t think it’s appropriate for you to be asking me that’. If you’re not sure why you’re being asked a question, you have every right to ask why someone needs to know that information about you, and make a decision about what you are comfortable sharing.
3. Do your research - it’s okay to ask your GP questions
While your doctor should help you to access the care you need, no-one knows everything, not even your GP. Even if you’re not entirely sure what you want from the NHS at the moment, or may want in the future, it can be really helpful to have a good idea of the different options which might be available to you before your appointment. You can find and share this information on websites, social media channels and through local trans support groups.
Having done your research, take notes to help yourself remember. It can be really helpful to take some of these notes into your appointment – you don’t need to tell your GP all the details you might have jotted down, but it can help you both to make sure you get the treatment or referrals you need without having to make multiple appointments. That said, don’t automatically underestimate the medical knowledge your GP may have in this and other related areas. It can be really helpful to ask your GP if they have any particular insight which may be useful – especially if you have any existing medical conditions that they’re helping you to manage.
4. There are people who can help – you don’t have to go alone
It’s your body, your identity and your wellbeing at stake so it’s hugely important to make yourself heard. Clinical environments can be a little intimidating sometimes and it can feel difficult to assert yourself, but what happens at your GP and other appointments has a major impact on your life and you need to have a voice in those spaces.
You are the most important person in the room. If you feel like your GP has misunderstood what you’re telling them or they’re recommending something that you don’t think is going to work for you then it’s important to put your viewpoint forward. This way you can either discuss alternatives together, or they can work to explain themselves better to help put your mind at rest.
Other times, even just going to your GP with certain issues can feel like a real challenge – you could be worried that you might face discrimination or a lack of understanding and that can have a really negative impact on your experience. In all of these instances it can be really helpful to have someone else with you who does understand, who can help you to make sure you say everything you need to say and to stand up for you if necessary. You are absolutely entitled to take someone into your appointment with you - this might be a friend, partner, carer, family member or advocate. It’s best to discuss the appointment in advance with them to make it clear exactly what you want from the appointment, what type of support you want from them and any concerns you might have.
5. You have the right to dignity and a high standard of care
While it’s great to see the positive steps taken towards trans inclusion and equality, both in the NHS and more broadly, navigating the NHS as a trans person can still be really hard work. You have the right to be respected in your identity, you have the right to not be asked inappropriate and invasive questions, you have the right to privacy, you have the right to access the treatment you need, and you have the right to receive that treatment and care to a high standard. We have one of the best healthcare systems in the world – make sure you get the best out of it.