Caring for Trans People Dr Christine Mimnagh GP

Caring for Trans People • Dr Christine Mimnagh GP Chair CMAGIC • Dr Stenton Mackenzie Forensic Anthropologist

How many trans people are there? POLL OPEN 1. 2% of population 2. 1% of population 3. Nobody knows 4. None- its just a delusion Vote Trigger

POLL OPEN How many GICs are there ? 1. >10 2. 7 3. 5 4. 3 Vote Trigger

How long is the average waiting time? POLL OPEN 1. Circa 4 Years 2. 18 months 3. 18 weeks 4. Time is an illusion Vote Trigger

What percentage of Trans People self medicate? POLL OPEN 1. 75% 2. 50% 3. 25% Vote Trigger

The Trans Agenda • Transgender, Who? What? Why? • Practical Care • Medical Care

The Lived Experience

Transgender Who What Why • Transgender and Non Binary • 0. 6 -1. 2% of the population ( we think) • Complicated (nature, nurture, epigenetic)

CMAGIC Trans Care Pyramid Surgical GIS Medical Specialist GP Psychology GPSI Identity Trans Community

East Coast Mainline?

The Pathway • There is no pathway • 60% have surgery at some point • 1 in 4 Self Medicate, Average waiting GIC in England 18 months In 2016, NHS England pledged to reduce waiting times to below 18 weeks by 2018 • Psychology: 60% relationship failure, 40% self harm (CYP) • Identity: Minority apply for GRC

Shifting Patterns • Historically more Trans Women • Now more Trans Men • Increasing Non Binary • Younger age group

Let’s talk about demand The “trans trender”

General Care • Be positive and proactive in your approach to welcoming trans patients to your care • Always treat trans patients in a respectful way, as you would any other patient • If you are unsure about a person’s gender identity or need more clarity about how they would like to be addressed, then ask politely and discreetly • Avoid disclosing a patient’s trans status to anyone who does not explicitly need to know • Discuss issues related to a patient’s gender identity in private and with care and sensitivity. Fair Care for Trans Patients RCN 2017

Inpatient Trans Care Pyramid Surgical Medication Medical Investigations Psychology Placement Identity Demographics!

Education • Fantastic Opportunity • Certificate/ Diploma • Full Curriculum

Questions?

"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed it is the only thing that ever has. ” –Margaret Mead