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Found 41 results
  1. News Article
    The family of a young trans woman who is believed to have taken her own life have said she was “failed by those tasked with her care”, as the coroner investigating her death described services for transgender people as “underfunded and insufficiently resourced”. Alice Litman had been waiting to receive gender-affirming healthcare for more than three years when she died in Brighton at the age of 20 in May 2022. Ahead of an inquest which began in Hove on Monday, her mother, Dr Caroline Litman, described Alice’s death as “preventable with access to the right support”. Adjourning the inquest on Wednesday to give a narrative conclusion in two weeks’ time, the coroner Sarah Clarke told the court: “It seems to me that all of these services are underfunded and insufficiently resourced for the level of need that the society we live in now presents". Describing the trans healthcare system as “not fit for purpose”, Alice's family, who are being supported by the Good Law Project, added: “We are grateful that the coroner has agreed that the conditions of Alice’s death warrant a report to prevent future deaths.” Read full story Source: The Guardian, 20 September 2023
  2. News Article
    Transgender people may be banned from single-sex hospital wards under plans to restore "common sense" in the NHS, the health secretary says. Speaking at the Conservative party conference, Steve Barclay announced a consultation on strengthening the protections in place for women. NHS guidance issued in 2021 said trans people may be placed on wards according to the gender they identify as. The change would stop that with trans people given their own rooms and areas. But doctors have questioned whether there are the facilities available to achieve that. And the move would have to meet the legal threshold set by the Equality Act, which allows trans people to be excluded from single-sex spaces if there is a proportionate means of achieving a legitimate aim, such as privacy or safety. Mr Barclay said he wanted to make sure the "dignity, safety and privacy" of all patients was respected, while the rights of women are protected. Read full story Source: BBC News, 3 October 2023
  3. Content Article
    In April 2023, National Voices held a workshop with members, supported by The Disrupt Foundation, on the unequal impact of the Covid-19 pandemic. It explored how communities and groups were affected differently by both the virus itself and the measures brought in to control it.   It painted a grim picture of the ways in which the pandemic response exacerbated existing, deep-rooted inequalities across the UK and compounded the disadvantages experienced by people from minoritised communities, by disabled people and by people living with long term conditions.  Just some examples include people who are immunocompromised, who were asked to go into isolation for huge periods of time and still feel completely overlooked as control measures have been lifted. Or the use of DNRs (Do Not Resuscitate orders) which were disproportionately applied to people with learning disabilities.  With the Covid-19 Inquiry underway, it is imperative that we capture the lessons learnt from the pandemic, and use them to suggest action for the future.
  4. Content Article
    There is a well-established case for involving communities and people with lived experience in health and care policy, service design and delivery. NHS England guidance on working in partnership with communities highlights the financial benefits and improvements to quality and health outcomes that working with local communities brings. But could this involvement go further? In this article, Loreen Chikwira, Researcher at The King's Fund looks at the arguments for the use of intersectional approaches in understanding people’s lived experience of care in tackling ethnic health inequalities. These intersectional approaches help health and care providers shift their focus from people’s behaviours to also identifying and addressing ways of working that create and reinforce inequalities and poor experiences of care.
  5. News Article
    Vanderbilt University Medical Center is facing a federal civil rights investigation after turning the medical records of transgender patients over to Tennessee’s attorney general, hospital officials have confirmed. The U.S. Department of Health and Human Services’ investigation comes just weeks after two patients sued VUMC for releasing their records to Attorney General Jonathan Skrmetti late last year. “We have been contacted by and are working with the Office of Civil Rights,” spokesperson John Howser said in a statement late Thursday. “We have no further comment since this is an ongoing investigation.” VUMC has come under fire for waiting months before telling patients in June that their medical information was shared late last year, acting only after the existence of the requests emerged as evidence in another court case. The news sparked alarm for many families living in the ruby red state where GOP lawmakers have sought to ban gender-affirming care for transgender youth and limit LGBTQ rights. The patients suing over the release of their information say VUMC should have removed personally identifying information before turning over the records because the hospital was aware of Tennessee authorities’ hostile attitude toward the rights of transgender people. Many of the patients who had their private medical information shared with Skrmetti’s office are state workers, or their adult children or spouses; others are on TennCare, the state’s Medicaid plan. Some were not even patients at VUMC’s clinic that provides transgender care. “The more we learn about the breadth of the deeply personal information that VUMC disclosed, the more horrified we are,” said attorney Tricia Herzfeld, who is representing the patients. “Our clients are encouraged that the federal government is looking into what happened here.” Read full story Source: NBC News, 10 August 2023
  6. News Article
    Bisexual people experience worse health outcomes than other adults in England, a study has found. Data from lesbian, gay or bisexual (LGB) patients indicates these groups have poorer health outcomes compared to those who identify as heterosexual. The new findings indicate that bisexual people face additional health disparities within an already marginalised community. Experts from the Brighton and Sussex Medical School, and Anglia Ruskin University who led the analysis of more than 835,000 adults in England, suggest the differences could result from unique prejudice and discrimination that can come from both mainstream society and LGBTQ+ communities. Read full story Source: The Independent, 25 July 2023
  7. News Article
    The only NHS gender identity service for children in England and Wales is under unsustainable pressure as the demand for the service outstrips capacity, a review has found. The interim report of the Cass Review, commissioned by NHS England in 2020, recommends that a network of regional hubs be created to provide care and support to young people with gender incongruence or dysphoria, arguing their care is “everyone’s business”. Led by the paediatrician Hilary Cass, the interim report explains that the significant rise in referrals to the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS foundation trust in London has resulted in overwhelmed staff and waiting lists of up to two years that leave young people “at considerable risk” of distress and deteriorating mental health. Last spring, the Care Quality Commission demanded monthly updates on numbers on waiting lists and actions to reduce them in a highly critical report on GIDS. Differing views and lack of open discussion about the nature of gender incongruence in childhood and adolescence – and whether transition is always the best option – means that patients can experience a “clinician lottery”, says the new review, which carried out extensive interviews with professionals and those with lived experience. It notes that the clinical approach used by GIDS “has not been subjected to some of the usual control measures” typically applied with new treatments. Another significant issue raised with the review team was that of “diagnostic overshadowing”, whereby once a young person is identified as having gender-related distress, other complex needs – such as neurodiversity or a mental health problem that would normally be managed by local services – can be overlooked. Read full story Source: The Guardian, 10 March 2022
  8. News Article
    The death of a "vulnerable" transgender teenager who struggled to get help was preventable, a coroner has said. Daniel France, 17, was known to Cambridgeshire County Council and Cambridgeshire and Peterborough Foundation Trust (CPFT) when he took his own life on 3 April 2020. The coroner said his death showed a "dangerous gap" between services. When he died, Mr France was in the process of being transferred from children and adolescent mental health services (CAMHS) in Suffolk to adult services in Cambridgeshire. The First Response Service, which provides help for people experiencing a mental health crisis, also assessed Mr France but he had been considered not in need of urgent intervention, the coroner's report said. Cambridgeshire County Council had received two safeguarding referrals for Daniel, in October 2019 and January 2020, but had closed both. "It was accepted that the decision to close both referrals was incorrect", Mr Barlow said in his report. Mr Barlow wrote in his report, sent to both the council and CPFT: "My concern in this case is that a vulnerable young person can be known to the county council and [the] mental health trust and yet not receive the support they need pending substantive treatment." He highlighted Daniel was "repeatedly assessed as not meeting the criteria for urgent intervention" but that waiting lists for phycological therapy could mean more than a year between asking for help and being given it. "That gap between urgent and non-urgent services is potentially dangerous for a vulnerable young person, where there is a chronic risk of an impulsive act," Mr Barlow said. Read full story Source: BBC News, 25 February 2022
  9. News Article
    Sexual health charities and LGBT groups are calling for the government to step up efforts to control the monkeypox outbreak in the UK. In an open letter to Health Secretary Steven Barclay, they say that without a quicker and wider vaccine rollout, the virus could become "endemic". There have been more than 2,600 cases of monkeypox in the UK so far, mostly among men who have sex with men. The Department of Health & Social Care (DHSC) says it is working "rapidly" to vaccinate those at risk. The Terrence Higgins Trust, which co-wrote the letter, says the rollout needs to be speeded up across the UK to help combat "fear and anxiety" within the LGBT community. Trust head of policy Ceri Smith told BBC News: "We need to see far better co-ordination, increased vaccine procurement, improved delivery and a cash injection to sexual health services to treat monkeypox." The letter reads: "Without urgent action, we risk monkeypox becoming endemic in the UK. This poses a serious risk to health and will exacerbate the health inequalities already experienced by gay and bisexual men and other men who have sex with men. "Vaccinating those most at risk of monkeypox must be a priority if we are to stand a chance of preventing the virus from becoming endemic in the UK." Read full story Source: BBC News, 5 August 2022
  10. News Article
    A retired consultant gastroenterologist has been struck off the UK medical register for “wide ranging failings” in treating young transgender patients and in prescribing testosterone for men. Michael Webberley, who was charged with failing to provide good care to 24 patients, acted outside the limits of his expertise, a medical practitioners tribunal concluded. Through the private online clinic GenderGP, which he ran with his wife Helen, a GP, Webberley prescribed puberty blockers to a child of nine and cross sex hormones to a teenager who died by suicide a few months later. He faced charges over his care of seven transgender patients, and the tribunal found that he had provided treatment that was not clinically indicated or that had been prescribed without adequate tests, assessments, or examinations. Read full story (paywalled) Source: BMJ, 30 May 2022
  11. News Article
    A damning report last year from Dr Hilary Cass into the Tavistock Gender Identity Development Service (GIDS) found that it was putting children at “considerable risk”. Her full report is due to be published later this year. Whistleblower Dr Anna Hutchinson, a senior clinical psychologist at GIDS, describes when she realised something was very wrong. “I just couldn’t comfortably keep being part of a process that was, I felt, putting children — but also my colleagues — at risk,” Hutchinson explains. Faced with no discernible action from the executive, staff began to look for other ways to raise their concerns, to other people who might listen — and act. Hutchinson approached the Tavistock’s Freedom to Speak Up guardian. At least four other colleagues did the same in 2017. That same year, another four clinicians took their concerns outside GIDS to the children’s safeguarding lead for the Tavistock trust." Read full story (paywalled) Source: The Times, 13 February 2023
  12. News Article
    A group of transgender people have lost their legal case against NHS England over waiting times to get seen by a gender specialist. The two trans adults and two trans children had tried to get the wait times - more than four years in one of their cases - deemed illegal. But a High Court judge ruled on Monday the waiting times are lawful. The Good Law Project - which helped to bring the legal action - said it would seek permission to appeal. The four people brought the legal action against NHS England (NHSE) over the waiting time to get a first appointment with a gender dysphoria specialist. The claimants argued that NHS England was failing to meet a duty to ensure 92% of patients referred for non-urgent care start treatment within 18 weeks. They said the waiting times were discriminatory, arguing the delays faced by trans people were longer than for other types of NHS treatment. But the judge dismissed the claim on several grounds. Read full story Source: BBC News, 16 January 2023
  13. News Article
    Patients may be found guilty of discrimination if they refuse the care of a transgender medic, according to new NHS guidance. Health bosses have been warned that patients have no right to be told a healthcare worker’s assigned sex at birth. However, transgender health workers can choose not to treat patients if they feel uncomfortable doing so, the report by NHS Confederation says. The report, published earlier this month in partnership with the LGBT Foundation, says patients can only request care from a same-sex staff member in limited circumstances, such as if they are having an intimate examination. It states that when a patient requests an employee administering care to be a woman or a man, “the comfort of the staff member should be prioritised”. Read full story Source: Telegraph, 9 June 2023
  14. News Article
    A doctor with a key role in reforming a controversial gender identity clinic for children has been recorded questioning the need for change. Prof Gary Butler, clinical lead for the children's gender clinic in England and Wales, also appeared to accuse the author of a report, which will underpin the new service, of "nepotism". He was recorded making the comments in a keynote speech at a major conference. The Gender Identity Development Service (Gids), based at London's Tavistock and Portman NHS Foundation Trust, was rated as "inadequate" by inspectors, who visited in late 2020. It was earmarked for closure in July 2022. An independent review, led by Dr Hilary Cass, also called for a "fundamentally different" model of care for children with gender dysphoria. Prof Butler has been awarded a key role in shaping the new service, as one of several people tasked with implementing a new training programme, underpinned by Dr Cass's recommendations. However, BBC Newsnight has learned Prof Butler has publicly questioned the need for change and described Dr Cass's recommendations as "slightly unusual". In the 14-minute speech at the conference, he talked about current services across the UK, the legal challenges to the situation in England, and how he felt Gids has been the subject of "lies" in the media. Read full story Source: BBC News, 24 May 2023
  15. News Article
    A host of algorithms used by medics to assess disease risk and help make decisions on treatment are failing to take transgender patients into account, doctors have said. Many metrics and thresholds in medicine, including ideal body weight, alcohol clearance rates, kidney function and risk of cardiovascular disease vary by gender. A team of UK doctors and medical students have issued a warning over a lack of evidence as to whether trans patients should be considered for these gender-based scores according to their gender assigned at birth or the gender they have transitioned to – or whether alternative scores are required. In an effort to tackle the issue, the team have launched a research initiative called Trans Gap Project. Dr Michael Niman, a junior NHS doctor and chair of the project, said: “Currently, daily medical decisions involving gender-based scores have limited to no research for the trans community. This means that trans patients are often forgotten about or not considered in the medical world, leading to a significant gap in their access to appropriate medical care.” “When scores that haven’t considered trans people are used, patient autonomy is impaired for trans and gender-diverse patients, as they can’t make true informed decisions on their care – which is one of the bioethic pillars,” Niman said. In some cases, there could be safety concerns. “Clinicians are currently faced with uncertainty regarding the best clinical practice to address these scenarios, owing to a lack of evidence-based guidance,” Niman said. “It is vital clinicians take a vested interest in the research of gender-based scores for the trans community due to the importance of safe practice considerations within the NHS.” Read full story Source: The Guardian, 5 May 2023
  16. News Article
    Twenty years ago, David Freedman helped to conduct an audit of the first 124 young people referred to the gender clinic, now he discovers it was never followed up. David Freedman, 73, helped to conduct a clinical audit of the first 124 young people referred to the Gender Identity Development Service (Gids) from its inception in 1989. The London-based service, part of the Tavistock and Portman NHS Foundation Trust, is the only dedicated NHS clinic for transgender children. When he discovered his clinical audit from two decades ago remained the only one conducted by the service, Freedman said he was “gobsmacked”, adding: “This was a service that was sailing into uncharted territory with vulnerable children and adolescents, where one has an extra duty of care, and the failure to collect any data in a coherent form to look at what they were doing . . . it’s pretty mind-boggling.” Read full story (paywalled) Source: The Times, 19 March 2023
  17. Content Article
    The only NHS service in England to offer gender identity services to children announced it would be closing down last year - after years of whistleblowers who worked there trying to raise the alarm about a scandal in their midst: a failure to safeguard some of the country's most vulnerable young adults. What went wrong? And how much did the toxic political climate at the time over trans issues contribute to a work practice that was not fit for purpose. Investigative reporter Hannah Barnes reflects her years spent talking to those involved - the staff, the families and most importantly, the children themselves.
  18. Content Article
    In this interview with the publisher Bloomsbury, freelance health journalist and founder of the Hysterical Women blog Sarah Graham talks about her book, Rebel Bodies: A guide to the gender health gap revolution. She discusses the recurrent themes she came across in her work as a health journalist which inspired her to set up her blog: women's experiences of gaslighting, dismissal and disbelief by the medical system. Sarah talks about how her book aims to bring together all the stories and ideas she has worked on for the last five or so years and highlight how closely they’re linked. The book also celebrates the resilience, determination, sisterhood and solidarity Sarah has witnessed from patient advocates and campaigners across the sphere of women’s health and trans health. Read Sarah's 2020 blog, Gender bias: A threat to women’s health, on the hub.
  19. Content Article
    A recent survey by the British Medical Association (BMA) and the Association of LGBTQ+ Doctors and Dentists (GLADD) highlighted the difficulties faced by LGBTQ+ NHS staff.  The author of this Kings Fund article, Kelly Ameneshoa, looks at how discrimination and bias is affecting the health of LGBTQ+ staff and patients and what can be done moving forward to improve experiences, safety and outcomes.
  20. News Article
    NHS England has acted unlawfully by making thousands of patients with gender dysphoria wait “extreme” periods of time for treatment, the high court has heard. Transgender claimants, who have suffered distress as a result of delays, want the court to declare that NHSE broke the law by failing to meet a target for 92% of patients to commence treatment within 18 weeks. NHSE figures show there are 26,234 adults waiting for a first appointment with an adult gender dysphoria clinic, of whom 23,561 have been waiting more than 18 weeks. The number of children on the waiting list is approximately 7,600, of whom about 6,100 have been waiting more than 18 weeks. In a witness statement, one of the claimants, Eva Echo, said she received a referral in October 2017 but had still not been given a first appointment, leaving her in “painful indefinite limbo”. A co-claimant, Alexander Harvey, who has been waiting for a first appointment since 2019, said the delay “means that I have to continue to live in a body which I don’t feel is mine and which does not reflect who I am”. He said he had twice tried to kill himself. In written submissions for Tuesday’s hearing, David Lock KC, representing the claimants, said delays to puberty-blocking treatment – the current waiting time for children to access services is more than two years – could cause “intense anxiety and distress” to adolescents as a result of them experiencing “permanent and irreversible bodily changes”. While NHSE accepts it has not met the 92% target across the cohort of patients for whom its health services are commissioned, it claims a breach does not give rise to enforceable individual rights. Read full story Source: The Guardian, 29 November 2022
  21. News Article
    The coronavirus lockdown has provoked a mental health crisis among the LGBTQ community, with younger people confined with bigoted relatives the most depressed, researchers found. A study of LGBTQ people’s experience during the pandemic, by University College London (UCL) and Sussex University, found 69% of respondents suffered depressive symptoms, rising to about 90% of those who had experienced homophobia or transphobia. Almost 10% of people reported they felt unsafe in their homes. The study called for more government support for LGBTQ charities, which have experienced significant rises in demand since the start of the pandemic. It warned: “Poor LGBTQ+ mental health may remain unchecked without a substantial policy commitment and funding directed to ameliorating health inequalities exacerbated by the pandemic.” Read full story Source: The Guardian, 5 August 2020
  22. News Article
    There has been a significant rise during lockdown in the UK in the number of LGBT people seeking suicide-prevention support. Support group LGBT Hero reports 11,000 people have accessed its suicide-prevention web pages - up over 44% on the first three months of the year. The government considers LGBT people to be at higher risk of suicide but no national data on LGBT suicides is kept. In total, eight charities told BBC News they had seen an increase in LGBT people accessing their support for suicide prevention. The LGBT Foundation has received more calls about suicide "than ever before". Gavin Boyd, of The Rainbow Project, based in Northern Ireland, said: "In just the last three weeks, we know of three LGBT people who have ended their lives." And another chief executive of a charity, in the south of England, who did not want to be named in case it affected its funding, said: "We know of two young LGBT people in the past two weeks. We're under more pressure to deliver than ever before. The government has done absolutely nothing to help regional LGBT charities cope with the demand from our already struggling service users." Read full story Source: BBC News, 2 July 2020
  23. Content Article
    This Healthcare Safety Investigation Branch (HSIB) investigation explores the care of patients who present to child and adolescent mental health services (CAMHS) with questions about their gender identity and are referred to specialised gender dysphoria services. Gender dysphoria is a sense of unease, distress or discomfort that a person may have because of a mismatch between their biological sex and their gender identity. For example, a child who is registered as male at birth might feel or say that they are a girl, or feel that neither ‘boy’ nor ‘girl’ are the right word to describe how they feel about themselves. Gender dysphoria is not identified as a mental illness by the NHS, but some people may develop mental health problems because of gender dysphoria.
  24. Content Article
    At present there is a single specialist service providing gender identity services for children and young people – the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust. In recent years GIDS has experienced a significant increase in referrals which has contributed to long waiting lists and growing concern about how the NHS should most appropriately assess, diagnose and care for this population of children and young people. The Cass Review has submitted an interim report to NHS England, which sets out their work to date, what has been learnt so far and the approach going forward. The report does not set out final recommendations at this stage.
  25. Content Article
    In this blog for BJGP Life, GP and Public Health Specialty Registrar Richard Armitage looks at the patient safety implications of changes made to gender markers on patient records. Patients in the UK are able to change the gender marker on their NHS patient record on request at any time. This action triggers the creation of a new NHS number and imports the patient’s medical information into a new patient record, without any reference to the patient's previous gender identity or original NHS number. The author highlights that failure to transfer this information could inhibit high quality care for trans patients, especially with regard to population screening programmes which invite patients according to age and gender markers on their patient record. He argues that public health officials, in collaboration with their primary care colleagues, should: respectfully communicate sex-specific health risks with their trans patients encourage them to consider requesting and accessing the appropriate population screening programmes support them in accessing screening in a dignified manner.
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