The term ‘trans’ is used within to illustrate the experience of a people whose perceived gender and sex assigned at birth and identity is incongruent with the way in which they recognise and describe their own sex and gender identity. The term ‘Gender-variant’ relates to the experience of people whose view of their own gender expression, or sense of gender identity varies from societal definitions, norms or expectations. Trans and gender nonconforming people may be described as ‘gender diverse’.
A gender diverse person may identify with one, many or none of the following terms: trans, transgender, gender variant, gender-non conforming, gender neutral, demigender, queer, gender-queer, gender-fluid, non-binary, agender, gender questioning, or a range of other terms, to describe the way in which they may define, and situate, their experience within society. Alongside positive identification, identity labels often support an individual to shape their sense of self and interactions with the world.
Trans and gender variant people generally are more likely to have poorer health, wealth and wellbeing outcomes and this has been recorded and discussed by multiple studies (Whittle et al – Trans MH study etc edit: to consider if in-depth studies are needed). Trans and gender nonconforming people are more likely to be a target of hate crime; to encounter homelessness or insecure housing; and experience economic poverty.
Equality Act (2010):
All public bodies have a responsibility and duty as designated by the Equality Act 2010 to implement the Public Sector Equality Duty (2010) which puts the responsibility within public sector agencies to ensure equality of opportunity. Within the Act itself ‘Gender reassignment’ and ‘Sex’ are two ‘protected characteristics’. In response to this, in 2016, the Women and Equalities Committee undertook the largest scale Transgender Equality Inquiry for England (HM Government, 2016) (1) which has since provided a wealth of recommendations and evidence to illustrate the range and reality of experiences and challenges faced every day in the UK gender diverse people, alongside providing recommendations to begin to redress this balance.
Note: A trans, gender diverse, and or gender variant person is protected by the Equality Act 2010 if they consider themselves to be or are identify themselves to be in the process of gender reassignment. It is not a requirement for a person to be actively undergoing medical intervention in order to receive protections under the law. It is important to recognise trans individuals may belong to a number of ‘protected characteristics’ and thus face multifaceted and intersectional oppression.
Increasing media coverage and visibility of gender diversity has been supported by several recent instances high profile individuals who have often undertaken a public social transition of gender. The term ‘transition’ is used to describe the social and cultural aspects a person may opt to adjust; including but not always, name, pronouns (term they wish to be described as such as she/he/they), honorific title (Ms, Mr, Mx) and alongside outward gender expression (although is not always the case). Individuals may opt to undertake surgical and hormonal interventions within or as part of their transition but this is an individual and personal decision.
There have been fewer instances of positive recognition of non-binary people in the mainstream media but increasing numbers of individuals identifying openly as non-binary with activist networks developing both nationally, (http://beyondthebinary.co.uk/) and locally, ‘Non-Binary Action’ (https://www.facebook.com/groups/1028970493867461/) reflects an emerging need for policy, practice and guidance to include the needs of those who describe themselves as outside of the binary.
Accurate statistics to evidence the number of trans, gender diverse and gender variant identified persons living in the UK do not currently exist due to the absence of large-scale equality recording through the UK Census; currently lacking a question relating to trans status. It is estimated that between 300,000-500,000 persons in the UK population are transgender or trans, thought to be just below 1% of the general population (ECHR, 2016). Across the West of England, estimated population figures are 1,439,400 in 2016 (2) which would mean a population of just over 14,000 trans and gender variant persons within the area if assuming a 1% incidence.
Access to medical care:
Young people and adults accessing specialist Gender Identity Clinic (GIC) services during the most recent data period of August – October 2015 (UK Trans Info, 2015): https://uktrans.info/attachments/article/341/patientpopulation-oct15.pdf)
was 14,674 young people and adults engaged within the care of a GIC. During this same period of three months 517 persons were discharged from their care, largely due to completing their care pathway. These statistics do not include those who have undertaken private treatment, those who have not engaged with medical support services (by personal choice), those who have completed their care and those currently on waiting lists for regional specialist services. There is no Gender Identity Clinic within the West of England with the nearest specialist service, The Laurels, based in Exeter for those aged 18+ and the Tavistock and Portman Gender Identity Development Service for those under 18 and their parents/carers.
In addition to a lack of GIC within the West of England reported findings from trans people within the West of England is a lack of continuation care. Local providers should be able to manage trans person’s related healthcare. A lack of information, training and awareness
Responding to increased need:
Childline and NSPCC (2016) (2) reported figures of 8 calls per day accessing their support related to direct concerns about their gender identity as a sharp rise (translating to annually 2920 calls). Young people across the West of England currently have access to social and emotional support through voluntary sector and community groups. It is crucial that face-to-face support is safeguarded for young people.
All West of England residents every day encounter organisational systems across the public, private and voluntary sector which have often been designed as with a two-option model usually offering options of male/female, man/woman with limited recognition or opportunity for those who situate themselves outside of binary categories to have their gender identity accurately reflected, recorded or recognised.
At present, UK birth certificates allow two options: male and female with a lack of representation or opportunity for other terms (eg. intersex or non-binary) persons to be recorded if they wish to be. It is important to state that not all Intersex persons identify, or may identify with the term trans or transgender but may face discrimination from perceived gender diversity. This binary system of recording is reflected throughout documentation and systems of organisation; eg. Birth certificates, Passports, Marriage and Death certificates. Frequently organisations and agencies require or monitor gender identity unnecessarily and often have limited options or categories in how they do so.
In 2004 the introduction of the Gender Recognition Act allowed, for the first time, trans individuals the right to obtain a birth certificate in the gender in which they identify themselves to be, however this only meets the needs of those who describe themselves as male or female. This process, in 2016, continues to be subject to criticism for both its cost, length, bureaucracy, and reliance upon medical and social evidence. Individuals going before the Gender Recognition Panel are required to provide sufficient documentation that they have been recognised and are living as either male or female and submit both social, medical and financial evidence spanning a time-period of a minimum of two years.
Obtaining a Gender Recognition Certificate (GRC) is one of the only reasons a UK Birth Certificate can be edited. Only a Registrar has the right to ask for a GRC when transferring a person’s birth certificate and once this process is complete the certificate is no longer of use. Organisations cannot and should not ask to see a person’s Gender Recognition Certificate.
Documentation such as Passports, Driving licenses and gender marker identification held by agencies (eg. public and private bodies) can and should be altered without a Gender Recognition Certificate. HMRC and Births Marriages and Deaths are the exceptions. HMRC however can alter a person’s front facing record and provide a lock on records.
For trans people who wish to, and are able to, alter their gender marker on records they are able to without a Gender Recognition Certificate. It is important to remember for those who identify outside of ‘male’ or ‘female’; for example, non-binary persons, it is impossible at this present moment in time to have this reflected in documentation.
For those with trans experience or with a trans history who, do not, or would not, consider themselves as trans or transgender – it is crucial to consider issues of confidentiality and data protection duties for organisations to uphold in order to ensure a person’s right to privacy. In such instances a person may no longer identify or align themselves as transgender, but may still face oppression being perceived as transgender.
The need for comprehensive awareness training for all staff; front-line colleagues, managers and elected officers is necessary to increase knowledge and understanding of the needs of trans, gender diverse and gender variant people in the West of England.
A resilience strategy for trans, gender diverse and gender variant people:
An action plan is required to ensure and safeguard the needs and rights of trans, gender diverse and gender variant people across the West of England to be represented, recognised and respected. The resilience strategy seeks to provide a basis of discussion and development of strategy that results in meaningful change for all trans, gender diverse and gender variant people in the region.
In collaboration with the community we have identified key areas of need for commitment for change.
• Commitment to ensuring trans and gender variant people and their lives are represented, recognised and reflected in all West of England local authority provided services, literature and documentation. Imagery used should reflect and include trans and gender diverse people. Language should be inclusive and monitoring should allow for non-restrictive self-identification of gender identity beyond binary options. Feedback should be sought from services to evidence their commitment to inclusion and parity of opportunity for trans, gender diverse and gender variant people.
• Services should appoint a lead person/ single-contact point to develop service-specific trans and gender variant inclusion policy for staff and users of services. Appointing former and current users of services who identify as trans or gender variant and ensuring feedback includes and seeks out the voice of the trans and gender variant communities. EG. School Governor panels should have an appointed individual with a LGBT+ specialism and positive identification. EG. Housing
• Trans and gender variant people are under-represented within the paid workforce and trans people are more likely to be unemployed or underemployed (Prospects, 2000) (4) or experience discrimination within employment. Opportunities for trans people to become champions and ‘experts with experience’ within services should be implemented where possible.
• Visibility of positive local role models who are trans or gender diverse should be promoted. An example of this being the ‘OUT in the Workplace’ guide by Bristol City Council.
• Ensuring availability of gender-neutral toilets within all local authority. A commitment to implementing gender neutral toilets within all buildings where feasible.
• Single-gender service provisions; assessing the need and improving provision for those who identify outside of the male and female binary.
• Specialist leads appointed to ensure implementation of trans awareness and education across teams. EG, A Housing Officer with the responsibility of ensuring fair and equal treatment for trans people accessing Housing Services.
• Events such as Transgender Day of Remembrance ; Transgender Day of Visibility; South West Trans Pride; International Day Against Homophobia, Biphobia and Transphobia are important events in the calendar which demonstrate support and awareness raising activities. These events should be supported by West of England Authorities. Events for LGBT+ History month should be planned and suitability of speakers or debates should be considered
• Social media should be used to advertise and extend West of England services commitment to working with trans, gender diverse and gender variant people. Use of the internet can be a way in which to engage with the community to promote inclusivity and involvement.
• Events or debates should be challenged for their suitability before they are supported by local authorities. Speakers should not promote negative attitudes or deny the right of trans, gender diverse or gender variant people to exist.
• Trans, gender diverse and gender variant people should expect an equal experience within all West of England services. Presumption that all individuals accessing services are cisgender is problematic and leads to a lack of provision and unmet need across the region.
• Focussed strategy to improve low rates of transphobic hate incident and hate crime reporting across the West of England in order to improve reporting and everyday experience for trans, gender diverse and gender variant people.
• All young people should be given LGBT+ inclusive education to reduce stigma and transphobic and or gender-related bullying towards all young people.
• All individuals should be supported to self-determine their gender identity. Schools should provide support for young people who are transitioning gender.
• West of England should be a beacon of best practice for trans, gender diverse and gender variant people. Leading with shaping attitudes of residents of the West of England begins with education, training and a commitment to ensuring trans, gender diverse and gender variant people
• All trans, gender diverse and gender variant people should feel safe within schools, universities and supported by schools to ensure they have full and fair access to an education.
• Ensure change of name and gender marker within council-led and run services is undertaken by a single point of contact and this information is shared with relevant agencies (if agreed and requested).
• Services should have an up to date and relevant policies which support staff and residents of the West of England to be aware of their rights.
• Ensuring availability and accuracy of information on support provisions for trans, gender diverse and gender variant people.
• Training should be mandatory and provided for all council staff in working with residents of the West of England. Across health, social care, education and
Managers and elected officials. Training should be provided by accredited and trans, gender diverse and gender variant trainers.
• Trans organisations and trans people should be at the forefront of developing new services and be led by trans, gender diverse and gender variant people.
• Community and peer- led services are integral to ensure trans and gender variant people have access to information, advice and support to improve wellbeing. Services for trans, gender diverse and gender variant people should be considered in all recommissioning processes.
• Access to support, information and advice that is informed and should be available to all trans people. Face-to-face support groups should be supported and encouraged across the region.
• An LGBT+ centre which would cater for and house services for trans and gender variant persons allowing them access to support, information and advice should be developed for the region.
• Support for parents, carers and families of trans, gender diverse and gender variant people should be developed further within the region. National services such as Mermaids exists to support parents and young people: http://www.mermaidsuk.org.uk/ but similar provisions for wider family, or those over the age of 25 is
• Intersectional identities; a person who identifies as trans, gender diverse, or gender variant may also align themselves with other ‘protected’ diverse characteristics. Services should be reflective and responsive to needs running parallel – an older trans person accessing a service who may have a learning disability may face multiple vehicles of oppression which should be
• Monitoring and research. Further statistical evidence of need should be undertaken with a commitment for a West of England focus for the community in order to ensure services
– Adoption of an Action Plan to ensure the rights, representation, and respect for trans, gender diverse, and gender variant people with implementation with agreed time-scale across the West of England.
Specific feedback considerations/experiences from the community gained through consultation with individuals:
– Schools denying young trans people the ‘right’ to transition. Services such as Freedom Youth, Bristol are advocating and managing inconsistent approaches from schools.
Lack of Department for Education guidance on working with transgender young people (awaiting release)
Young person told they are ‘too young’ to transition and that
Rates of gender-based and transphobic bullying at school.
Low levels of face-to-face specialist support for parents/carers of trans young people.
Not wanting to disclose gender identity or gender history to workers due to fear of ignorance or abuse.
Feeling support is geared towards younger people.
Being afraid of getting older and worries around receiving personal care as a transgender person.
Social support groups and networks
Community groups struggling to obtain free space
Funding not West of England focussed
Few venues that are not alcohol focussed or safe spaces just or trans people.
Not enough groups or services.
Speakers at events have expressed anti-trans statements and events funded by public bodies should be anti-discriminatory.
Not enough events.
Trans community seemingly having to self organise – not a commitment by council/s to organise events.
Confidentiality about gender history or previous names being broken by Housing authorities.
Worries around complaining about confidentiality due to potential negative effect on care / services.
LGBT+ specific education still not mandatory in schools.
Young person reporting lack of response from school about transphobic bullying.
School unwilling to support young person who did not have support of parent.
– Discrimination in job due to transition – contract not renewed. Discrimination not always overt.
Person getting to interview stage but on disclosing non-binary identity not progressing further.
Facing lack of understanding of negative impact on mental health by employer due to transitioning gender.
Lack of support from parents meaning young person’s school unwilling to support and recognise their gender identity.
No specialist support for children whose parents identify as trans, gender diverse or gender variant.
Hate crime / Hate incidents.
Not feeling safe in the community.
Experiencing hatred from neighbours
Experiencing bullying at school. Young person and parent did not wish to pursue.
– Being tired of reporting transphobic incidents in housing association.
No local gender identity clinic in Bristol – should be developed for those who cannot travel or cannot afford to.
GP unsure of how to support trans person. Unwilling to support with everyday healthcare.
Poor experience of working with Care Coordinator who had not received trans awareness training.
Repeated admission to A&E where misgendered and mispronounced.
Gender identity not recognised on admission to acute mental health ward.
Young person referred wrongly to mental health services as opposed to specialist gender identity development service.
Clinics should do outreach for LGBT+ people at pride
Dr’s surgeries should be more welcoming
Trans people should not have to fight or educate their doctor.
Model – as seen in 56 Dean Street- and Brighton, CliniQ, responds to and provides a service for trans and gender diverse people.
Staff should be trained and trans aware in clinics – would encourage testing.
No LGBT+ safe house for those who have experienced domestic abuse.
People should be allowed to move quickly if they experience transphobia
Trans people may only know other trans people online.
More groups for trans people
Less groups in alcoholic venues.
More groups for people who are disabled and trans.
Language and terminology
Forms and Documentation should ask pronouns
Letters should not assume pronouns.
Forms should include gender neutral titles: eg. Mx.
Monitoring and evaluation
Remove gender identity monitoring – ask about trans history.
Sports: implement a trans support Officer. Ensure trans people can use swimming baths – hold trans swimming sessions as in other areas of the country.