UK Transgender Patient Satisfaction

Survey of Patient Satisfaction with
Transgender Services from The Audit Information & Analysis Unit for London, Kent, Surrey, Sussex, Essex, Beds & Herts.

A total of 647 responses were submitted over the six month survey period – 539 online and 108 on paper.

• The ratio of MtF:FtM was 4:1 which reflects results found in other studies.
• The age range of the population was 14 – 82 years with a median and mean age of 44 years. However there were differences between the MtF population where the average age was 46 and the FtM population where the average age was lower at 36.
• In total 98% of those who had surgery felt it was a positive or mainly positive experience and were happy with their outcomes.
• Almost two thirds of respondents (62%) felt that their GP addressed their needs appropriately but less than a fifth (19%) said their GP was knowledgeable about treatments and only 12% said their GP was able to explain to them what treatments were available
• 39.5% of respondents were either totally happy with the care received at the GIC or felt it had more good than bad aspects.
• 16% of respondents felt negatively or very negatively about the care they received at the GIC.
• 35% felt that the care provided at their GP surgery could be improved and just under half (49%) felt that treatment for trans people at GICs could and should be improved.

There is an issue in that some GPs refuse to prescribe hormones when asked to by the GIC. As part of the ongoing holistic care of a trans person it is important that GPs are involved with the
hormone regime as they are able to provide more local and personalised care.
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On a more general note, given the lack of knowledge evident in many areas of the NHS and cases of discrimination found, it may be that a more fundamental change is required with trans awareness being incorporated into general medical training for all doctors.
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The results of this study have not bought up any new areas of concern. On the contrary they have confirmed anecdotal accounts and therefore it is useful to have performed this survey.
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The survey found that generally respondents had a positive experience as over half (53%, n=339) felt that their GP could always or sometimes help and support them adequately. 17% (n=111) had a negative experience as their GP was never able to help and support them.
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Although the results show that generally the respondents felt their GPs were helpful, supportive and addressed their needs appropriately, it is clear that GPs’ levels of knowledge are often not as high. Less than a fifth (19%) felt that their GP was knowledgeable about treatment and only 12% said their GP explained what treatments were available.
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Although it varies, most NHS GICs require a patient to have lived in role (the ‘real life test/experience’ (RLE)) for a period of time before they will prescribe hormones and this can cause problems for some patients. For this reason patients often pay privately for hormone therapy before they begin treatment at a GIC which can cause conflict with the GIC. One patient who had been on hormones for two years privately whilst waiting for an appointment to a GIC had their prescription withdrawn at their first appointment and was told they had to start from scratch. This contradicts the WPATH guidelines which state that the RLE is not a diagnostic measure so the lack of a formal recorded RLE at a GIC is not a reason for withholding hormone therapy.

Read the whole thing. There's plenty of room for improvement.