This document provides an introduction to transgender equality. It discusses that gender is a social construct distinct from sex assigned at birth. It describes gender dysphoria and the spectrum of transgender identity. It notes that transgender people exist in all cultures and seek to live authentically. It discusses challenges transgender people face, like lack of support and high rates of suicide attempts. It outlines UK legislation and the medical process for transition. It emphasizes the need for respect, support and inclusion of transgender people in healthcare, housing, and society in general.

1. Introduction to
Transgender Equality
Facilitated by
Equality South West

2. Personal Identity

Sex – determined by physical
examination at birth

Gender – a social construct

Sexuality – how we express our
physical desires

3. Gender Dysphoria
 Means ‘discomfort’ with your assigned gender
 Trans people identify with or wish to be considered as
the opposite gender. There is a spectrum of identity that
is not necessarily static – gender variance
 Transsexual people wish to change their gender
completely and seek medical interventions to confirm
that need
 Emerging evidence that the brain anatomy and
physiology in transsexual people is similar to that of the
desired gender1 and develops whilst still in the womb.
1
Atypical Gender Development – A Review
International Journal of Transgenderism

4. Trans People

Appear in every culture – not just a Western thing

Have existed through recorded history

Cross all economic and social boundaries

Are both ‘women’ and ‘men’

Are not “sick” or “defective”

Are simply part of natural variation

Want no more than to be themselves, in peace

May need the assistance of medicine to reach that goal

Need to be treated with respect

5. Britain today
 Approximately 21 in every 100,000
people in the UK is transsexual (GIRES)
 Only 20% felt they encountered no
problems2
 34.4% said they thought about or
attempted suicide or self harm2
2
Engendered Penalties – Whittle, Turner and Al-Alami –
The Equalities Review, Feb 2007

6. Legislation
 Human Rights Act 1998
 Gender Recognition Act 2004
• Gender Recognition Certificate
 Equality Act 2010
• Gender reassignment – no longer need to be
under medical supervision.

7. Early years
 80% of those who go on to transition knew by
the time they were 8 years old that their gender
identity was at odds with society’s perception.
(SWTEN report)
“I have felt like a gay boy trapped in a girl’s body since I
was five and don't understand why… My head is messed
up over this stuff and there doesn't seem to be anybody
who understands or who I can talk to. It affects me
everyday.”
(PP&T contributor)

8. Pressing the pause
button

Changes at puberty “can be terrifying and repulsive to a
transgendered person”.

"People are always afraid that (puberty blocking) will be
harmful for the children. But what they never take into
account is that it is also harmful to not give them this
treatment.”

Some clinics in Australia, Canada, Germany, the U.S.,
and the UK have started to offer treatment to
transgendered teens in order to prevent their onset of
puberty.

9. Transition

Can be extremely stressful

It’s the one of the biggest changes anyone can make
to their lives

Many lose friends, jobs, family and homes, often all in
one go and trans people need support

Many years of male/female socialisation may need to
be unlearnt and new behaviours to be acquired

Hormone therapy and gender confirmation surgery
works well, but is not widely available in the UK for
people under 18

10. Ruth’s Story
Ruth was born in a male body but knew from
the age of 16 that she wanted to be a woman.
Learn about her hormone treatment and
surgery, and how she feels now.

11. Vulnerability






Social exclusion and bullying and abuse
Isolation
Loss of family and home
Potential loss of place of employment
High anxiety states
Paranoia

12. Supporting mental
health and well being
 Gender Dysphoria is not a mental health problem,
although it is treated as one by most of the medical
profession
 The stresses of coming to terms GD and going through
transition can trigger mental health issues
 Physical health can be affected too
 Loss of confidence and self esteem
 Can lead to isolation, self harm and suicide

13. The NHS Experience
1
 16% of trans respondents think that the quality
of care delivered by their current GP is poor or
very poor, while 62% think it is good or very
good
 Many trans people experience difficulties finding
a trans-friendly (or non-transphobic) GP and the
process of finding such a GP is subject to pure
chance
1
Count Me In Too Trans People Report
Browne & Lim – Dec 2008

14. Sexual health
 Over half 56% of trans people do not know
where to find help around sex and relationships
 Trans people are more likely than non-trans
people to not know where to find help around
sex and relationships
 Trans people are more likely than non-trans
people to say they have never had a sexual
health check up
1
Count Me In Too Trans People Report
Browne & Lim – Dec 2008

15. From NHS gate keeping
to transition pathway...
 Trans people “frequently experience barriers in health
service provision ... policies and access to adequate and
safe treatment ... inconsistent and generally
unsatisfactory.”
 Wasteful emphasis (in some cases) on repeated
involvement of mental health assessment.
 Important for people to know what lies ahead...
 Need to move from GP discretion and inconsistencies to
a recognised gender reassignment pathway.

16. Awareness and respect
in the NHS - Voices
Need for Transgender champions in the
NHS?
“Sorry, I can't really help you - you're rather Uncharted
Territory,”
“What have they sent you here for? We only deal with life
threatening illness here”
“Unnecessary surgery, that in there, and we're supposed
to look after him!”

17. Health and well-being:
Key Messages from
PPT research
• All providers – including voluntary sector: publicise Trans
inclusiveness
• All staff and volunteers: awareness training and respect in
practice
• GPs: attitudes and clinical knowledge key - Trans surgerybased specialists?
• Health and social care, and supported housing providers:
need to understand complexities of LGB and Trans ageing
• All providers: monitor sexual/gender identities
• Mental health services: more counselling, more timely
and more LGB and Trans aware

18. Ageing as a Trans
person
 Long term impact of treatments: “a paucity of research
into the long-term outcomes of treatment for
transsexualism” (SWTEN report)
“I am over 65 and a transwoman - I am concerned at almost the
complete lack of information that will inform my GP and myself re
my hormone treatment, its long term effects on my body and on
other treatment e.g. heart etc.”

19. Ageing as a Trans
person
 Entering the care system (PP&T contributors)
“The realisation that it will not be too long before I will
need residential/ similar care I do not think the
providers are geared up to this.”
“Worry that I will suffer from dementia or similar as I get
older and will get confused about my identity which
will cause problems with the respect and dignity that I
will require as a human right”.

20. Awareness and Respect:
Voices
“Being trans can attract unwanted attention and
make your life more difficult. You can be seen as
a threat ... or simply mocked.”
“They just could not imagine or really deal with
how I could be feeling (following an assault) as
they were uneducated in Trans issues. I felt
unheard, pacified and patronised.”

21. Awareness and Respect:
Voices
“There is an overarching need for health and social care
professionals to receive appropriate training in relation to
gender dysphoria and the kinds of interventions and care
required, this should be refreshed as the knowledge
base grows, and trans people should be invited to
contribute actively to this learning process.”
(SWTEN report)
“A more informed, respectful and genuinely caring
attitude would be preferable to an ignorant, disrespectful,
humiliating and often very frightening one.” (PP&T
contributor)

22. “Health care providers
need to realise that there
is more than one way to
live and love. As soon as
they’ve got that down,
we’ll be fine.”
sa
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“The people who most need
to change are the media.”
“I do feel restricted
in what form of
voluntary work I
seek to undertake
particularly where it
involves children,
older people or
religious groups”
“Educat
ion of
health a
nd care
professi
onals in
Trans is
sues.”
Menta
l is
I do no sues conce
rn me
t
point o want to get
to the
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nd
withou
t a qua ence
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Alzhei
mer's” ty of life - e.
g.

23. What Trans People
Want
 Over 65% of trans respondents would like a
specialist local support service
 51% cite the need for a specialist GP
 53% say that psychotherapy could have improved
their experience of transition
 47% of trans people said that their transition would
have been improved by better information
 To be a visible part of society

To be consulted and involved.

24. How Can You Help?
 Having anti-discriminatory and anti-bullying
policies
 Being informed and understanding – training for
staff and awareness raising with service users
 Providing a mentor who can help a trans person
– good pastoral care
 Embracing diversity – staff and service users
alike

25. Break

26. My Personal
Journey

27. Round Up

28. Some useful links
 The Beaumont trust:
http://www.beaumontsociety.org.uk/help_and_advice.html
 GIRES - Information for trans people, their families and the
professionals who care for them: http://www.gires.org.uk/
 Press for Change: http://www.pfc.org.uk/
 NHS website: An Introduction to working with Transgender people:
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@d
h/@en/documents/digitalasset/dh_074254.pdf
 SW Transgender Equality Network – to get involved and find out
more, including local groups, research and general information:
http://www.equalitysouthwest.org.uk/transgender

Transgender Information: transgender.information@yahoo.co.uk
Text: 0781 609 3291

29. Thank you for
listening