https://orcid.org/0000-0002-1785-8826
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Abstract
Background
Trans and non-binary children and young people in England, UK struggle to gain access to affirming clinical care, despite the international research evidence pointing toward this best practice approach. Concurrently, they are subject to constant discussion in the UK national media and politics, where many negative assumptions are made about their needs, experiences and clinical provision. Their journey to seek appropriate care has not yet been documented.
Aims
We trace the experiences of trans and non-binary children and youth and their families in their decision to seek, searches for and experiences with affirmative and non-affirmative clinical input for help with their gender.
Method
27 dyadic, semi-structured interviews were undertaken with trans and non-binary children and young people and their parents from 13 families.
Results
The process of seeking support via National Health Service clinical routes in England, UK is beset with lengthy waiting lists, issues with geographical inaccessibility, a lack of relevant clinical knowledge, and a failure to recognize the value of family expertise. Family doctors provide contraceptive hormones in lieu of proper access to puberty blocking or gender affirming hormones, and most families resort to private care they can ill afford.
Discussion
Training in gender identity and gender dysphoria is recommended for both family doctors, and children’s mental health services. Gender identity development services could be decentralized, with local hubs offering more accessible support.
Statement of human rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Conflict of interest
The authors declare that they have no conflict of interest
Notes
1 A note on language: In this paper we use the acronym ‘TNB’ (trans and non-binary) in order to be inclusive of the diversity of the community and to allow for the range of terms used in self-identification in the UK (Adams et al., Citation2017; Vincent Citation2018). It should be noted that the term ‘trans and gender diverse’ (TGD) is often used in literature which reports data on this topic collected in Australia (Strauss et al., Citation2020) and Canada (Pullen Sansfaçon et al., Citation2019, Citation2020). ‘Trans’ is also used in this article as an umbrella term where appropriate (Vincent, Citation2018). To explain participants’ journeys it is sometimes important to state their sex assigned at birth to distinguish between this and their gender; in these cases we use ‘assigned sex’ (Adams et al., Citation2017). We also use the term ‘non-binary’ on its own to describe people whose gender identity falls outside the gender binary (Vincent, Citation2018). We use ‘cisgender’ to refer to people who are not trans or non-binary (Adams et al., Citation2017; Vincent, Citation2018). In the ‘Results’ section, we use the terms the young people have used to describe themselves.