Messages to healthcare professionals from parents and carers of young trans and gender-diverse people

The parents and carers we talked to had important messages for health professionals working with young trans and gender diverse people and their families. In this section, you can read and hear the advice they gave. This included:
  • the need for awareness;
  • being respectful, friendly and honest;
  • being mindful of language and how records are kept;
  • being trans may be relevant to why the person is consulting, or it may not be;
  • meeting the young person where they are today and approaching them holistically;
  • seeking training; and
  • making sure to also offer support to the families.

Mel highlights that the experiences that children and young people have of healthcare professionals will shape their future engagement with health care.

View profile

Each of these people have got an individual story behind why they, they are there. And it’s the same for the children, you know, and whatever personal judgements there are cannot be seen by the children. They just need to be dealt with in the best possible way, so they have the best possible experience because they’re such impressionable ages. These experiences that they take with the GPs, nurses, will follow them for the rest of their life and so, it’s got to be good and consistent as well.

Embed Print Transcript

The need for awareness

Many parents we spoke to felt it was important to firstly recognise that trans and gender diverse children and young people exist. Parents encouraged health professionals to be accepting. For some, like Elijah, this doesn’t mean that the healthcare professional can’t explore the topic with the child or young person. It was important that this was carefully and sensitively approached though. Ali thought that healthcare professionals might help young people anticipate health problems they could encounter.

Being respectful, friendly and honest

Parents we spoke to talked about the importance of being respectful, honest and empathetic when working with young trans and gender diverse people and their families. For example, when asked about the advice he had for doctors and nurses, Ross said: ‘Empathy, I think would probably be the word. Try and kind of put yourself in their shoes a little bit.’

Mel talked about the need to listen, being respectful and sensitive to the needs of the young person.

View profile

Really listen. I think doctors can be accused of being, not having such a great bedside manner because, you know, people are in and out all the time, in out, in out. And to be, there’s a way of being, this really, really sensitive stuff and in dealing with children and being able to meet the needs of the kids in a professional manner whilst being respectful to them and being sensitive to their needs I think is really important.

Embed Print Transcript

Richard thought it was important for health professionals to be honest and respectful when speaking with young trans people.

View profile

What advice would you give to doctors and nurses working with young trans people?

To be confident to be honest. And, the best technique to talk about awkward, embarrassing conversations is to tell the person that they may find this bit of the conversation awkward or embarrassing and deliver the information in a friendly, honest way and the young person is likely to respect them for feeling respected.

Embed Print Transcript

Being mindful of language and how records are kept

It is important to ask people how they want to be addressed and respect their preferences. Using the right pronouns, titles and names makes a positive difference to trans and gender diverse people’s experiences of health services. E said this was a ‘really simple’ thing, but one which is very important. Parents we spoke to talked about how using the correct pronouns and names was a matter of respect and how misgendering created further barriers to good quality care. Josie said: ‘Even things that seem little… like having the correct name flashing up on the screen or having the correct name on a letter and… all little things like that. It’s just basic respect and courtesy. I think that’s really really important.’

Leigh thinks health professionals should ask young trans and gender diverse people how they want to be addressed.

View profile

It doesnt hurt to use pronouns and names of, of what they want to use. You know, it’s [sighs] just basic respect, you know. There should be on an intake form what pronouns would you like to use. What name do you prefer to be named by. You know and it’s not, it’s a simple tick box. Just respect the young people for who they are the same as you would do an adult. We are all human at the end of day, it makes no difference who we are. We are all human.

Embed Print Transcript

Ross talked about misgendering being offensive and the need to use the right language.

View profile

I guess it’s having training in specific trans issues. But a lot of things that they don’t realise are as offensive as they are, like miss-gendering. You can, they can get it right four times out of ten and the patient will come out feeling misgendered, because theyve got it wrong six times out of ten. So, kind of really paying attention to it or using non-gendered terms, which, within the training of nurses and people could be kind of commonplace, because it’s not difficult to use they/them rather than him/her or patient or use the person’s name. You, you, you fill in forms when you register, so they know your name whether you use your Christian name of your Surname doesnt matter, but cutting out the Mr or Mrs and just using the person’s name.

Embed Print Transcript
Some parents said that forms and computer system records should include options for pronouns, preferred names and titles to avoid misgendering. Georgina suggested that doctors should keep records of people’s gender identity.

Georgina suggests that a healthcare professional could add a note to the patient records to help avoid confusion.

View profile

As soon as they know that there’s a a different name or whatever to maybe what’s on the records, cause obviously that’s what confuses a lot of people or if you go in for an infection that is in a body part that maybe that person doesnt look like they should have, play it down. don’t be all confused. Just play it down and be like, oka and then just write a little note so that anybody else who sees those notes understands so we don’t have to have confusion with every different person along the chain.

Embed Print Transcript

Being trans may be relevant to why the person is consulting, or it may not be

Parents we spoke to talked about how health professionals need to be aware of trans-specific health needs and experiences, but should not assume every reason for consulting is related to being trans.
For one parent, it was important that health professionals treat trans and gender diverse children and young people like any other patients. She also felt strongly that it was not the role of health professionals to question young person’s gender identity, if they were being seen for something that was not gender-related.

Interview 1 talks about not treating trans children differently.

You know, just like if a child came and they were left-handed you wouldn’t treat them any differently unless you happen to be doing something about hand surgery or something. You know, there’s very few scenarios in which you would treat a child differently. Whereas for being trans, I think people, because people have got subconscious prejudices and worries and have bought into this concept that a child cant be trans. Trans kids in a whole load of ways get treated poorly. And I think if people could just treat a trans child as well as they would treat a left-handed child and just not problematise it and not and, and give that unconditional and immediate affirmation, like if a child comes and says or a parent of a child says, Here’s my child and theyre trans. The medical professionals should just take that as fact and move on and not see their role as to probe, or undermine, or challenge, or question that. Particularly, if, if their interaction is not gender focused. But even when it is gender focused I think the same, they should just accept a child as valid, you know, where they are.

Embed Print Transcript

Meeting the young person where they are today and approaching them holistically

Some parents and carers talked about how it is important to meet the young person where they are today as opposed to trying to predict their future and  health professionals should focus on being there to help. Jan felt that it was important for health professionals to recognise that the young person might be facing difficulties at school, work or at university. She thought that it was key to recognise the wider context and the challenges young trans and gender diverse people face in their daily lives.
Approaching the person holistically and exploring what is going on in their life was also an important point for D, who thought that to support trans and gender diverse people GPs should do more than just refer them to specialist services.

E talked about how GPs should treat the young person holistically.

View profile

You know, I think I would be encouraged to treat them holistically and sort of ex, you know, explore their issues of gender. Other, you know, lots of ways that they could help themselves. And you know, being a good GP is all about the assessing in a similar situation. I think I would encourage people not to just to say, okay, you say you’ve gotta gender issue. Let’s send you off to the gender clinic, but look at them in a, in a more rounded way and say, what’s distressing you? What’s making you unhappy? What is going on in your life? And trying to find out, you know, what will be a most appropriate help for them.

Embed Print Transcript

Seeking training

Parents we spoke to thought that health professionals needed more training in the area of trans healthcare, and especially GPs could benefit from more awareness and education on trans health and identities. Leigh highlighted training on trans health and issues that was available online for health professionals. She felt health professionals should do such training and pass their knowledge on to their colleagues. VM made a similar point when she said: ‘If you don’t understand then either find out where they can get the right help or start learning about it… Go on a course, go and do some more training. Send someone from the practice so the next time they know, you think to yourself right, I’m not equipped to deal with this but I know someone who can.’
Oonagh, who had a negative experience when she visited Accident & Emergency (A&E) with her child, felt all healthcare staff should be aware of trans health. Some parents also emphasised that it was not the patient’s responsibility to educate the health professionals.

Oonagh thought it was important to have diversity training on gender diversity for all health professionals.

View profile

If they come across trans kids as part of their job, so they work in A&E or in a different, in a different kind of clinic where, you know, any sort of NHS service then every single member of NHS staff needs to have an understanding about trans gender children, I would be hopeful that they would have that in place, diversity training and organisations coming into the workplace and explaining what it means to be trans or gender diverse and a willingness to understand what it means and to be able to implement the recommendations in their everyday practice.

Embed Print Transcript

Jan talked about the importance of understanding the difficulties young trans people face and educating yourself as a health professional.

View profile

What advice would you give to doctors and nurses working with trans youth?

I would advise them to understand the difficulties that they face and it’s, you know, it’s not just the difficulties in how theyre feeling, but it’s, you know, the situations that they face at school, in college, at university. They need to be educated and they need to take some responsibility for educating themselves for understanding and providing that care to their patients.

Embed Print Transcript

Making sure to also offer support to the families

Because trans and gender diverse people face prejudice and discrimination, having a trans or gender variant child can be challenging for parents and carers. It is important for healthcare professionals to be aware that families need support too.

Andrew thought health professionals should look beyond the medical issues and be more understanding of families with trans children.

View profile

Try and try and be a bit more understanding of the psychological and medical needs of trans kids and their families. When you go to a GP it’s very much, I find it’s very much the medical problem is, is all they want to see and talk about. But there’s so much more to do with, it’s a huge minefield, trans, transgender, having a transgender kid. it’s a big, it’s a challenging time for everyone.

Embed Print Transcript