Under 18s
Healthcare & Justice Report
This is one of three Community Engagement reports from the TRANSforming Futures partnership. Drawing on workshops and contributions from trans young people, the parents of trans children and trans community experts working with trans young people under the age of 18, this community consultation details trans young people’s experiences when accessing healthcare and justice systems, and highlights their proposed solutions to some of the problems they encounter.
Community consultation contributors defined healthcare as including general practice, gender identity services, mental health, hospitals, and any interactions with healthcare providers, as well as general social factors that play into well-being or ill health.
Community consultation contributors defined justice broadly to include their experiences of harassment at school, interactions with state agencies, legal challenges to trans inclusion, and vulnerability to violence.
This report is the starting point of a conversation. As well as exploring trans young people’s experiences of healthcare and justice, this project provided crucial time and space for trans communities to discuss the problems they face. Even more importantly, participants were asked to imagine their own solutions – large and small – to these problems. This in itself is an act of healing and reclaiming power.
These are not policy recommendations, and they do not represent the view of any one organisation or individual. We have foregrounded a range of suggestions from trans young people themselves to stimulate further discussion and future action. If you are inspired to take action based upon the ideas, we recommend looking at our collaboration page to find out how we can support you in taking action.
Accessibility
We also have a version of the report that is for people using screen readers, and those who find plain text reports easier to read.
Report Summary:
Issues in healthcare for trans young people aged under 18
Workshops consisted of trans young people aged under 18, and parents of trans young people aged under 11. They were asked about their experiences in healthcare systems, and what they felt the biggest issues for trans young people in England are. Their ideas were as wide-ranging as the perspectives and experiences of the group. The issues they identified included:
Attitudes of Healthcare Professionals
Trans young people encounter healthcare providers with a lack of knowledge about trans people’s healthcare needs, leading to compromised healthcare and invalidating interactions.
Inadequate and Pathologising Mental Health Services
Trans young people are rarely able to find trans-competent mental health support, and often face long wait times, untrained mental health providers, or explicit transphobia in mental health settings.
Navigating GIDS Referrals and Medical Transition Pathways:
Trans young people and their parents struggle to navigate GIDS referrals, a lack of shared care options, and a lack of trustworthy knowledge about how to find affirming healthcare options
Waiting lists
Trans young people are experiencing high levels of hopelessness and frustration, during a crucial period of their lives, because they are on years-long waiting lists for their necessary healthcare.
Medical Gatekeeping and Treatment through GIDS
Many trans young people and parents find the GIDS system traumatising and pathologising, and struggle with the medicalised gender assessment process required to access transition-related healthcare.
Ideas for improving healthcare systems for trans people aged under 18
After identifying problems that trans people aged under 18 experienced in healthcare systems, workshop participants were asked to generate ideas they thought would help alleviate these problems. Their ideas were as wide-ranging as the perspectives and experiences of the group. Ideas included:
Map the Medical Transition Process
Provide a comprehensive guide for young people and parents about how to navigate medical transition and find the best options for individuals.
Create Welcoming, Less Impersonal Spaces
Make healthcare spaces more welcoming to trans young people experiencing high anxiety when accessing healthcare.
Introduce Trans Youth Healthcare Advocates
Employ and standardise trans youth healthcare advocates to help young people and parents navigate appointments.
Remove Restrictions around Referrals and Blockers
Remove GIDS referral requirements and blocker restrictions at the beginning of medical transition processes, to eliminate the distress of time pressure around puberty and allow trans young people more time to make decisions while on blockers.
Provide Non-Assessment Mental Health Support
Establish trans-specific mental health supports that are not linked to pathologising assessment processes, and which can be accessed by any trans young person.
Provide Transition Care Through GPs
Allow primary care providers to prescribe blockers and hormones and provide long-term transition care in an accessible way.
Legal Challenges to Trans Healthcare
Young people are increasingly impacted by legal challenges to their healthcare on the NHS and the rise of legal anxieties surrounding private healthcare.
Ideas for improving justice institutions for trans people aged under 18
After identifying problems that trans people aged under 18 experienced in justice systems, workshop participants were asked to generate ideas they thought would help alleviate these problems. Their ideas were as wide-ranging as the perspectives and experiences of the group. Ideas included:
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Ideas for improving justice systems for trans people aged under 18
After identifying problems that trans people aged under 18 experienced in justice systems, workshop participants were asked to generate ideas they thought would help alleviate these problems. Their ideas were as wide-ranging as the perspectives and experiences of the group. Ideas included:
Report Summary:
Issues in justice systems for trans young people aged under 18
Workshops consisted of trans young people aged under 18, and parents of trans young people aged under 11. They were asked about their experiences in justice systems, and what they felt the biggest issues for trans young people in England are. Their ideas were as wide-ranging as the perspectives and experiences of the group. The issues they identified included:
Bullying and Inadequate Response to School Harassment
Trans young people experience high levels of harassment from fellow students and a lack of support from many education professionals.
Mistreatment by School Authority Figures
Many young people spend their school days with teachers who refuse to use their correct names and pronouns.
Bathrooms, Changing Rooms, Uniforms, and Sports
School experience is marked by gender segregation, leaving trans young people with inadequate and unsafe options when it comes to bathrooms, changing facilities, and participation more broadly.
Legal Challenges to Trans Inclusion
Schools and councils trying to introduce trans-affirming guidance are being challenged by anti-trans organisations, creating an atmosphere of anxiety around supporting trans young people.
Legal Gender and Census Monitoring
Trans young people struggle to navigate official name and gender marker changes, and express concern around the lack of legal non-binary gender recognition.
Establish Trans-Specific Young People’s Spaces
Create and expand services and spaces for trans young people to seek support, establish connections, and build resilience and confidence.
Enable Healthy Peer Support
Develop supports for trans young people with their friends and communities, and provide opportunities to learn about boundaries and healthy relationships.
Introduce Trans Youth Justice Advocates
Introduce and standardise justice advocates for trans young people, to support trans young people who have been mistreated.
Provide Trans Representation, History, and Culture
Connect trans young people to their communities and histories as sources of support.
Teach about Trans Experiences in Schools
Require education for both teachers and students about trans experience, to increase understanding and decrease instances of ignorance and harassment.
Establish Safer Spaces and LGBTQ+ Groups in Schools
Create safe and affirming spaces for trans young people in schools, especially those who cannot seek support from home.
Fund Trans Legal Defence and Policy Teams
Fund existing legal and policy initiatives, and create networks of knowledgeable professionals who can address trans young people’s legal concerns and make trans-informed policy recommendations.