Written evidence submitted by Royal College of Nursing (GRA1931)

 


 

The Royal College of Nursing (RCN) submission: Women and Equalities Committee Inquiry into the Gender Recognition Act reform.

 

1.Introduction

 

1.1   With a membership of around 450,00 registered nurses, midwives, health visitors, nursing students and nursing support workers and nurse cadets, the RCN is the largest trade union and professional body of nursing staff across the UK.

 

1.2   We look forward to the Committee’s recommendations about reforming the Gender Recognition Act as it has the potential to ensure that trans people and communities have equality of opportunity in completing realising their gender identity which should be as free as possible from unnecessary and inappropriately intrusive bureaucracy.

 

1.3   Nursing is highly-skilled profession that requires a broad range of clinical expertise and knowledge to provide person-centred and holistic care for all individuals and communities.  As a trade union and professional body, the RCN actively supports members to challenge transphobia in the workplace and within the scope of professional practice.

 

1.4   This submission focuses on the wider issues and provides information about the    difficulties faced by trans people in accessing health services.

2. Fair care for trans and non-binary people

 

2.1 The RCN has voiced its concern with about the quality of care experienced by trans and non-binary people. In 2010, the RCN voted at its annual congress, to lobby for consistent and equitable care for trans patients and service users.

 

2.2 The RCN’s published guidance entitled Fair Care for Trans and non-binary patients highlights the role that nursing can play in supporting individuals to live in their chosen gender identity and working to clearly affirm the preferred gender expression of trans and non-binary patients and service services.

 

2.3 The Fair Care for Trans and non-binary patients aims to support nursing staff to maintain strong patient-centred approaches that place the rights, preferences and voices of trans and non-binary staff at the heart of care and health policy-making.

 

2.4 Recent research has sought to understand the challenges faced by trans and non-binary people in accessing health and social care services. The research highlights a common message which is that trans and non-binary patients and service users feel that there remains a lack of understanding and awareness amongst many health care professionals in meeting their health and social care needs.

 

2.5 In the light of this research, it is important that there is full support for all nursing staff  on the part of employers and service providers in all care settings to access high-quality continuing professional development in this space and have access to a clearly-defined career structure if they choose to specialise in delivering care in this area.

Additionally, nursing students and other pre-registration health care professionals should be able to benefit from the teaching of skills and knowledge that equip them to provide holistic patient care for trans and non-binary people.

 

3. Removing structural barriers to equity

 

3.1  A number of factors have been identified as impacting on the health and well-being of trans and non-binary people including gaps in documenting evidence on the determinants and status of trans and non-binary people.

 

3.2 It is vital that the specific health care challenges of trans and non-binary people are better understood and that barriers to accessing health and social care services, including both social and legal drivers of ill-health are tackled more effectively, and that any underlying issues that generate and reproduce social exclusion in ways that undermine the full enjoyment of human rights are systematically identified and addressed.

 

4. Recommendations

 

4.1 The RCN expects that the Inquiry will identify the steps that will need to be taken by a wide range of organisations to swiftly improve the opportunities that trans people have to self-define their gender identity.

 

 

 

References

 

Blondeel K, Say L, Chou D, Toskin I, Khosla R, Scolaro E, et al (2016)  Evidence and knowledge gaps on the disease burden in sexual and gender minorities: a review of systematic reviews. Int J Equity Health. 2016. January 22;15:16. 10.1186/s12939-016-0304-1 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

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Delaney & McCann (2020) Phenomenological exploration of transgender people’s experiences of mental health services in Ireland. Journal of Nursing Management. https@//doi.org/10.1111/jonm.13115

 

Harrison et al (2020) Understanding the Lived Experiences of Transitioning Adults with Gender Dysphoria in the United Kingdom: An Interpretative Phenomenological Analysis. https://doi.org.10.1080/15538605.2020.1711292

 

HealthWatch (2020) Trans healthcare: What can we learn from people’s experiences? Blog 11/3/2020 https://www.healthwatch.co.uk/blog/2020-03-11/trans-healthcare-what-can-we-learn-people%E2%80%99s-experiences

 

Higgens et al (2019) Pedagogical principles and methods underpinning education of health and social care practitioners on experiences and needs of older LGBT+ people: Findings from a systematic review, Nurse Education in Practice https://10.1016/j.nepf.2019.`01625

 

Kneale & Bacares (2020) The mental health and experiences of discrimination of LGBTQ+ people during the COVID-19 pandemic: Initial findings from the Queerantine Study.  MedRXIVdoi: https://doi.org/10.1101/2020.08.03.20167403

 

Kneale et al (2019) Inequalities in older LGBT people’s health and care needs in the United Kingdom: a systematic scoping review. Ageing & Society (2019), 1–23 https://doi:10.1017/S0144686X19001326

McCann & Brown (2017) Discrimination and resilience and the needs of people who identify as Transgender: a narrative review of quantitative research studies. Journal of Clinical Nursing https://oi.org/10.1111/jocn.13913

RCN (2018) Fair care for trans patients: an RCN guide for nursing and healthcare professionals. London. RCN.

Thomas et al (2017) Ensuring an inclusive  global health agenda for transgender people. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5327942/pdf/BLT.16.183913.pdf

UNISON (2020) Reform of the Gender Recognition Act: A Factsheet. UNISON

 

Valentine (2016) Non binary peoples’ experiences in the UK. Scottish Trans Equality Network Final Report https://www.scottishtrans.org/wp-content/uploads/2016/11/Non-binary-report.pdf

Witcomb et al (2019) Experiences and Psychological Wellbeing Outcomes Associated with Bullying in Treatment-Seeking Transgender and Gender-Diverse Youth. LGBT Health Volume 6, Number 5, 2019 ª Mary Ann Liebert, Inc. https://doi:10.1089/lgbt.2018.0179

 

November 2020

 

 

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