To mark Transgender Day of Visibility, GP Dr Christine Mimnagh talks about the importance of transgender healthcare and education.
Transgender Day of Visibility is one of those days that should not really exist. Trans people should be unremarkable, accepted as a tiny minority of society, not quite as common as people with ginger hair (no offence Ed Sheeran). Given the number of articles about trans people since The transgender tipping point – a piece in Time magazine in 2014 that described the increased visibility of transgender people in popular culture – you would think that we were as common as dangerous dog attacks were in the late 1980s. Although we may well be a talking point in the media-hyped culture wars, the simple truth is we have always existed – and we always will exist.
I came out as transgender to the world only a few years ago, so in many ways I’ve been invisible most of my life. My gender issues have not been invisible to me; they have been there constantly, in my head, and every conversation I’ve ever had. Imagine talking to somebody and thinking ‘you seem to like me, but if you knew who I was, would you like me then?’
I’m not going to write the typical 500 words on ‘my story of transition’, so often told, and badly portrayed in the media. Instead, let’s talk about the visibility of transgender health in our clinical practice, and in our professional life.
Firstly, healthcare for transgender people exists, whether you believe in it or not, and is part of good healthcare just as much as sexual health, maternity care, public health – or indeed any medical condition.
Secondly, providing healthcare for transgender people is not a political issue. It is often used as a political issue by people who see it as a way of furthering their agendas, but in reality it's a practical healthcare topic that is woefully underrepresented in both undergraduate and postgraduate teaching.
Thirdly, transgender healthcare is not difficult. It's simply a question of following the platinum rule: ‘do unto others as they would have you do unto them’. In practice, this means that just because you have grown up with a particular set of pronouns, that does not mean that the person in front of you also has those pronouns. Eliciting your patient’s concerns and expectations, and understanding their identity and healthcare needs, is the cornerstone of good care.
This brings me on to how we make care of trans and non-binary people an available topic for undergraduate and postgraduate education. I’m not an educationalist; despite the qualification, I’m #justaGP looking for a world where colleagues declining care to trans and non-binary people is a thing of the past.
In a world where one in four trans people self-medicate and 50% will go private, partly forced by huge waiting times and a need to gain autonomy, it is essential that, regardless of their specialty, clinicians understand the basics of transgender healthcare.
Education is available for clinicians, ranging from the General Medical Council’s Ethics Hub to RCP certification. The rise of the NHS trans healthcare pilot sites will greatly reduce the distance – both temporal and physical – between you and your nearest source of support when caring for somebody with gender identity healthcare needs.
On this Transgender Day of Visibility, don't look for trans people. Look for trans education, and maybe we won't need this day in the future.