Experiences of trans and non-binary people using GP services in Sheffield

Healthwatch Sheffield report on the Sheffield responses to the Healthwatch England survey on trans and non-binary people's experiences of GP services. 81 people responded.

Overall, the report finds that experiences of GP services vary widely, with more positive feedback about general healthcare but significant challenges in accessing gender-affirming care. Many participants reported that while some GPs were supportive and respectful, others lacked knowledge of trans healthcare or were dismissive of patient needs. As a result, patients often had to educate healthcare professionals themselves and seek out inclusive practices through word of mouth.

A major issue identified is the difficulty in accessing gender-affirming care through GPs. Problems included refusal to enter shared care agreements with gender identity clinics, reluctance to provide bridging hormone prescriptions, and long waiting times for specialist services. These barriers sometimes led individuals to seek unregulated “DIY” hormone treatments, which can pose health risks.

Participants also reported problems with referrals, including incorrect or incomplete referrals and poor communication between GPs and specialist services. Long waiting times for gender identity clinics, often exceeding five years, further exacerbated these difficulties and contributed to stress and worsening mental health.

In contrast, experiences of general GP care were more positive, although common issues such as difficulty getting appointments and long waits were still reported. However, confidence in using GP services as a trans or non-binary person was low, with only 10% of respondents feeling extremely confident. Negative past experiences led some people to avoid seeking care altogether.

The report highlights mixed experiences of being treated with respect by GP staff. Practice nurses were viewed most positively, followed by GPs, while reception staff received the lowest ratings. Misgendering and lack of understanding from staff were reported to have significant negative impacts on individuals’ mental health and trust in services.

The report also notes that 59% of respondents identified as neurodivergent, and this group reported particularly poor experiences of general care. Participants suggested that improving accessibility for neurodivergent people would benefit many trans patients.

Administrative systems were identified as another key area of concern. While most people who changed their name with their GP reported positive experiences, a minority still experienced incorrect name usage. Similarly, although many had shared their pronouns, only about half said staff always used them correctly.

Changing gender markers on NHS records was also problematic. Only around a quarter of respondents had successfully done so, with many unaware it was possible or deterred by perceived barriers. Non-binary participants highlighted the lack of appropriate options beyond “male” and “female.” For those who did change their gender marker, some experienced negative consequences such as loss of access to their medical record, disruption to prescriptions, and removal from relevant health screening programmes.

The report concludes that there is a need for improved awareness, training, and systems within GP services to better support trans and non-binary patients. It recommends sharing findings with local healthcare providers to encourage improvements in inclusivity, communication, and access to appropriate care across both primary care and wider health services.