Non-Binary Working Group - primary care sub-group minutes: 2 September 2021

Attendees and apologies

Group members

• Dr Ben Vincent, (Chair)
• Oceana Maund, Scottish Trans
• Vic Valentine, Scottish Trans
• Sarah Anderson, LGBT Youth Scotland 
• Megan Snedden, Stonewall Scotland
• Non-Binary Community members

Secretariat

• Catrina Steenberg, Equality and Inclusion Division, Scottish Government
• Laurie Donaldson, Equality and Inclusion Division , Scottish Government

Apologies

• Caitlin Byrne, Primary Care, Scottish Government

Items and actions

Note of key points and actions

Key discussion points

The group discussed:

CHI numbers

• difficulties created by CHI numbers when accessing treatment and potential solutions to this, e.g. adding a non-binary code or removing sex/gender element
• unintegrated NHS IT systems making non-binary addition to CHI numbers difficult
• how CHI numbers are used to call specific groups of patients for certain screenings and this can lead to issues for trans/non-binary people
• creating further guidance for GPs around referrals for non-surgical healthcare i.e. hair removal, voice therapy
• cost and capacity issues when implementing recommended changes

Training for healthcare practitioners

• notable difference between practitioners who had received training and had knowledge of non-binary people on how  non-binary people were treated
• lack of awareness about training opportunities available
• disparity between care given in urban and rural settings
• the self-referral service for speech and language therapy (SALT) that was available but not widely known amongst GPs and the non-binary community
• importance of GPs having a basic, general understanding of how to treat non-binary people so that non-binary people can trust and engage with GP
• the need for medical governing bodies to engage with trans and non-binary communities to review their access to healthcare

Review of GP surgeries and funding guidance

• funding for GPs to be able to refer or prescribe treatments currently expected from Gender Identity Clinics (GICs) e.g. for hair treatment, voice therapy. This would reduce waiting times
• reported concerns felt by some GPs around possibility of litigation and potential impact on treatment for trans and non-binary people. Identification of the need for reassurance that this is rare
• a primary care pilot taking place in England where GPs were carrying out work of the GICs
• engaging with sexual health officials about locally enhanced services
• unnecessary gendering and questioning patients’ non-binary identity
• beyond GPs, improvement to services needed to be embedded throughout primary care, including pharmacy, optometry, and dentistry

LGBTI Equality Team

September 2021