consultation

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NHS Gender Identity Services consultation: it’s really important, and you can take part

 

For the past few months, NHS England have been running a consultation on Gender Identity Services for Adults (i.e. services typically provided through a Gender Identity Clinic, or GIC).

There’s still just over a week to respond: the consultation is open until Monday 16th October, and you can respond here.

Unfortunately, NHS England have not made the consultation process particularly clear. The documents are quite long and the whole thing can appear unnecessarily complex. So in this blog post, I explain what the consultation is about, why it matters, and how you can participate. I also outline some key issues within the consultation.

 

What is this all about?

NHS England have prepared two draft service specification documents: one for surgical services (including genital and chest surgeries), and one for non-surgical services (basically everything else, including assessment and diagnosis, hormones, counselling, voice therapy etc.

These draft documents are currently under consultation, with stakeholders (i.e. trans people, medical professionals and other interested parties) invited to comment on them.

 

Who is affected?

Basically everyone who is accessing (or intends to access) a GIC or surgery through the NHS in England, and every medical professional and NHS worker involved in delivering these services. This includes all patients based at England GICs. It will also indirectly affect patients in Wales who access treatment through Charing Cross, and patients across the whole of the UK who access surgical services in England. In time, Wales should get its own GIC, but this isn’t due to happen yet for some time.

 

What will this consultation do?

Following the consultation, the service specification documents will be used to commission services. That means: a GIC will need to meet the requirements of the service specification in order for NHS England to commission them.

If the GIC does not meet the requirements of the service specification, they may lose their right to provide services through the NHS.

So, in the future the service specification documents can (in theory) be used to hold GICs to account. If certain inappropriate or discriminatory practices at a GIC are seen to contravene the service specification, then they might effectively have their funding pulled.

There are a lot of clauses in the new service specification documents that would effectively ban a range of potentially harmful practices that currently exist in some GICs. For example, some GICs require that patients undergo unnecessary genital examinations prior to hormone therapy, while others insist that family members attend assessment meetings in order to corroborate patients’ accounts of gender dysphoria. Both of these practices are explicitly prohibited in the draft guidelines.

At the same time, there are some really questionable elements that remain in the service specification, such as the requirement for GIC patients to be registered with a GP. This can discriminate against people of no fixed abode, such as asylum seekers, homeless people, Travellers and many sex workers.

In responding to the consultation, you get a say on what the new guidelines should look like – the bits you think are good, and the bits you think need re-thinking.

 

What will this consultation not do?

An issue I have with this consultation is that it doesn’t address the fundamental power imbalance that currently exists between GIC gatekeepers and trans patients.

The consultation also doesn’t directly address the commissioning of new services; instead, it focuses on existing services. So, interventions that aren’t already currently funded as standard by NHS England (such as breast augmentation and facial feminisation surgeries) are not included.

These are things you may wish to comment on in your response (I have done so). However, you should bear in mind that this consultation is primarily about improving existing practice, rather than undertaking fundamental reform. So, by responding you should definitely be able to help improve people’s lives in the short term, but we also need to continue being proactive with trans health activism in order to bring about bigger changes in the long term.


But wait, haven’t we been here before?

Yes. NHS England previously consulted on draft commissioning documents in 2013 and 2015. On both occasions, a considerable number of trans stakeholders indicated that the documents weren’t fit for purpose: they were too strict, too binary, and pathologised trans people too much. Each time, NHS England went back to the drawing board.

I studied these documents for my PhD. One of the really interesting things about them, is that each time they’re revised and come back to consultation, they’re more progressive, reflecting interventions from trans health advocates. For example, non-binary and genderqueer identities and experiences were barely mentioned in the 2013 document. There was some level of inclusion in 2015, and then the current non-surgical specification makes a real effort to avoid binary language altogether.

From the lessons I’ve learned in my work, I also think that this time around, the service specification will be implemented. This is a bigger and more wide-ranging consultation from before, and at events NHS England representatives have given a strong indication that they’re very keen to re-commission services during 2017-18. So, this is our major chance to bring about change in some areas.

 

Okay, so how do I take part?

There are three documents to read. There are the two service specification documents:

Surgical specification.

Non-surgical specification.

There is also a third document: the consultation guide. This one’s a bit of a mess.

The consultation guide provides information on the background to the consultation (pages 5-8), and includes some questions for respondents to consider (pages 9-12).

Four options are outlines for how hormone prescriptions might be managed in the future (pages 13-20).

Finally, there’s an equality impact assessment, which summarises the impact (both positive and negative) that NHS England thinks the document will have upon particular marginalised groups, including older and younger trans people, disabled trans people, trans people of different genders and sexualities, married trans people, trans people of colour, and trans people of faith (pages 21-32).

Once you’ve read the documents, you can email your thoughts about what you think is good and what needs changing to NHS England: england.scengagement@nhs.net.

You can also take part in an online survey: https://www.engage.england.nhs.uk/survey/gender-identity-services-for-adults/consultation/.

The survey refers to the three main consultation documents at various points, so have these handy when you take it.

Altogether, reading the documents and responding to the survey took me about four hours. If that feels like a really long time, bear in mind that you don’t have to respond to everything in the documents in order to take part in the consultation. You can choose to respond just to particular key issues (see below for two examples), or do it a bit at a time.

In particular, it’s worth bearing in mind that the online survey allows you to save your response and come back to it later.


Key issues

Since this is such a big consultation, there’s a lot to talk about. I’m trying to keep this post relatively concise, so I can’t cover it all (although I do link to some further reading at the end if you want look into this further).

So, here’s a couple of things that I feel are particularly worth focusing on.

  1. Prescribing arrangementsUnder the current system, patients are referred by their GP to a GIC. At the GIC they are assessed for gender dysphoria. Upon receiving a diagnosis, the GIC instructs the patient’s GP to prescribe hormones, if this is something the patient wants.The consultation proposes that this approach potentially be changed. It offers four options for different systems, which are outlined in the consultation guide, on pages 13-20. Option A is the status quo, as described above.

    Options B and C offer variations on this: in Option B, the GIC provides the first prescription and then the GP provides prescriptions thereafter. This would mean that patients can pick up their first prescription pretty much immediately. Option C requires prescriptions to be provided by the GIC for the first year. This would mean that patients would approach the GIC for a repeat prescription during this time.

    Option D proposes a major change: the appointment of a local specialist by each Clinical Commissioning Group, which means (in theory) there is a GP specialising in trans hormones in each local area. It is not entirely clear whether or not these GPs would continue to rely on GICs for assessments, nor if other GPs will be able to prescribe hormones still as they do at present.

    Option D is the most interesting option here in part because it offers the most radical change. There are some serious potential benefits and drawbacks. For example, this approach might lead to a decentralisation of care, whereby patients might access hormones (and potentially other services) from a specialist GP working in collaboration with an endocrinologist. On the other hand, it might lead to less GPs providing basic services as they do at present, which might be a problem particularly in rural areas.

    Ultimately, none of these options are perfect. Personally, I feel some combination of A and D could be beneficial: but I recommend reading through the options yourself and having a think.

  2. Referral to GICs
    At present, English patients are generally referred to GICs by their GP, although they can also be referred by a local mental health provider. This contrasts with Wales, where at present patients are referred first to a local mental health provider who then refers on to the GIC, and Scotland, where some providers accept self-referral.The draft service specification for non-surgical services currently insists that all patients be registered with a GP, who provides the referral to a GIC. The rationale for this is that – under the existing system – patients require a co-operative GP in order to provide hormone prescriptions.However, not all NHS patients are registered with a GP. This is acknowledged in the equality impact assessment included in the consultation guide, which states that people of no fixed abode might not have access to gender identity services as a result. Moreover, trans patients sometimes have to search for a long time for a GP who will provide them with a referral.

    I propose that NHS England follow the existing NHS Scotland guidelines in allowing for self-referral. This means that patients have the opportunity to find a supportive GP while they are on a waiting list and/or undergoing assessment. Moreover, it would be beneficial if some arrangement can be made to support patients who are still without a GP following diagnosis (perhaps some variant on Option C for hormone prescriptions).

 

Further reading

The above two issues are by no means the only pressing matters in the consultation: just two that I feel are particularly important. You may feel otherwise!

For more information, thoughts, reflections and ideas for responding to the consultation, here is a range of further reading.

My response to the consultation (Twitter thread)

My summary of a consultation event in Leeds (Twitter thread)

Response from UK Trans Info

Response from the National LGB&T Partnership

Thoughts from Michael Toze (general)

Response from Michael Toze (hysterectomies)

Response from Edinburgh Action for Trans Health (Trans Health Manifesto)

 

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“Living as a woman” – MPs take on the Real Life Test

I’m currently writing up a section of my thesis that describes trans people’s experiences of navigating the public health system in the UK. A large part of this is related to the “real life test”, a stage of treatment which patients are required to live for a period of time in their “acquired gender” in order to demonstrate that they are suitable candidates for hormone therapy and/or surgery.

This requirement (which, incidentally was absent from the latest version of the international World Professional Association for Transgender Health Standards of Care) has a lot of issues. These include the prioritisation of cisnormative standards, little-to-no recognition of non-binary identities, white-centric cultural insensitivity, and the frequent demand that patients hold down “an occupation” as part of the test (particularly pernicious in a time of high unemployment).

It was therefore very interesting to see MPs questioning the idea of the real life test during the fourth and final session of the UK Parliament Women & Equalities Committee’s inquiry into transgender equality earlier this week. The conversation, in which MPs quizzed Ministers and NHS England representative Will Huxter, went as follows:

Jess Phillips MP:
“I think I’d like to go back again to this idea of living in one gender identity: I wonder if you can tell me – clinically – what ‘living like a woman’ – or alternatively, man – actually means?”

Will Huxter:
“I’m not a clinician I can’t tell you what that’s – ”

Jess Phillips MP:
“Do you think that there is a clinical way to live as a woman? Or a man?”

Will Huxter:
“The point I am making is that we are guided by specialists who work in this area, the clinical consensus among gender identity specialists about how services should operate. We are absolutely open to looking at how that might change, but I’m not in a position to make a change to the way in which those services are commissioned without having gone through a clinical process”.

Maria Miller MP:
“Mr Huxter, sorry, I think we’re going to have to press you on that. Is – this is just factual, we have read that people have to ‘live like a woman’ or ‘live like a man’, we as a committee have struggled to know what that looks like in a day and age where men and women live in very similar ways. What do you – factually – what does that mean?”

Will Huxter:
“Well in terms of what is required by the clinic I’d be very happy to provide some details from clinical colleagues after this because it’s not – I don’t deliver the services nor am I a clinician. I feel I could give a better representation to the committee if I provided that outside.”

Maria Miller MP:
“Is the Minister comfortable with the fact that the government requires this information to be available, or that individuals have to live ‘like a man’ or ‘live like a woman’ in order to be able to change their identity?”

Jane Ellison MP:
“Well, I mean, put as you put it to us, I mean obviously you know it gives cause for concern in a sense that, you know, who wouldn’t have sympathy for someone put in that situation etc , clearly the committee has heard I know some really difficult evidence and I quite understand why you wish to reflect that. I mean I think that as Will has said you know there is actually currently a review going on anyway about this very issue, which is essentially about looking at the current guidelines, about understanding that represents current better practice, about giving some challenge to that. There are a number of – compared to even five years ago – there wasn’t a mechanism for the NHS to receive that sort of, you know, feedback from critical friends or otherwise. Those now exist, the transgender network has been set up, the various stakeholder groups that are, you know, really locked into the process. So I think what I’m saying is I don’t think there is ever, you know, clinical understanding of situations is rarely completely frozen in time, I mean this one particularly isn’t, because for a lot of people this is a very new speciality, and therefore I would imagine over the next ten years for example, the next few years, you will see an evolution. And that process is underway, which is exactly why the NHS is consulting and is looking at, particularly at its clinical, you know, specification. That process is actually going on at the moment and, as Will has said, very open to the committee’s recommendations being fed into that. But I know I’m not a clinician too, and I know from other areas of my portfolio perhaps better than this one because I’ve been doing it longer, I do know that you do need to test. Because once you commission to a standard, once you’ve got that, you know you do, you need to make sure you’ve tested your views, and that you actually capture a clinical consensus, because that’s the only way you can move forward. But that consensus will evolve.”

Jess Phillips MP:
“Okay, I just – from the Minister – just, I suppose, what I’m looking to hear, is that you recognise that there is not a single list of attributes that represents what it is to be a woman and/or a man; and therefore, there cannot be a clinical list of things that a person can be told to do by a doctor in order to tick those boxes. Do you recognise that fact?”

Jane Ellison MP:
“Well I understand what you’re saying and I think that it would be very helpful if we – subsequent to this hearing – write to the committee with some – with an example from a clinician operating in the field as to what they would mean by that, because obviously you know people are sitting down with individual people and saying, you know, requiring them to do that and they must have an idea of what that requirement is, what that looks like. So I think we should ask the question of clinicians and supply the committee with some, perhaps some examples, obviously anonymised, of where that’s already happening in clinical practice, and what that looks like.”

You can watch the footage here.

women and equalities

All of this is relevant to the law – in addition to clinical practice – because of the current functioning of the Gender Recognition Act. In order to gain “full” legal recognition as female or male (non-binary options aren’t available) people who have transitioned are required to apply for a Gender Recognition Certificate (GRC). In addition to £140, a whole load of paperwork and scrutiny from the national Gender Recognition Panel (no, really), individuals wishing to acquire a GRC need clinical approval. It’s no wonder that many trans people simply refuse to play along, leading to consequences such as the Tara Hudson case.

As it turns out, there is an answer to be found in the clinical literature. Charing Cross GIC clinical lead James Barrett has the following to say on the subject of the real life test in his book, Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management:

“The question immediately arises of what constitutes ‘success’ in a chosen gender role. In essence, ‘success’ amounts to occupation, sexual, relationship and psychological stability. Of these, the first can be measured by whether or not the patient can manage to hold down a full-time (or equivalent part-time occupation in the chosen role for a year, in the course of the real life experience […] ‘Success’ in an occupation is achieved if the patient is treated by most others as if they are of the assumed sex. It is not necessarily that those around the patient believe that they are that sex […] Rather than being believed to be the assumed sex, the goal should be taken as an treated as that sex.”

[…]

“Some patients fiercely maintain that they do not care what others think of them, and that their own conviction of their gender is what matters. This position is at odds with the philosophy of a real life experience and if followed seems not to be predictive of a good longer-term outcome.”

Barrett further qualifies that “success cannot occur within a “purely transvestite or transsexual environment”, because “others may be supranormally accepting”.

So there you have it: “living as a woman” or “living as a man” means being taken as such within a cis environment. A very postmodern basis for clinical excellence!

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Imagining a trans-inclusive Stonewall

“The meeting actually went pretty well, didn’t it?”

I heard a number of variations upon this statement echo around the pub we gathered in yesterday evening, as some 40-odd trans activists digested the day’s work. There was an undertone of incredulity: most of us had managed our expectations carefully in advance of the day. This was due in part to the fractious nature of trans communities, but also stemmed from our difficult history with Stonewall.

Back in 2008, many of us had been present at a loud, colourful demonstration outside the Victoria and Albert Museum as it hosted the annual Stonewall awards. We were there to express our displeasure at an organisation that didn’t simply exclude trans people, but seemed to keep making mistakes that caused harm to us.

A lot can happen in six years. Change has come from two directions: from continued external pressure from trans people, but also from a genuine willingness to reconsider matters from Stonewall following a shift in management in February.

In this post, I outline the themes and outcomes of a meeting held on Saturday to discuss potential options for trans inclusion in Stonewall. I will repeat some of the points made by CN Lester and Zoe O’Connell in their accounts of the day, but recommend you also have a look at what they have to say. For an idea of what is at stake, I recommend posts by Natacha Kennedy and Kat Gupta, as well as my previous writing on the topic.


A meeting with trans activists

The meeting – held in central London – was attended by a large number of trans activists who had been directly invited to the event, as well as three cis attendees: new Stonewall CEO Ruth Hunt, Jan Gooding who is Chair of trustees for the group, and a facilitator (who, incidentally, did a very good job).

A number of us felt that a more open meeting or more transparent means of securing invitation would have been beneficial. I’ve made my own views about this clear (particularly on social media) but in this post I will focus upon what we actually achieved, and what will happen next.

The event was in some ways quite diverse, and in others ways very limited in terms of representation. There were a wide variety of experiences represented, and views from across the political spectrum. There were a great range of gender identities represented, although a particularly large part of the group were trans women. There were attendees from across England and Wales, with James Morton from the Scottish Transgender Alliance present to talk about the situation in Scotland (where Stonewall is an LGBT organisation). The group was overwhelmingly white. There were a number of disabled people present, but not many with experiences of physical impairment.

Several commentators have stated that Stonewall were responsible for the make-up of the meeting, and therefore could have made more effort in terms of inviting a diverse range of participants. This is true, but I feel that trans activists also need to step up and take some responsibility here. Most of our loudest voices are white trans women like myself. We need to keep our own house in order: by reaching out to communities of trans people from under-represented groups, by “boosting the signal” and talking about the work of trans people from under-represented groups, and by ensuring that it’s not just us with places at the table.

It’s worth noting that this event was framed by Ruth as one part of a far wider consultation on Stonewall’s future engagement with trans issues. If you’re trans please ensure that your voice is heard in this. You can do so by writing to Stonewall here, or by emailing: trans@stonewall.org.uk. There will be more about the next steps of consultation later in this post.

The meeting ultimately had two purposes: to move on from the problems of the past, and examine potential options for future collaboration between Stonewall and trans communities.


An apology from Ruth Hunt

The day began with a refreshingly honest admission of fault on the part of Stonewall from Ruth. She offered a point-by-point account of how Stonewall has let trans people down over the past few years, and offered both apology and explanation for these incidents, as well as an account of how these are now being addressed.

This was not the main focus of the day, instead clearing the air from the start to enable a productive discussion. However, I feel it is important to provide a public record of this session: if we are to collectively move on from the past, then we need to remember that Stonewall has demonstrated a commitment to change.

Some of the issues discussed by Ruth included:

  • Nominating transphobic individuals for awards. This was acknowledged as a mistake, and we were assured that nominees are now scrutinised more carefully (not just for transphobia).
  • Insensitive use of language in Fit, Stonewall’s video resource for schools. Ruth explained that the inappropriate section has been removed from the DVD.
  • Stonewall’s campaign with Paddy Power, who were severely rebuked by Advertising Standards Authority for a transphobic advert in 2012. Ruth noted that Stonewall is now using its relationship with Paddy Power feed back on advertising they consider to be offensive (interventions which are not just limited to addressing homophobia) which has resulted in a number of changes being made.
  • Stonewall representatives speaking out inappropriately and/or not speaking out on trans issues whilst lobbying Government and MPs. There’s a long and complex history here that I’m not going into in this post: suffice to say that one aim of Saturday’s meeting was to ensure that this is done better in the future.

There was also significant evidence that Stonewall is undergoing major institutional change in regards to trans issues. I was pleasantly surprised to hear that Ruth had emphasised seeking a solution to the organisation’s difficult relationship with trans people when applying for the position of CEO, and that this was viewed favourably by trustees who considered her job application. Trans employees of Stonewall are reportedly more likely to be “out” and feel comfortable speaking about trans issues and concerns.


What’s on the table?

We then moved onto the main point of the event: to discuss proposals for a new relationship between Stonewall and trans people. There were four options for us to consider in group conversations, with attendees also encouraged to suggest any additional solutions that might not have been considered.

The options were:

  1. A fully inclusive LGBT Stonewall, which considers campaigning on trans issues to be a full part of its remit.
  2. Stonewall becomes nominally LGBT, but also funds and provides resources and guidance for the creation of a new, effectively autonomous trans organisation to work on trans campaigns. This organisation will eventually become independent, but can work closely with Stonewall.
  3. Stonewall remains LGB, and provides grants for a number of trans organisations so they can do their own campaigning work.
  4. Stonewall remains LGB, and works to be better ally.

Ruth explained that option (4) was not really favoured by Stonewall, particularly given the appetite for a closer relationship amongst many trans activists. The general feeling of the room reflected this, and we focussed our discussion upon the first three options.

Option (3) was largely rejected also. Criticisms raised included concerns about who would get the money, the impact of competition between smaller trans organisations, about what the conditions might be for such grants, and the amount of money and energy that would be spent by both Stonewall and trans groups on managing the system and applying for grants – money and energy that could be better spent on actual campaigning. Ruth further pointed out that Stonewall doesn’t actually have a lot of money to spare, outlining how money is currently spent on Stonewall’s employees and existing campaigns.  If the grant scheme was to go ahead, then there would likely be a knock-on effect on (for instance) campaigning in schools, and Stonewall might need to apply for extra money from funding pots that are already used by trans groups.

Options (1) and (2) both had great deal of support from within the room. Several groups suggested variations upon an “option 1.5” that sat between the two – proposals included the creation of a “trans department” within Stonewall, and semi-autonomous “sibling” organisation linked permanently to Stonewall.


Outcomes

There was a pretty clear consensus on the following points at the end of the day:

  • Barring the unexpected (e.g. widespread opposition from trans people contributing to the public consultation) Stonewall will become an LGBT organisation, in one form or another.
  • Any eventual solution should provide for joint ‘LGBT’ campaigning on shared issues, such as homophobia and transphobia in schools.
  • Any eventual solution should provide for campaigning on trans-specific issues, such as on relevant legislation (e.g. the Gender Recognition Act and amendments to the recent Marriage Act) and on addressing issues with health care.
  • Future campaigning work must be intersectional, recognising the diversity of trans experience in areas such as gender identity, race, disability and age.

 

What happens next?

  • The public consultation will continue for several months. If you’re trans, please make sure your voice is heard!
  • There will be further meetings held with people from under-represented groups. This is a vital opportunity to address the problem of diversity at Saturday’s meeting. Stonewall are planning meetings with people from a number of groups, including intersex people as well as trans people of colour, disabled trans people and young trans people. If you want to attend one of these meetings, please contact Stonewall: trans@stonewall.org.uk
  • There will be a formal proposal for trans inclusion in Stonewall made in January 2015 in the shape of a report. This will then be consulted upon internally (i.e. within Stonewall) and externally (i.e. amongst trans people).
  • A final decision on the future of Stonewall should be made in April 2015. If this involves full trans inclusion and/or the creation of a new trans group, this will take several months to implement.

It’s important to note that this is not a process that can take place overnight! The process of consultation is lengthy in order to take on board the views of as many trans people as possible. We have such a range of perspectives that there is no chance that everyone will be happy, but the aim is for change to be trans-led, and to reflect the desires and interests of as many people as possible.

Once the consultation ends, its results cannot be implement immediately either. Stonewall may need to revise its priorities and work plans, and Ruth noted that a full-scale programme of training on trans issues and awareness will be necessary for the organisation’s staff.


Personal reflections

I feel positive about the future. There is so much unnecessary suffering amongst the trans population that allies are vital, and Stonewall could be a particularly large and powerful ally.

I believe in diversity of tactics to bring about change, and Stonewall takes a particularly centrist, “insider” approach to this. It is vitally important that Stonewall is never the only voice in LGBT activism, and that other groups continue to take more radical approaches to trans campaigning. It is also important that we remain capable of critiquing Stonewall, and holding it to account. Ultimately though, I’d rather be a critical friend than an entrenched foe.

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Have your say on England’s “gender dysphoria services”

Following hot on the heels of the new Scottish protocol for transition-related services, the Department of Health has published a draft guide for England.

They’re not holding a formal consultation on the document (meaning that it’s not available on the Department of Health website), but are “seeking the views of stakeholders […] to find out if the ‘journey’ outlined in the document reflects the experience transgender people actually have and, where there are differences, what they are.”

This is a really important opportunity for you to offer feedback on the proposed guide to English services.

A copy of the document is available below:

Gender Dysphoria Services – An English Protocol

When you’ve read the document, you can share your views through the following link:

Survey

I’m planning to post my own analysis of the draft protocol when I’ve had time to read through it properly.

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Government Equality Office to consult trans youth: Thursday 28 July

Boosting the signal on this one. It’d be great to see a load of outspoken young trans people at this event – if you don’t represent an organisation, it’s probably worth giving it a shot anyway!

Dear friends and colleagues,

The Government Equalities Office would like to invite you to a trans youth workshop we are holding on Thursday 28 July at the Home Office, 17.30-19.30.

The Government published Working for Lesbian, Gay, Bisexual and Transgender Equality: Moving Forward on 14 March 2011.  This document included a commitment to publish the first ever Government transgender equality action plan by the end of 2011. The action plan will outline commitments that the Government will deliver within specific timescales, to improve equality for trans people, including young trans people.

To shape the development of this action plan we will continue to talk to the widest range of people, including groups or individuals we have not spoken to substantially in the past.  This includes young trans people.  The workshop will be a fantastic opportunity for trans people aged 14-30 to tell us directly what has gone well, what are the specific challenges they face and how we may be able to address them, whether it’s at college, university or when starting a career.

The meeting will be held at the Home Office, 2 Marsham Street, London SW1P 4DF.  A map can be found here.  A detailed agenda will be sent closer to the workshop.

Reasonable travel costs (standard rail fares) will be reimbursed. This is train fare only – other expenses or non-standard rail fare must be agreed in advance.

Can you please confirm to me by Friday 15 July whether you or, if applicable, another representative of your organisation will be able to attend? Please note places are limited so we are accepting responses on a first come, first serve basis.  Because of security reasons, you will not be able to attend unless you have confirmed attendance with us first.  

Please note that the usual procedure to enter Home Office buildings is to bring photo ID.  If you have photo ID we would be grateful if you could bring it with you.  However if you are unable to produce photo ID please let us know in advance and we will make sure you can enter the building.  Please let us know if you have any disability needs.

I look forward to seeing you at the workshop.

Regards

Anne-Yael Halevi

Government Equalities Office

Anne-Yael.Halevi@geo.gsi.gov.uk

Want to get involved?  Please check our second transgender e-bulletin here.