Agenda item - Trans Healthcare: Sussex Gender Service

30.1    This item was presented by Dr Kat Allen, Consultant Clinical Psychologist and Clinical Lead, Sussex Gender Service (SGS) Pilot, Sussex Partnership NHS Foundation Trust (SPFT); Dr Julia Rutherford, SPFT; and by Dr Andy Hodson, Deputy Chief Medical Officer, NHS Sussex.

30.2    Dr Allen outlined key aspects of the SGS to the committee:

·       The pilot period is for 2 years with the potential to extend for an additional year

·       The SGS was mobilised between March and August 2023

·       The SGS went live in September 2023, with services operating at full capacity by July 2024

·       SGS receives support from an existing gender service, the Nottingham Centre for Transgender Health

·       The SGS partners with The Clare Project to deliver extensive and ongoing community engagement

·       The SGS will see around 1300 service users across the life of the pilot

·       The SGS operates a 2-stage assessment process, with an initial appointment with a nurse, and a follow-up appointment with either a GP or a clinical psychologist as appropriate

·       259 stage 1 appointments and 220 stage 2 appointments were delivered in the first year of operation

·       The SGS was intended, in part, to help tackle the very long waiting lists for gender services. This has been successful, with average waits now down to around 3.5 years from 5 years plus when the SGS began.

30.3    Members asked a number of questions on issues including:

·       How people waiting for assessment could access hormone therapy

·       What will happen to the SGS when the lengthy waiting list has been successfully reduced

·       Where patients can access gender surgery

·       How the impacts of waiting a long time for assessment are supported and how the mental health of people waiting for assessment is monitored

·       Co-working with existing gender services to which people on the Sussex waiting list were originally assigned

·       Local GP support for trans people, including people on the waiting list

·       How the Nottingham gender service supports the SGS

·       How people on the SGS waiting list can access fertility preservation services

·       The process by which the pilot can be made permanent

·       The details of the SGS assessment process

·       The percentage of people on the waiting list who choose not to progress with gender reassignment

·       The number of people using the service and whether people move to Sussex in order to access services

·       The age at which hormones may be prescribed

·       The gender split in the younger cohort using the SGS

·       Prescription practices

·       The minimum age of referral to the SGS

·       Links between the SGS and children and young people services

·       What happens to people on the SGS waiting list who move out of Sussex

·       How GPs who take on a large number of trans patients are reimbursed

30.4    Dr Allen agreed to provide additional information on the gender split of SGS patients; the percentage of patients who choose not to progress; the details of the holistic assessment process; and demographic information on SGS patients.

30.5    Cllr Hill had a number of questions but was unable to ask them all as the presenters had to leave. She expressed disappointment at this but agreed that she would submit some questions in writing. Cllr Hill made some comments from a personal perspective as a trans person who uses local GP services, but who is not on the SGA waiting list. Cllr Hill noted:

·       That using fertility preservation services may require delaying hormone treatment. It is important that the SGS supports local GPs to understand this issue.

·       Some trans people manufacture their own hormones – it is important that services are alert to this and have a process for moving people to proper prescriptions

·       waiting lists remain a major concern – long waits can have major negative impacts on service users, including suicide

·       There is concern in the local trans community about unsupportive GPs and about the Integrated Care Board’s (ICB) decision to cease running the Trans Community Board, and it would be helpful to have information in public about this decision.

Dr Hodson replied that the ICB had suspended the Trans Community Board as it is currently reviewing how best to embed people with protected characteristics into governance processes. A report back is due at the end of February; Dr Hodson will check whether this can be made public.

30.6    RESOLVED – that the report be noted.