The BMA is committed to eliminating the disparities and injustices faced by trans and non-binary individuals in healthcare settings. Our policy position is centred around the need to advocate for equitable access to healthcare, create safe and inclusive workplaces for trans and non-binary people working in healthcare settings, and end discrimination related to gender identity. 

Key principles

• The BMA supports the rights of all trans and non-binary individuals to live their lives free from discrimination and persecution. Trans and non-binary individuals should be able to live with dignity, autonomy, and respect.
• We support the rights of trans and non-binary people to have equitable access to healthcare, including timely access to gender affirming care and being accommodated on wards in accordance with their gender identity.
• We support informed and considerate discussion by medical professionals to determine the most appropriate care for individual patients. This approach must be patient-centred, maintain patient privacy and confidentiality, and respect patients’ identities and pronouns.
• We are committed to ensuring that trans and non-binary doctors and medical students can train and work in inclusive environments, free from discrimination, bullying, and harassment.
• We support the inclusion of trans and non-binary people in all aspects of healthcare research and decision-making processes that affect them. In regard to gender affirming care, their perspectives and experiences should inform both research and the development of clinical guidelines, so that care is truly patient-centred, respectful, and evidence-based. 

What we are calling for

A comprehensive ban on conversion practices

The BMA holds a clear position that conversion practices should be banned, including for trans and non-binary individuals. These practices aim to forcefully change an individual's sexual orientation or understanding of their own gender; they are unethical, harmful, and offer no clinical benefit. Many conversion practices amount to torture or inhumane punishment under international law.

A fairer system for trans and non-binary people to gain legal recognition of their identity

The BMA advocates for improved processes for trans and non-binary people to gain legal recognition of their gender identity. At present, non-binary genders are not recognised in UK law. Legal reforms are therefore needed for non-binary and gender diverse people to gain legal recognition. While trans people can gain legal recognition, the current process for acquiring a

Gender Recognition Certificate (GRC) is onerous, overly medicalised, and expensive. The BMA position is that obtaining a GRC should not be a medicalised process. This is based on the recognition that trans and gender diverse identities are not conditions of mental ill-health. We have called for measures to allow trans and non-binary people to gain legal recognition by witnessed, sworn statement and without the need for a medical diagnosis. 

Resourcing for gender affirming care

The BMA calls for trans and non-binary people to have timely access to high quality and evidence-based care, including gender affirming care, in line with the NHS Constitution. Specialist gender identity services in England are severely under-resourced, leading to excessive waiting times and inconsistent access to care for trans and non-binary patients. Substantial investment in specialist services is required to meet demand, accompanied by national guidelines to reduce regional variation in service provision. There is also an urgent need for a clear, funded commissioning arrangement that supports primary care involvement and ensures equitable, timely access to gender affirming care at the local level.

Access to appropriate facilities and accommodation

The BMA calls on healthcare providers to ensure that all healthcare workers and patients have access to facilities and accommodation they feel comfortable using. This is essential for fostering an inclusive and respectful environment for everyone. Employers should ensure that trans and non-binary staff members have equitable access to facilities in accordance with their gender identity. Hospitals should ensure that trans and non-binary patients are accommodated on wards in accordance with their gender identity. We also call for greater resources for hospitals to guarantee the privacy, dignity, safety, and inclusion of all patients. 

Healthcare providers should also consider, where reasonably practicable, alternative or additional facility options for those who express genuine privacy or safety concerns, while ensuring these do not discriminate against trans and non-binary people. Providers should clearly communicate where individuals can find appropriate facilities, e.g. toilets and changing facilities. 

Improved education and training about trans and non-binary people’s health needs

The BMA advocates for changes to undergraduate and postgraduate medical curricula to ensure that trans health is fully integrated into both undergraduate and postgraduate training. We also call for more resources to enable doctors’ continuing professional development, so they are equipped to deliver evidence-based, inclusive, and appropriate healthcare to trans and non-binary patients. This includes fully funded training pathways for doctors who want to become gender specialists. 

Healthcare professionals with responsibility for managing patient data (e.g. reception and administrative staff) should receive training on patients’ rights according to the Gender Recognition Act 2004. The BMA also supports the development of guidance and training materials for senior leaders, managers, and medical educators to enable them to foster inclusive workplaces for trans and non-binary staff.

Action to address discrimination and ensure an inclusive working environment

The BMA calls for better data collection on the experiences of trans and non-binary medical professionals, improved reporting routes, and greater organisational accountability for addressing discrimination against trans and non-binary medical professionals. 

We also call on employers to uphold the rights of healthcare workers not to disclose their sex registered at birth. We understand that patients may sometimes request a clinician or chaperone of their own gender. These requests are usually justified for personal reasons and should be dealt with sensitively on a case-by-case basis. However, patients and employers do not have a right to know a healthcare worker’s sex registered at birth.

Action to update electronic health record systems and protect patient confidentiality

The BMA calls for an update to NHS IT systems to enable patients to more easily update their name and gender markers. This work should include consultation with patients and clinical experts in how to record sex and gender characteristics relevant to healthcare in a way that upholds patient privacy and safety, and that improves clinical care. 

It is imperative that any updates to NHS IT systems protect patient confidentiality. Medical professionals may need to request information from patients about the sex they were registered at birth, their organs, and any gender affirming care they have accessed, where it is clinically relevant. As per the Gender Recognition Act 2004, this information must be stored securely and only shared on a need-to-know basis and with patient consent.