Improving health and social care for trans and non-binary people

I started working for Bristol Dementia Wellbeing Service in 2021 following early retirement. I had left a career in teaching to care for my parents – both from ethnic minority communities and living with dementia.

I saw first-hand the challenges faced by people from marginalised communities to be heard and have a voice when it comes to health and social care. After my parents died, I felt compelled to make a difference.

Bristol Dementia Wellbeing Service is a partnership between Alzheimer’s Society and Devon Partnership NHS Trust.

We want people from all communities in Bristol get the best dementia support and to know we’re here for them.

Reaching out to the LGBTQ+ (lesbian, gay, bi, trans, queer plus) community is a focus for me in my role.

Work had previously started on guidance for professionals that would help to improve the experience of trans and non-binary people when they need to access health or social care.

Professionals may be supporting someone who’s trans or non-binary, and improving their awareness and understanding will help them to do this.

Seeing this through to completion was a priority for everyone involved.

What was the need?

We knew there was a real need for this guidance. As one community member told researchers, ‘What prevents me from accessing services is not knowing how staff members will react, and how much knowledge about trans issues they will have.’

There are also many challenges that particularly affect trans people living with dementia.

Those who have transitioned, or are in the process of doing so, might not remember that they’ve begun or been through this process. If they have a partner or friend who’s transitioning, they may also forget this.

If a trans person who usually takes hormones forgets to, or suddenly stops taking them, they could develop health problems. It’s important for those supporting the person to be aware of any treatments.

As dementia progresses, the person is more likely to remember older memories than more recent ones.

Their experience might be that they’re living in an earlier time of their life, and for a trans person this could be before they felt any sense of acceptance or belonging, or before they came out to anyone.

The more knowledge and understanding that health professionals have, the more likely that trans and non-binary people 
will be able to get vital support and care whenever they need it.

Hope for the future

To create this guidance, Bristol Dementia Wellbeing Service worked alongside specialist agencies and local advocates, all coordinated by another local charity. Importantly, members of the trans and non-binary community were included in this.

When we launched the guidance last year, it was fabulous to see the response.

One trans man told us it had given him the confidence to trust his GP – a vital starting point for anyone with concerns about dementia.

I hope this guidance will mean that trans and non-binary people in Bristol – including those affected by dementia – feel more confident about getting support from professionals.

I also hope that professionals in other areas can do the same for trans and non-binary communities everywhere.