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#CareThroughout – Research on Trans access to Sexual Health Services published

At the start of October, Waverley Care published a joint report with the Scottish Trans Alliance, charting the experiences of trans people across Scotland accessing sexual health services. This ground-breaking, peer-led research is the first study of its kind in Scotland and makes wide-ranging recommendations to promote inclusive access to sexual health services.


Why was this research needed? 

There is lots of evidence telling us that trans and non-binary people experience poorer health outcomes linked to their sexual health.  

For example, we know that trans women are at higher risk of contracting HIV than the general population and that they are less likely to visit sexual health services than there cis counterparts. 

However, what we don’t know is why. This research was developed to begin to bridge that gap. 

What did we do? 

To make sure our research captured the views of trans people, we followed a peer-led approach, involving trans men and women in the design and delivery of the research. 

We carried out an online survey, involving 289 trans people, followed this up with a series of interviews and focus groups with trans participants, then finally interviewed a group of sexual health workers to find out about their experiences. 

What did we find? 

From the outset, the survey revealed examples of good practice, where people had supportive experiences in sexual health services. However, it also revealed several areas where there was room for improvement. These were explored through the interviews. 

The people we spoke to told us about barriers at various levels that impacted on the way they used services.  

At a personal level, fear was a huge factor, with people worried about feeling judged and discriminated against. Many of the people we spoke to told us that they often felt they had to educate staff about their circumstances, which put many off even trying to access support.   

Meanwhile, at a social level, peer support and accessible, relevant information were found to help alleviate these fears – but experiences across the country differed leaving many people feeling isolated from support. 

Trans people told us that there were positive steps that sexual health services could make to make them feel more inclusive, from physical changes to public waiting areas to training for staff to help them feel more confident of supporting trans people. 

Finally, we heard about broader policy and cultural barriers including transphobia, most visibly displayed in the ongoing debate around the Gender Recognition Act in Scotland and the UK. 

As part of the research, we also spoke to clinicians, who were broadly open in their acknowledgement that more could be done. The professionals we spoke to told us of a willingness to access specialist training, and the need for patient-led approaches that can build confidence in services. 

What have we recommended? 

The report makes a wide range of recommendations targeted at Government, NHS, sexual health and charity service providers. It also outlines steps that trans advocacy charities can look at to help strengthen their services. 

We are now working to share the findings with relevant partners and to discuss next steps to drive the work forward. You can read the full recommendations in the report. 

During a launch event, the findings of the report were broadly welcomed, and there was really interesting discussion of what comes next. The consensus was that the report can be part of the building blocks of delivering more trans inclusive services, but that it is just a beginning. It was also acknowledged that there is more we can do to reach under-represented groups, in particular, black and minority ethnic trans people, and older trans people

Where can I find out more? 

We’ve now published a full report, and a shorter summary of the key points, and these can be accessed from the links below: 


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