Statement in Response to the news of the NHS Sussex Gender Identity Clinic Pilot
In Summer 2021 Sussex Partnership Foundation Trust (SPFT) funded The Clare Project to deliver a county-wide survey asking trans/TNBI people what they want from a Sussex GIC. 700 TNBI adults responded in just 6 days. The respondents demanded an innovative model of care that moved away from psychiatric-led models which further traumatise and pathologise our experience as people requiring gender-affirming care.
The £5 million contract has been awarded to Sussex Partnership Foundation Trust (SPFT), and the model provided is the same as other GICs up and down the country. We demanded something different, and SPFT are delivering a grossly outdated, harmful and dehumanising ‘(psychological) assessment and treatment’ model, that also furthers gatekeeping for TNBI people who are Autistic, ADHD, or otherwise neurodivergent.
In Summer 2022, following over a year of silence from SPFT, The Clare Project met with SPFT and demanded that the Trust ensure the pilot includes (and not appropriates) the relentless hard work of community-led and affirming practices in Sussex thus far (for example Clinic T, WellBN, Trans Health Hub). In addition, we insisted that the model being imposed on Sussex’s TNBI community be evaluated effectively and independently, in order to make apparent the desperate need for a fundamental national change to NHS guidelines relating to gender-affirming care. Neither of these actions has been delivered.
The model being provided by SPFT is not what the thousands of TNBI people living in Sussex and seeking gender-affirming care desperately need. This is a graphic, and explicit example of being tokenistically asked, only to be given something entirely different, ultimately harmful, and offensively outdated. The Clare Project will continue to advocate tirelessly for our communities’ desperate need for all-encompassing, intersectionality- inclusive, and affirmative healthcare provision in Sussex.
Background to Statement
Alongside other trans and non-binary organisations, activists and allies, The Clare Project has spent the last 22 years advocating for the rights of our community and our access to healthcare. Over the past four years, we have worked towards improving inclusion in all aspects of health, paying particular attention to gender-affirming healthcare. Obtainable solely in Gender Identity Clinics (GICs), this healthcare route currently generates a wait time of at least 5 years.
Our work has included the development of community resources, delivery of the Trans Health Hub, training delivery within Locally Commissioned Services (LCS), community advocacy, holding a seat at the NHS Sussex Trans Health Improvement Board, and much more.
The arrival of a Sussex GIC has been long-awaited, and although for many this may be framed as ‘positive news’ for those of our TNBI community seeking gender-affirming care, it is not what we asked for, and far from what the thousands of TNBI people living in Sussex desperately need.
In Summer 2021, The Clare Project was commissioned by Sussex Partnership Foundation Trust (SPFT) to run a survey of what the TNBI community wanted from a Sussex GIC, in order to inform their bid to NHS England for the £5 million contract to deliver the service. Within just 6 days of the digital survey running, 700 TNBI adults living in Sussex responded. This is the largest engagement of TNBI adults in any specific county ever achieved in the UK (and possibly beyond – a similar survey that ran for several weeks only reached 150 participants). As we have previously done for many years, our TNBI community stepped forward, tirelessly continuing to press our demands for what we need and deserve in gender-affirming care.
This community engagement piece held key findings and recommendations:
- The ‘(psychological) assessment and treatment’ model of GICs is grossly outdated, harmful to our community, and pathologises our experiences as TNBI people.
- People who are Autistic, have ADHD or are neurodivergent should not have to be forced through an ‘additional needs pathway’.
- A Sussex GIC needs to be community-led and informed wherever possible, with integration of our Community & Voluntary Sector (CVS), and be influenced by Sussex’s innovative delivery of care so far (as for example, in Clinic T, WellBN, Trans Health Hub).
- Any Sussex GIC pilot should work towards developing and delivering a service which takes both a person-centred and holistic approach, whilst demonstrating the need to move towards a model of care in which patients can opt for an ‘informed consent’ model of care.
Shortly after our delivery of the findings, SPFT disengaged with The Clare Project and other community stakeholders, and continued to bid for the contract. Neither we, the community or consultants involved in the project thus far, heard anything for over a year – despite our asking to share the results with survey participants/wider community members, and various other pieces of work crucial to our communities’ insight.
In early July 2022 (a year after the survey), another department in SPFT attempted to engage The Clare Project in the development of an outdated Trans Patients Inclusion Policy, to which we declined due to the aforementioned silence. They then proceeded to ask other LGBT and TNBI charities to take part (also unpaid) who also declined, before then approaching community members at Trans Pride Brighton, who (being aware of the other approaches) cancelled their stall at the event.
Representatives of The Clare Project met with SPFT and highlighted explicit concerns that the results of the survey, and engagement thus far, were being ignored. We also raised concerns regarding their lack of updated governance, including an offensive ‘Gender Reassignment Policy’ for staff, and their questionable reputation as the county’s mental health services provider for both adults and children. It also became evident during this meeting that The Clare Project and wider Community Voluntary Sector were named in SPFT’s bid – both in their model of care and community engagement strategy – for the NHS contract without our input, or even our consent.
The Clare Project continues to make our position very clear, that:
- we will not be involved in any healthcare provision, gender-affirming or otherwise, that by its approach dehumanises, pathologises, and traumatises our TNBI community.
- we will not allow the campaigning, innovation and hard work of our community and of allies before us, to be appropriated, tokenised, or used opportunistically in order to profit.
- we will not be silenced, and be forced passively to accept whatever we are given, because we are in desperate need to survive.
We commit to continued and tireless efforts to demand well-informed, all-round and all-encompassing healthcare for our TNBI community. Wherever possible, we want you to remain informed and involved.
Waiting to be seen?
If you are living in, or registered with a GP in Sussex, and waiting to be seen by any GIC, please fill in this very short contact collection, where you can also give your thoughts on the news of the Sussex GIC and receive information on community briefings/Q&As/updates.