"Trans and gender diversity (TGD) & social isolation"

I raised my TGD concerns follow-up phone call, and was asked to submit the online form (which I will note provides an opportunity for this to fall through the gaps, as it relies on my capacity to follow through).

I was admitted for a gastroscopy (day procedure) recently.

1) I first want to highlight that staff were accommodating to barriers in terms of social isolation and my own fierce independence, although I was challenged by the idea that when the hospital *requires* someone to have a support person with them overnight, they do not always have the autonomy to refuse, and may be left in the power of the hospital to deny the procedure. I would like to know if there is a process in place to support/accommodate isolated residents who do not have family support.

2) on TGD inclusion: healthcare is a unique situation where the patient is often being talked about in front of themselves, both by name and gendered pronouns. Your systems do not seem to allow an opportunity for people to disclose trans or gender diversity, or preferred name. 'Sex' is the only field in the admission paperwork (something that is relevant in a medical context, and may be more complex than m/f for trans and gender-diverse people).

3) intersection with disability:

I have ptsd from childhood medical trauma that makes it very difficult for me to advocate for myself in the moment. As a result, a general expectation that I advocate for myself on the day or in person is challenging.

2 & 3) While I noted a preferred name on my admissions form, this was overlooked. The admitting nurse was quick to adapt to chosen name and highlight that with the rest of the team when I spoke up on the day, making a note under 'cultural needs' (or similar) and adding it to the front of my file folder. However, when I awkwardly raised that I use they/them pronouns, I felt that was brushed off as being unimportant (and in that moment I was unable to further advocate for myself), so I was constantly referred to as incorrect pronouns throughout.

Overall, my experience was positive. Staff were a friendly team, and seemed well coordinated, shifting patients effectively through an old building that doesn't seem quite designed for the theatre flow-though it gets - a happy compromise at being able to have the procedure done locally.

To improve on trans and gender-diverse inclusion, I believe it would be great to see promotion of training with staff, reinforcing that assumptions based on age and appearance can be wrong. I would also like to see pro-active rather than re-active inclusion - ways to identify that your services are safe and inclusive for lgbtqia+ people, including a contact person that people can access prior to or during admission (along with visible, easily accessible contact information), and ways to highlight specific needs that actually filters through to the treating care team, without depending on lgbtqia people to 'come out' over and over in order to have those needs met.