Demographic characteristics, long-term health conditions and healthcare experiences of 6333 trans and non-binary adults in England: nationally representative evidence from the 2021 GP Patient Survey

Catherine L Saunders; Alison Berner; Jenny Lund; Amy M Mason; Tash Oakes-Monger; Meg Roberts; Jack Smith; Robbie Duschinsky

doi:10.1136/bmjopen-2022-068099

Demographic characteristics, long-term health conditions and healthcare experiences of 6333 trans and non-binary adults in England: nationally representative evidence from the 2021 GP Patient Survey

BMJ Open. 2023 Feb 2;13(2):e068099. doi: 10.1136/bmjopen-2022-068099.

Authors

Catherine L Saunders¹, Alison Berner^{2

3}, Jenny Lund⁴, Amy M Mason⁵, Tash Oakes-Monger⁶, Meg Roberts⁷, Jack Smith⁸, Robbie Duschinsky⁴

Affiliations

¹ Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK ks659@medschl.cam.ac.uk.
² Barts Cancer Institute, Queen Mary University of London, London, UK.
³ Tavistock and Portman NHS Foundation Trust, London, UK.
⁴ Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
⁵ Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
⁶ NHS England, London, UK.
⁷ University of Cambridge, Cambridge, UK.
⁸ Lifestrong, Wolverhampton, UK.

Abstract

Objective: In order to address the lack of data on the health and healthcare needs of trans and non-binary adults, NHS England includes questions asking about both gender and trans status in its surveys to support quality improvement programmes.We used self-reported data from the GP Patient Survey to answer the research question: what are the demographic characteristics, health conditions and healthcare experiences of trans and non-binary adults in England?

Design/setting: Nationally representative, population-based cross-sectional survey in England with survey data collection from January to March 2021.

Participants: 840 691 survey respondents including 6333 trans and non-binary adults.

Outcomes: We calculated weighted descriptive statistics, and using logistic regression explored 15 long-term physical and mental health conditions, and 18 patient experience items, covering overall experience, access, communication and continuity.

Results: Trans and non-binary adults were younger, more likely to be from Asian, black, mixed or other ethnic groups and more likely to live in more deprived parts of the country. Age-specific patterns of long-term conditions were broadly similar among trans and non-binary adults compared with all other survey respondents, with some variation by condition. Overall, inequalities in long-term health conditions were largest for autism: OR (95% CI), 5.8 (5.0 to 6.6), dementia: 3.1 (2.5 to 3.9), learning disabilities: 2.8 (2.4 to 3.2) and mental health: 2.0 (1.9 to 2.2), with variation by age. In healthcare experience, disparities are much greater for interpersonal communication (OR for reporting a positive experience, range 0.4 to 0.7 across items) than access (OR range 0.8 to 1.2). Additionally, trans and non-binary adults report much higher preference for continuity 1.7 (1.6 to 1.8), with no evidence of any differences in being able to see or speak to a preferred general practitioner.

Conclusion: This research adds up to date evidence about population demographics, health and healthcare needs to support healthcare improvement for trans and non-binary adults.

Keywords: HEALTH SERVICES ADMINISTRATION & MANAGEMENT; PRIMARY CARE; Quality in health care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cross-Sectional Studies
Delivery of Health Care*
Ethnicity
Humans
Surveys and Questionnaires
Transsexualism*

Abstract

Publication types

MeSH terms

Grants and funding