Guide To Supporting Patients Accessing Specialist Gender Identity Services
After a minimum of two years and if certain key criteria are met, some trans people can apply for a Gender Recognition Certificate (GRC) under the Gender Recognition Act (GRA) 2004. If granted, the person acquires all the legal rights and responsibilities of their new gender and can get a new birth certificate.
Section 22 of the GRA states that it is an offence for a person who has acquired protected information in an official capacity to disclose the information to any other person. “Protected information” is defined in Section 22(2) as information relating to a person who has applied for a gender recognition certificate under the Act, and which concerns that application (or a subsequent application by them), or their gender prior to being granted a full GRC.
In simplified terms, Section 22 is a privacy measure. It prevents officials who discover in the course of their work that a person holds or has applied for a GRC from disclosing this (thus identifying that the person has a trans history), or the person’s previous gender. A breach of the Act is a criminal offence that can carry a fine of up to £5000.
However, there are exemptions from Section 22 for medical professionals. Section 5 of Statutory Instrument 2005 No.635 provides an exemption that applies to: registered medical practitioners, dentists, pharmaceutical chemists, nurses, paramedics, operating department practitioners and trainees in these professions. The following circumstances must apply:
- The disclosure is made to a health professional;
- The disclosure is made for medical purposes; and
- The person making the disclosure reasonably believes that the subject has given consent to the disclosure or cannot give such consent.
Section 5 therefore gives medical professionals an exemption from committing an offence if disclosing that a person holds/has applied for a GRC or their gender history. However, the exemption is limited to the circumstances above. It is essential that any person handling information about trans patients is aware of the provisions of Section 22 of the GRA 2004.
You can find sources of further information on the GRA 2004 in the table below.
About Patients Without a GRC
Patients should never be asked to produce a GRC to ‘prove’ their trans status. Trans people are not required to obtain a GRC: many simply choose not to while others may not (yet) meet the eligibility criteria. As a precautionary measure, it is good practice to apply the Section 5 criteria set out above to all disclosures of information about the trans status of a patient; it may not be accurately known whether the person has a GRC or not.
In addition, the general protocols on medical confidentiality and information governance apply to all patients whether they have a GRC or not. Good information governance around this is essential because unlawful and unwarranted disclosures of a person’s trans status leave GPs open to legal proceedings and can have serious and unforeseen consequences in ‘outing’ trans people.
Introduction Guide Home Page
Section 1.0 About This Guide
Section 1.1 Why This Guide Is Needed
Section 1.2 Current Context
Section 2.0 Developing Understanding About Trans People
Section 2.1 New Thinking About Gender
Section 2.2 About Trans Identities
Section 2.3 About Gender Pronouns
Section 3.0 High Quality Services for Trans People
Section 3.1 Getting It Right
Section 3.2 A Special Note on Children and Young People
Section 3.3 A Special Note on Screening: Screen for the Organs Present
Section 4.0 Understanding the Patient Groups
Section 4.1 Understanding Specialist Gender Identity Services
Section 4.2 The Approach to Treatment
Section 4.3 Treatment Protocols
Section 4.4 Available Treatments - Adults
Section 4.5 Available Treatments - Children and Young People
Section 4.6 The Role of the GP
Section 5.0 Changing NHS Records
Section 5.1 Information Sharing - The Gender Recognition Act 2004
Section 5.2 Medical Reports
Section 6.0 Supporting Patients
Section 6.1 Sources of Information and Support
Section 7.0 Glossary