Evidence map›Paper›PMID 34182985›Full record

ArticleBMC health services research2021

Accessing and utilising gender-affirming healthcare in England and Wales: trans and non-binary people's accounts of navigating gender identity clinics.

Talen Wright, Emily Jay Nicholls, Alison J Rodger, Fiona M Burns, Peter Weatherburn, Roger Pebody, Leanne McCabe, Aedan Wolton, Mitzy Gafos, T Charles Witzel

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In one paragraph

Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Transgender and gender diverse youths' experiences of healthcare: A systematic review of qualitative studies.Journal of child health care : for professionals working with children in the hospital and community · 2025
    Pooled it
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  14. Sexually transmitted infections · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Talen WrightDivision of Psychiatry, Faculty of Brain Sciences, University College London, London, UK. Talen.wright.20@ucl.ac.uk.
Emily Jay NichollsDepartment of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London , UK.
Alison J RodgerInstitute for Global Health, University College London, London, UK.
Fiona M BurnsInstitute for Global Health, University College London, London, UK.
Peter WeatherburnDepartment of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London , UK.
Roger PebodyNAM, London, UK.
Leanne McCabeMRC Clinical Trials Unit, University College London, London, UK.
Aedan Wolton, 56T, 56 Dean Street, London, UK.
Mitzy GafosDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
T Charles WitzelDepartment of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London , UK.

Funding

National Institute for Social Care and Health Research RP-PG-1212-20006
6 · The paper itself

Abstract

backgroundTransgender, or trans, people experience a number of barriers to accessing gender-affirming healthcare and have a range of barriers and facilitators to primary care and specialist services, commonly citing discrimination and cisgenderism playing a central role in shaping accessibility. The pathway through primary care to specialist services is a particularly precarious time for trans people, and misinformation and poorly applied protocols can have a detrimental impact on wellbeing.

methodWe recruited trans participants from an HIV Self-Testing Public Health Intervention (SELPHI) trial to interviews which explored contemporary gender-affirming service experiences, with an aim to examine the path from primary care services through to specialist gender services, in the UK.

resultsA narrative synthesis of vignettes and thematic analysis of in-depth qualitative interviews were conducted with twenty trans individuals. We summarise positive and negative accounts of care under three broad categories: Experiences with primary care physicians, referrals to gender identity clinics (GICs), and experiences at GICs.

conclusionsWe discuss implications of this research in terms of how to improve best practice for trans people attempting to access gender-affirming healthcare in the UK. Here we highlight the importance of GP's access to knowledge around pathways and protocols and clinical practice which treats trans patients holistically.

Indexed as

Transgender PersonsTranssexualismEnglandFemaleGender IdentityHealth Services AccessibilityHumansMaleQualitative ResearchWaleshealthcare experiencesMental healthQualitative researchTrans

Identifiers

PMID34182985
PMCPMC8240290

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.