I am a statistician working in the Primary Care Unit at the University of Cambridge. I work on health services and policy research and evaluation projects using quantitative methods, and routine healthcare data; currently evaluating the health and wellbeing impact of the construction of phase 2 of HS2, researching how to improve LGBTQ+ health and healthcare outcomes, and as part of the BRACE rapid evaluation centre.
Award Title: Career Development Award
Start Date: 1 April 2022
End Date: 31 March 2024
Project Title: Understanding Mental Health Outcomes in Trans and Non-binary Adults in England
Brief summary: Primary care supports people across the courses of their lives as their health and healthcare needs change over time. Understanding the primary care experiences of minority groups including those with protected characteristics – those characteristics for which it is against the law in the UK to discriminate against someone, and which include gender reassignment – is important for addressing potential inequalities and allowing the NHS to plan long-term.
Since 2021, the annual GP Patient Survey conducted by NHS England has included questions about both gender and trans status in its surveys. , analysed 850,000 survey responses received to the 2021 survey, which included over 6,300 responses where individuals identified as either trans or non-binary. Working closely with patient and public contributors I analysed these data for my NIHR Three Schools Career Development Award
Trans and non-binary respondents were more likely to be from Asian, Black, Mixed or Other ethnic groups, less likely to be heterosexual, and were more likely to live in more deprived parts of the country. They were also more likely to be younger – just under one in four (23.6%) trans and non-binary respondents was aged 16-34 years, almost double the proportion among other respondents (13.4%).
After adjustment for age, ethnicity and deprivation, trans and non-binary adults reported higher prevalence for 10 out of the 15 long-term conditions. They were around three times as likely to be living with dementia or to have a learning disability, and twice as likely to be experiencing mental health difficulties. They were almost six times as likely to be autistic.
We hope that the findings will help lead to improvements in treatment and care for trans and non-binary individuals.
- Project findings are reported here: https://www.cam.ac.uk/research/news/gp-survey-reveals-health-and-healthcare-inequalities-of-trans-and-non-binary-adults
- Reflections on PPI are reported here: https://www.phpc.cam.ac.uk/pcu/lgbtq-research-and-involvement-what-have-we-learnt/
Progression of stroke risk in patients aged <65 years diagnosed with atrial fibrillation: a cohort study in general practice
Silvia C Mendonça et al, (2023), BJGP
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 et al, (2023), BMJ Open, BMJ Open 2023;13:e068099, 13