Dr Jamie Willo, child and adolescent psychoanalytic psychotherapist at Sussex Partnership Trust, shares their personal quest to ensure that trans people have timely access to NHS services and are treated by clinicians who understand their needs.
Why do NHS staff need gender identity training?
When I joined the NHS Child and Adolescent Mental Health Service (CAMHS), I became painfully aware of the lack of a unified transgender care pathway in CAMHS and beyond, and how, subsequently, clinicians found themselves feeling deskilled and unable to support trans people.
It became clear I was destined to don a cape and embark on a quest to improve the lives of trans people who access mental health services, and support NHS staff to join the quest in providing better services for trans people.
The national picture
There is a clear and growing need for trans people to have timely access to NHS services, and to be treated by clinicians who understand their needs.
Recent studies have highlighted ‘worryingly high rates of mental health, depression, anxiety, suicidal thoughts and attempted suicide amongst LGBT+ individuals in the UK’. Trans and non-binary individuals had the highest incidences of depression, anxiety, and self-harm (Stonewall and YouGov, 2018).
Mental health services must also be responsive to the needs of the trans community, both clinically for patients and for staff who work within them.
How I developed the training
Initially I failed miserably. Despite repeated attempts to develop and co-design an experienced-based transgender care pathway with my trust, transgender issues were never quite at the top of anyone’s list. I was about to hang up my cape, but instead undertook a Darzi Fellowship to gain leadership experience and senior level support.
With my new x-ray vision, I scanned for gaps in healthcare. I found that national review indicated the need for organisations to invest in data informed, evidence based, gender identity training. Also, local scoping identified that many health workers were not confident about supporting trans people and said they were ‘scared of getting it wrong’. I wanted to help NHS staff become less worried about interacting with trans people and more confident about their own superpowers.
I took courageous steps away from my clinical role in pursuit of developing gender identity training workshops for NHS staff, alongside Health Education England, to ensure that NHS staff had the right tools to develop their own superpowers and be part of a shift in consciousness.
The impact of gender identity training
Gender identity training takes place in a nurturing space where NHS staff can explore their fears, beliefs, and unconscious bias, build knowledge of language and terminology, and gain an awareness of how they can become more inclusive in their practice – including challenging prejudice and discrimination.
My substantial clinical experience in mental health and knowledge of patient issues allows me to think clinically with attendees and the training workshops are fully interactive and experiential.
I share my personal experience, when appropriate, to put learning into context. As a trans person, I'm seen as an expert in gender identity, and yet I still sometimes get it wrong when addressing individuals. Attendees often feedback that they feel reassured that I also make mistakes and we think together about how we might deal with situations like this. I always reinforce that there are no silly questions and it’s always better to ask individuals their gender identity and pronouns rather than to assume.
Gender identity training is so important for strengthening health services for trans people. By increasing the gender identity cultural competence of individual staff, teams and organisations, trans people will be able to feel welcome and safe to access services. Everyone needs the opportunity to recognise and develop their own superpowers.
Where to book the training
Jamie delivers LGBTQ+/ gender identity training to NHS trusts across the UK. Contact firstname.lastname@example.org for more information.
Dr Jamie Willo is a Darzi Fellow and a child and adolescent psychoanalytic psychotherapist. They have worked for Sussex Partnership NHS Foundation Trust for 14 years in CAMHS. They are now the trust’s LGBTQ+ inclusion training lead.