This blog is based on a Transvox podcast with Gillian Russell, Katie Munday & Dr.Virginia Quiney, which can be listened to here
Trans Aware Cancer Care is a project that involves talking to trans+ people and our allies around healthcare experiences, specifically around cancer services. Cancer services include being invited to screening, diagnosis, care and after care. These sessions were art-based and happened at Pride events in Hampshire as well as private workshops in Southampton and Bournemouth.
Themes that have emerged through the TACC project so far:
- Distrust of healthcare providers and practitioners (especially around being deadnamed and misgendered);
- The exhaustion of advocating for healthcare but also getting your name and pronouns respected;
- And how these effect both mental and physical health.
These themes consist of individual and systemic failings, including the antiquated database infrastructure in the NHS. There also remain uncertainty around screening in general – when will I be asked? At what age? What does this look like? However these questions were second to being taken seriously as a whole person.
Not all the experiences shared within TACC were negative – one person shared how his name and pronouns were respected throughout his cancer care and how he ended his care being called a ‘pleasant gentleman’ by one of his healthcare team. This shows two things: that the bar is quite low for good care (getting pronouns and names correct) but also that rapport and connection worked really well for this person. It worked so well that he created a thank-you card to the hospital within his artwork. The important part of TACC is not just what has gone wrong but also what works well and how this can be achieved consistently.
The long-term impact of TACC is creating better services and outcomes for trans+ people within cancer services. Drs and practitioners like Virigina Quiney are key to this success. Virginia became involved in TACC as a general practitioner to bring a personalised care perspective – in which a person’s autonomy is centred within their care. Personalised care also involves getting patients physically and emotionally fit for their healthcare journey, including cancer treatment.
Some practitioners are worried about getting things wrong as they worry this can put trans+ people off accessing care altogether. Virginia shared that training does exist across the NHS but isn’t consistent across Trusts. She also suggested that there needs to be a culture change individually and across the NHS which training alone cannot actuate. Healthcare professionals need to have the confidence to get things right and learn how to navigate things when they go wrong.
Katie reflected that all people get things wrong, and that often we have to get things wrong until we eventually get them consistently right. To help this process practitioners can:
- Have humility around getting things wrong;
- Try not to take it personally when trans+ people challenge or correct;
- Remain calm – apologise, correct and carry on;
- Build rapport so patients trust enough to share what does and doesn’t work for them;
- Continue this rapport and trust by respecting the person as a individual.
Virginia suggested that being open and honest about one’s needs and concerns could make the process easier for both the patient and the healthcare professional. However, she also acknowledged that this approach may not work for everyone and that it depends on the individual’s comfort level and the healthcare professional’s response.
Fabulous resources for trans+ issues and for LGBTQIA+ cancer:
OUTpatients – The UK’s LGBTIQ Cancer Charity
Macmillan – LGBTQ+ people and cancer
Beyond Reflections – Trans+ Charity based in the UK
TransActual – Resources for healthcare practitioners and trans patients