When we talk about improving gender identity healthcare the same recommendations come up: shorter wait times, better funding, and more inclusive policies. When you listen to people’s lived experiences — especially autistic and neurodivergent trans people — the real solutions sound a little different

Across conversations and research, several amazing ideas have emerged: we need a trans healthcare coordinator, better training, trauma-informed care, and above all, a bit more humanity in how we design and deliver care.

This blog looks at the recommendations from participants in two papers Exploring the Experiences of Autistic Transgender and Non-Binary Adults in Seeking Gender Identity Health Care and my, as yet unpublished, Stories from Across the Double Rainbow.

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A Trans Healthcare Coordinator Could Change Everything

One participant had an idea that made everyone pause: what if there were a dedicated trans healthcare coordinator?

Think of it like a “navigator” — someone who helps patients move through each step of the process, makes sure appointments don’t get lost or doubled up, and acts as your point of contact. Hospitals already do this in other areas, like breast cancer care. Why not in gender identity healthcare too?

This person could be the one who:

• Makes sure letters and appointment times make sense
• Keeps communication clear and consistent
• Comes to appointments if you need support
• Runs or connects you with local support groups
• Ensures no one gets “lost in the system”

It sounds simple, but it would solve so many of the issues participants raised — missed letters, scheduling errors, people being bumped to the bottom of the waiting list because of a miscommunication, or feeling like they have to start over every time they see a new doctor.

As one person put it:

“It would make gender identity healthcare… as nice as it can be. Nicer, more efficient, cheaper in the long run.”

Yes, you’d have to pay someone’s salary — but how much is already being wasted on missed appointments, duplicate tests, and admin chaos? Investing in coordination isn’t just kind; it’s cost-effective.

And imagine if that coordinator (or someone in a support role alongside them) had lived experience — someone who’s been through gender identity healthcare themselves. They’d understand the emotional landscape, the waiting, the uncertainty. They’d “get it.”

That empathy alone would change the tone of care for so many people.

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Practitioners Need Better Training — and Time to Learn

Another clear message: general practitioners (GPs) need better training around gender diversity, neurodivergence, and how the two intersect.

Many participants said their GP was kind but uninformed. One participant described having to teach their GP what to do next — who to call, what referral to make, what paperwork to complete. It wasn’t that the GP didn’t care; they just didn’t know.

And honestly, that’s not entirely their fault. GPs are expected to stay current on everything from diabetes to epilepsy to mental health to cancer care. It’s impossible to be an expert in all of it. But that’s exactly why representation and specialisation matter.

We need more trans, gender-diverse and neurodivergent people in healthcare — at every level. We need systems where patients aren’t educating their doctors just to access care.

One participant said:

“You’ve got to be really confident, with a lot of spoons and energy, to even know what to ask for. It’s a full-time job just managing the admin.”

That’s not a sustainable or fair expectation. We shouldn’t have to be advocates, researchers, and administrators all at once just to get basic care.

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Accessibility, please

For many autistic and neurodivergent people, the hardest part of gender identity healthcare isn’t the clinical process, it’s everything around it.

The phone calls that go unanswered.
The overwhelming hospital waiting rooms with buzzing lights, ringing phones, and antiseptic smells.
The confusing appointment letters written in bureaucratic code.
The pressure to “act normal” even when you’re anxious and overloaded.

As one participant shared:

“It’s high-stakes stuff. It’s not like ringing up to book a restaurant table — I wouldn’t do that either!”

These “small” barriers add up to real exclusion. They make people avoid appointments, miss calls, or shut down entirely. And then they’re blamed for being “non-compliant.”

Sometimes, all it would take is a practitioner saying, “I know this is hard. I appreciate that you made it here.”
That kind of acknowledgment goes a long way.

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Care Has to Be Trauma-Informed

Perhaps the most powerful recommendation of all: gender identity healthcare must be trauma-informed.

One participant told a story about someone who was discharged from a gender clinic and told they couldn’t reapply until they had a full year of perfect mental health.

What does that even mean? Who defines it? Yoga twice a day? No bad days? No anxiety about your gender in a world that constantly politicises it?

“So basically, if you can suffer by yourself for a year, you’re in. But if you reach out for help — we don’t want to hear about it.”

For autistic and neurodivergent people — most of whom have experienced trauma in some form — this kind of requirement isn’t just unrealistic, it’s cruel.

Many have faced bullying, discrimination, medical gaslighting, or worse. Add to that the trauma of being trans in a world where violence and prejudice are still rampant, and you have a population carrying an enormous emotional load.

We can’t ask those people to “prove” their stability before we help them. We have to design systems that assume trauma is present and respond with compassion and flexibility.

Because the truth is, healthcare of any kind — even for something joyful, like transition — can be overwhelming and triggering. As one participant said:

“Even when it’s positive, healthcare is stressful. There are sharp things, metal things, fluorescent lights… you’re out of control.”

If we truly want gender identity healthcare to heal rather than harm, it has to meet people where they are — messy, human, imperfect, and worthy of care right now, not after a year of “perfect” mental health.

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Every recommendation, every frustration, every idea in these conversations points back to one thing: kindness.

Kindness isn’t fluffy. It’s structure. It’s communication. It’s paying people properly to coordinate care. It’s listening to patients as experts in their own experience. It’s recognising that “doing gender right” or “acting normal” are ideas that do nothing but exclude.

As one person put it bluntly:

“It just feels devoid of empathy sometimes. If you can’t bring that to this job — why are you working in gender identity healthcare?”

We can build systems that are smarter, simpler, and softer.