Health board becomes first in UK to issue guidance on transgender dementia care

Ensuring transgender people are treated with dignity when they develop dementia is at the heart of new guidelines being developed by Betsi Cadwaladr University Health Board.

The North Wales health board is thought to be the first in the UK to develop guidelines on the considerations staff should take when caring for transgender people with dementia.

Jenny BurgessThis includes advice on how to deal with the sensitivities that can arise when dementia develops and transgender people may become confused between their gender preference and their gender of birth.

The guidance has been co-produced with activists from within the transgender community with the aim of ensuring that transgender people receive dignified and compassionate health care across the whole health board.

Last year, 75 transgender people from Wales were referred to the NHS for gender identity treatment – a figure that’s tripled since 2014.

Jenny Burgess made the transition in 2012. She’s one of a number of people from the transgender community who have helped to co-produce the guidelines with BCUHB staff.

Jenny said: “I made the decision to transition in 2012 and have never felt more happy and content as I am now.

“Myself and many others within the trans community are very concerned about what life will be like for them should they develop dementia, or are in need of care in later life, as over the years there has been some horrifying stories of the treatment trans people have been subjected to, due to ignorance and prejudice. It is a sad fact that trans people have an expectation to be treated unfairly.

“Take for instance a transgender woman – they may well get quite concerned and disturbed at being in female clothes.

“They may worry why certain parts are missing from their anatomy. So it’s these sort of things that I’d like staff to be aware of. There’s no simple answer…but it really is a worrying scenario.”

“Whilst I acknowledge there are many wonderful and understanding people working with BCUHB, there are many who are not so understanding because of ignorance and lack of education in trans issues.

“These guidelines are so important to me and it is my belief that they will go a long way in helping staff understand the issues surrounding trans people.

“It is my hope that these guidelines may one day be available to all staff working within the NHS nationwide.”

Sean Page – Transgender GuidelinesSean Page, Consultant Nurse for dementia at BCUHB, said: “In order for us to provide the very best care for people with dementia we must be ready to engage with them to discover how psychological needs including identity, attachment and comfort can be met. That applies to every person affected by dementia but for a transgender person who has dementia there are specific considerations that should be made to ensure these needs are met.

“As dementia progresses a person may not recall their current gender and they may see themselves being pre-transition and be surprised at the physical changes to their bodies. This can result in them becoming very disorientated and anxious. They may not understand why they are being referred to as being a certain gender as they cannot recall publicly voicing this preference.”

The guidelines also offer advice on how to work with the families and carers of transgender people affected by dementia, and how to help assist a transgender person with dementia to maintain their preferred appearance when they can no longer do it themselves.

Margaret Hanson, Vice Chair and Older Person’s Champion of BCUHB, said: “These guidelines are real proof of what the NHS can do when staff listen to what those we serve truly need and I hope they will bring about real change in how the NHS in North Wales supports this unique, but vulnerable, group of older citizens.”

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