National Gender Identity Healthcare Reference Group minutes: May 2024

Minutes of the meeting of the Group held on 21 May 2024.

Attendees and apologies

  • Dr Ewan Bell, (Co-chair), Associate Medical Director, NHS Dumfries and Galloway
  • Professor Graham Ellis, Deputy Chief Medical Officer, Scottish Government
  • Adam Black, Nurse Consultant/Clinical Nurse Manager Sexual & Reproductive Health, Chalmers Gender Identity Clinic, NHS Lothian
  • Kerry Cairns, Service Manager, Elmwood Gender Identity Clinic, NHS Grampian
  • Dr Fiona Clunie, Consultant Psychiatrist, Chalmers Gender Identity Clinic. NHS Lothian
  • Dr Emilia Crighton, Director of Public Health, NHS Greater Glasgow and Clyde
  • Neil Ferguson, Director, West of Scotland Regional Planning
  • Dr Kate Fraser, Counselling Psychologist, Elmwood Gender Identity Clinic, NHS Grampian
  • Linsey Galbraith, Principal Information Analyst, Public Health Scotland
  • Dr Fiona Gibson, Specialty Doctor, Gender and Sexual Health Services, NHS Highland
  • Catriona Johnson, Associate Director, NHS National Services Scotland
  • Jennifer Layden, Healthcare Improvement Scotland
  • Jane Harris, Head of Programme, Postgraduate and Post-registration Education and Continuing Professional Development, NHS Education for Scotland
  • Kimberley MacInnes, Service Manager, Raigmore Gender Identity Clinic, NHS Highland
  • Dr Christine Mimnagh, CMAGIC Clinical Lead, Mersey Care NHS Foundation Trust
  • David Parker, Senior Educator, NHS Education for Scotland
  • Dr Ruth Pearce, Lecturer, University of Glasgow
  • Dr Emily Retkiewicz, Clinical Psychologist, Elmwood Gender Identity Clinic,  NHS Grampian
  • Dr Susan Rooney, Clinical Lead, Sandyford Gender Clinic, NHS Greater Glasgow and Clyde
  • Dr Fiona Wardell, Standards and Indicators Team Lead, Healthcare Improvement Scotland
  • Mairi Watson, Public Health Scotland
  • Dr Michelle Watts, Senior Medical Advisor, Scottish Government
  • Dr Craig Wheelans, National Medical Advisor, Specialist Healthcare Commissioning, National Networks & National Planning, NHS National Services Scotland
  • Lived Experience Coordinator
  • Representative, * LGBT Health and Wellbeing
  • Representative, * LGBT Youth Scotland
  • Representative, Scottish Trans
  • Representative, TransparentSees


  • Professor Nicola Steedman, (Co-chair), Deputy Chief Medical Officer, Scottish Government
  • Dr Richard Anderson, Deputy Director Centre for Reproductive Health, University of Edinburgh
  • Colin Briggs, Director of Strategic Planning, NHS Lothian
  • Dr Paul Connelly, Clinical Lecturer in Diabetes & Endocrinology, University of Glasgow
  • Rhoda Macleod, Head of Sexual Health, Prison and Police Services, Sandyford Gender Clinic, NHS Greater Glasgow and Clyde
  • Dr Alison Poupart, Interim Consultant Clinical Psychologist, NHS Greater Glasgow and Clyde
  • Dr Craig Wheelans, National Medical Advisor, NHS National Services Scotland

Items and actions

Welcome and minutes of previous meeting

Ewan Bell (EB) welcomed attendees to the sixteenth meeting of the National Gender Identity Healthcare Reference Group (the Group). Apologies were noted.

EB welcomed Dr Emilia Crighton, Director of Public Health, NHS Greater Glasgow and Clyde, and highlighted that Dr Michelle Watts has now left the post with Scottish Government and will no longer be member of the Group. It was noted that Dr Fiona Gibson is retiring, and new members of the NHS Highland team were welcomed to the meeting.

Minutes of the previous meeting were approved and EB noted that the minutes will be published online in due course.

It was agreed that actions arising from 22 February meeting will be reviewed at 12 June meeting.

Reflections from Chair

EB reflected on the developments since the February meeting and on postponement of the 17 April meeting to 21 May, outlining the timelines and process. The significant public, media and Ministerial interest in the developments was highlighted. EB noted that there is still a lot of work to do to improve access to and delivery of the gender identity services, thanked the Group for all the work so far and expressed hope for future support.

NHS Greater Glasgow & Clyde (NHS GGC) / NHS Lothian updated position

Dr Emilia Crighton outlined the current NHS GGC position, the commitment to this work and the challenges that the service is facing, such as recruitment challenges.

Current work on clinical validation and work with academic partners to explore research options by the Health Board were highlighted.

Members of the Group shared their views on recent developments, including on NHS GGC/Lothian clinical decision on puberty blocker and cross-sex hormone prescription, the Cass Review and broader implications. Feedback and experiences from people with lived experience were shared, and the importance of keeping those affected informed and included was emphasised.

Chief Medical Officer (CMO) Multi-Disciplinary Team (CMO MDT)

Professor Graham Ellis outlined the membership of the separate CMO MDT and the work that the team is undertaking as it considers the recommendations of the Cass Review as it applies to Scottish context. The focus of the CMO MDT on opportunity for improvement informed by recommendations and importance of what is right and best for people in Scotland was highlighted.

Workforce, training, system design, commissioning, and learning from other models of delivery of this care nationally and internationally were discussed.

Next steps of MDT work were outlined, as was the fact that the CMO would write to the Parliament following its conclusion.

Young people's commissioning

Officials highlighted this work will be informed by outcomes of the process undertaken by CMO MDT and noted that more information will be provided following the submission of the CMO report to the Scottish Parliament.

NHS Highland - update on service and forward look

Dr Fiona Gibson, who is retiring at the end of May, reflected on the development of the service in NHS Highland and her time as Lead Clinician in their gender identity service. She has outlined significant progress made to improve and anchor service development, and acknowledged the importance of the strong support from the Service Manager and the funding from Scottish Government in driving these improvements. Fiona introduced the new team taking the work forward and thanked colleagues across Scotland for their support and advice during her career.

EB and Group members thanked Fiona for her work and support and wished her well in her retirement.


The next meeting of the Group was confirmed for 12 June 2024.

No other business was raised and the meeting was closed.

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