Non-Binary Working Group - primary care sub-group minutes: 2 September 2021

Minutes from the meeting of the sub-group on 2 September 2021.

Attendees and apologies

Group members

  • Dr Ben Vincent, (Chair)
  • Oceana Maund, Scottish Trans
  • Vic Valentine, Scottish Trans
  • Sarah Anderson, LGBT Youth Scotland 
  • Megan Snedden, Stonewall Scotland
  • Non-Binary Community members


  • Catrina Steenberg, Equality and Inclusion Division, Scottish Government
  • Laurie Donaldson, Equality and Inclusion Division , Scottish Government


  • Caitlin Byrne, Primary Care, Scottish Government

Items and actions

Note of key points and actions

Key discussion points

The group discussed:

CHI numbers

  • difficulties created by CHI numbers when accessing treatment and potential solutions to this, e.g. adding a non-binary code or removing sex/gender element
  • unintegrated NHS IT systems making non-binary addition to CHI numbers difficult
  • how CHI numbers are used to call specific groups of patients for certain screenings and this can lead to issues for trans/non-binary people
  • creating further guidance for GPs around referrals for non-surgical healthcare i.e. hair removal, voice therapy
  • cost and capacity issues when implementing recommended changes

Training for healthcare practitioners

  • notable difference between practitioners who had received training and had knowledge of non-binary people on how  non-binary people were treated
  • lack of awareness about training opportunities available
  • disparity between care given in urban and rural settings
  • the self-referral service for speech and language therapy (SALT) that was available but not widely known amongst GPs and the non-binary community
  • importance of GPs having a basic, general understanding of how to treat non-binary people so that non-binary people can trust and engage with GP
  • the need for medical governing bodies to engage with trans and non-binary communities to review their access to healthcare

Review of GP surgeries and funding guidance

  • funding for GPs to be able to refer or prescribe treatments currently expected from Gender Identity Clinics (GICs) e.g. for hair treatment, voice therapy. This would reduce waiting times
  • reported concerns felt by some GPs around possibility of litigation and potential impact on treatment for trans and non-binary people. Identification of the need for reassurance that this is rare
  • a primary care pilot taking place in England where GPs were carrying out work of the GICs
  • engaging with sexual health officials about locally enhanced services
  • unnecessary gendering and questioning patients’ non-binary identity
  • beyond GPs, improvement to services needed to be embedded throughout primary care, including pharmacy, optometry, and dentistry

LGBTI Equality Team

September 2021

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