We are glad that the Scottish Government is taking steps to improve healthcare for trans and non-binary people. The system has been broken for a long time and fixing it is a big priority for us. We need this process to be ambitious: our healthcare requires a total transformation (2). The national standards for our healthcare should be clear, and we should be able to change things when they are not working (3). Our services should be properly funded into the future (4), we should have equal access to healthcare services (5), and we should be able to get healthcare quickly (6). We should also have good quality mental health support (7) and fertility preservation (13 and 14). In all of this, we should be treated in the same way as cisgender people (12).
We need professionals to be trained in our healthcare needs (8, 11 and 15), and we need policy changes which centre our experiences and consult with us (9). We also simply need the IT systems which the NHS uses to stop causing problems for our healthcare (10 and 21). Across all of these recommendations, we need our healthcare to be based on equality, desegregation and informed consent, with trans and non-binary people empowered to be part of our own healthcare.
At the moment, non-binary people are often excluded from government surveys and research through bad questions and unclear advice. We need to be included in government surveys (16 and 22), which means empowering us to be part of developing new guidance (23). We also need to get a better understanding of our lives from the current research (17 and 18). Similarly, the services we use need better advice on how to gather data well (20), and on how to support us when our personal information changes (19). If non-binary people aren't counted properly in official research, it gets harder to make all the other changes we need, because we don't get good quality information about our lives.
We know that non-binary people are not going to be included in the current reforms to gender recognition laws: the Non-Binary Working Group was set up when that decision was made. However, we also know that legal status for non-binary people is important, so we want proper research to begin now about how to recognise us in law (24). Without that research, Scotland will keep falling behind other countries. We also need to make sure that future laws don't exclude us (25), and that state-issued IDs and documentation don't either (26). We're not asking for everything to be gender neutral, but we do know that lots of things are gendered when they don't need to be, and that changing that will improve all our lives.
Often the services non-binary people use in moments of crisis don't understand our needs, which makes getting help even more difficult. LGBTI+ people, including non-binary people, experience really high rates of homelessness, so we need specific plans and resources to end LGBTI+ homelessness (28). Similarly, we need specific support when we're victims or witnesses of abuse and violence (29 and 30), and we need better information on how we're currently getting support (31).
Sometimes the very buildings we use exclude us in how they're designed, so we need new building regulations to support inclusive design across public services (27). Like so much of what we're recommending, improving services for non-binary people means improving services for everyone.
Over half of trans people, including non-binary people, have been excluded from participating in sport – that's not mainly professional sport, but just regular public sports activity. We want to make it much easier for us all to join in, but the current UK-wide sports guidance about trans people is making participation harder instead. We want the Scottish Government to agree better principles for our participation (32), and to fund specific projects to support non-binary and trans sport (33). We should be able to take part in sport like everyone else.
Our recommendations for the education system come directly from non-binary young people. They want to see changes to school IT systems so that non-binary students are not excluded or outed without their consent, and can be properly recognised (34). They also want to make sure that non-binary young people are part of improving LGBT Inclusive Education in the future (35). Just like in many of our other recommendations, our lives improve when we have the power to shape our own services, and that's true for non-binary young people too.
These recommendations are just the start. We know that our work here is incomplete, and that we needed more time, resources and people to come up with the best ideas. The community members in the working group were unpaid and gave a lot of time to the process, but it's very difficult to do this when you're facing all of the barriers you're trying to change. As a result the most marginalised people were often not in the room when they needed to be. We did not include non-binary people of colour properly, and we were often frustrated by the limits of the process.
All this means we have one more recommendation to make that underpins everything else: future work the Government does to improve non-binary people's lives needs to empower people who are marginalised in multiple ways (1). This requires doing the work to find people who can participate, building trust with communities, compensating people for their time, and enabling communities to design their own ways of working.
We believe that it is possible to improve non-binary people's lives in Scotland, and that the ideas in this report are a good start. We need to be empowered to make that happen, and, like so much of this report, that's simply as true for us as it is for everyone else. The more non-binary people are supported to do the work to improve our lives, the better the results will be.
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