̽��ֱ�� of Cambridge - transgender

̽��ֱ��medic making a difference to the care of trans patients

cjb250 — Mon, 03 Feb 2025 08:00:21 +0000

Medical students are taught about some of the rarest diseases, yet do not learn something as important as how to care for trans patients. This needs to change, says intensive care specialist Luke Flower.

People who are autistic and transgender/gender diverse have poorer health and health care

cjb250 — Tue, 21 Jan 2025 01:00:31 +0000

Researchers at the Autism Research Centre at Cambridge ̽��ֱ�� found that these individuals also report experiencing lower quality healthcare than both autistic and non-autistic people whose gender identity matches their sex assigned at birth (cisgender).

̽��ֱ��findings have important implications for the healthcare and support of autistic transgender/gender diverse (TGD) individuals. This is the first large-scale study on the experiences of autistic TGD people and the results are published today in Molecular Autism.

Previous research suggests that both autistic people and TGD people separately have poorer healthcare experiences and are more likely to be diagnosed with physical and mental health conditions than other people. In addition, a 2020 study of over 640,000 people, carried out by the Autism Research Centre in Cambridge, found that TGD people are more likely to be autistic and have higher levels of autistic traits than other people. Several other studies now confirm this finding and show that autistic people are more likely to experience gender dysphoria than others. Despite these findings, there are no studies that consider risks of mental health conditions, physical health conditions, and healthcare quality among autistic TGD people.

In the largest study to date on this topic, the team at the Autism Research Centre used an anonymous, self-report survey to compare the experiences of 174 autistic TGD individuals, 1,094 autistic cisgender individuals, and 1,295 non-autistic cisgender individuals.

̽��ֱ��survey assessed rates of mental health conditions and physical health conditions, as well as the quality of 51 different aspects of healthcare experiences. ̽��ֱ��healthcare experiences questions were wide-ranging and included questions about communication, anxiety, access and advocacy, system-level issues, and sensory experiences among others. They addressed several very basic aspects of healthcare, including asking participants to endorse statements such as ‘If I need to go to see a healthcare professional, I am able to get there’, ‘I am able to describe how bad my pain feels’, and ‘I usually understand what my healthcare professional means when they discuss my health’.

Both autistic TGD and autistic cisgender adults reported significantly poorer healthcare experiences across 50 out of 51 items compared with non-autistic cisgender people, confirming that autistic people appear to have poorer quality healthcare than non-autistic cisgender individuals, regardless of their own gender identity.

Compared to non-autistic cisgender individuals, autistic TGD people were three to 11 times more likely to report anxiety, shutdowns, and meltdowns related to common healthcare experiences.

For every 10 cisgender non-autistic adults who endorsed the following statements, on average, only two autistic cisgender adults and only one autistic TGD adult stated that they: (i) understood what their healthcare professional meant when discussing their health; (ii) knew what was expected of them when seeing a healthcare professional; or (iii) were able to describe how bad their pain felt.

Autistic TGD people and autistic cisgender people were more likely to report both long-term physical and mental health conditions that were formally diagnosed, suspected, or that had been recommended for assessment by clinicians. For every 10 non-autistic cisgender people who had at least one diagnosed physical health condition, there were 15 autistic cisgender people and 23 autistic TGD people. For every 10 non-autistic cisgender people who reported at least one diagnosed mental health condition, there were 50 autistic cisgender people and 109 autistic TGD people who reported the same.

Alarmingly, it is now well-established that autistic people and TGD people are each at a much higher risk of suicide and suicide-related behaviours than other people. In 2023, the Department of Health and Social Care specifically recognized autistic people as a priority group in their Suicide prevention strategy for England: 2023 to 2028. ̽��ֱ��new study found that, compared to people who are non-autistic and cisgender, autistic cisgender individuals were 4.6 times more likely and autistic TGD people were 5.8 times more likely to report self-harm.

Dr Elizabeth Weir, a postdoctoral scientist at the Autism Research Centre, and one of the lead researchers of the study, said: “These findings add to the growing body of evidence that many autistic people experience unacceptably poor mental health and are at a very high risk of suicide-related behaviours. We need to consider how other aspects of identity, including gender, influence these risks.”

These results emphasise the importance of considering intersectionality in clinical settings, including health risks for individuals who hold multiple minoritised identities. ̽��ֱ��researchers say clinicians should be aware of these risks and the unique barriers to healthcare that autistic TGD people may experience. ̽��ֱ��findings also underscore that people who are autistic and transgender/gender diverse experience particularly high rates of mental health conditions and risks of self-harm.

Professor Sir Simon Baron-Cohen, Director of the Autism Research Centre and a member of the team, said: “We need to consider how to adapt healthcare systems and individual care to meet the needs of autistic transgender/gender diverse people. Policymakers, clinicians, and researchers should work collaboratively with autistic people to improve existing systems and reduce barriers to healthcare.”

Reference
Green, K.*, Weir, E.*, Wright, L.*, Allison, C., & Baron-Cohen, S. Autistic and transgender/gender diverse people’s experiences of health and healthcare. Molecular Autism; 21 Jan 2025; DOI: 10.1186/s13229-024-00634-0

Autistic transgender/gender diverse individuals are more likely to have long-term mental and physical health conditions, including alarmingly high rates of self-harm, new research from the ̽��ֱ�� of Cambridge suggests.

These findings add to the growing body of evidence that many autistic people experience unacceptably poor mental health and are at a very high risk of suicide-related behaviours

Elizabeth Weir

Kyle (Unsplash)

Woman with transgender flag make-up

̽��ֱ��text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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GP survey reveals health and healthcare inequalities of trans and non-binary adults

cjb250 — Tue, 07 Feb 2023 09:12:25 +0000

̽��ֱ��study, funded by the National Institute for Health and Care Research, also found that while trans and non-binary adults report no differences in access to primary care, they prefer to be able to see the same GP for each appointment. They also report more negative experiences of interpersonal communication, such as involvement in decision-making over treatment, and poorer confidence or trust.

Primary care supports people across the courses of their lives as their health and healthcare needs change over time. Understanding the primary care experiences of minority groups including those with protected characteristics – those characteristics for which it is against the law in the UK to discriminate against someone, and which include gender reassignment – is important for addressing potential inequalities and allowing the NHS to plan long-term.

Since 2021, the annual GP Patient Survey conducted by NHS England has included questions about both gender and trans status in its surveys. A team led by researchers at the Department of Public Health and Primary Care, ̽��ֱ�� of Cambridge, analysed 850,000 survey responses received to the 2021 survey, which included over 6,300 responses where individuals identified as either trans or non-binary. ̽��ֱ��results are published today in BMJ Open.

Trans and non-binary respondents were more likely to be from Asian, Black, Mixed or Other ethnic groups, less likely to be heterosexual, and were more likely to live in more deprived parts of the country. They were also more likely to be younger – just under one in four (23.6%) trans and non-binary respondents was aged 16-34 years, almost double the proportion among other respondents (13.4%).

After adjustment for age, ethnicity and deprivation, trans and non-binary adults reported higher prevalence for 10 out of the 15 long-term conditions. They were around three times as likely to be living with dementia or to have a learning disability, and twice as likely to be experiencing mental health difficulties. They were almost six times as likely to be autistic.

Dr Katie Saunders from the ̽��ֱ�� of Cambridge, the study’s first author, said: “These findings are consistent with other studies looking at long-term conditions among trans and non-binary adults. ̽��ֱ��reasons for these differences compared to the general population are likely to be complex, including a mixture of stress, experiences of discrimination, socioeconomic status and the biological effects of hormone treatments.

“It shouldn’t be too surprising that these communities experience higher rates of mental health problems, given media reporting around issues such as the Gender Recognition Act and the Equalities Act and the increasing levels of transphobia that many individuals face on a day-to-day basis.”

When the researchers looked at the experiences of trans and non-binary adults in primary care, they found no difference when it came to accessing primary care. However, almost two-thirds (64.2%) of trans and non-binary adults said they had a preferred GP compared to a half (50.2%) of other respondents.

Trans and non-binary adults were less likely to be involved in decisions about care and treatment (85.0% compared with 93.7%). Those trans and non-binary adults with mental health needs were less likely to have their needs recognised and understood (77.6% compared with 87.3%). Fewer trans and non-binary adults said that overall their needs were met (88.1% compared with 95.2%).

Dr Saunders added: “If you are trans or non-binary, then every time you see a new GP you are forced to decide whether or not to come out to them, so it isn’t surprising that they prefer continuity in primary care. Once you find a GP who understands your needs, you will want to see them each time you have an appointment.”

̽��ֱ��team hope that the findings will help lead to improvements in treatment and care for trans and non-binary individuals.

“There are currently very few guidelines for GPs on how to care for trans or non-binary patients,” said Dr Saunders. “We hope the evidence that we’re presenting will help change this. Knowing that a trans or non-binary patient is more likely to be autistic or to be experiencing mental health difficulties, for example, where guidelines do exist, could help GPs prepare for seeing their patients.”

Reference
Saunders, CL, et al. Demographic characteristics, long-term health conditions, and healthcare experiences of 6,333 trans and non-binary adults in England: nationally representative evidence from the 2021 GP Patient Survey. BMJ Open; 2 Feb 2023; DOI: 10.1136/bmjopen-2022-068099

Trans and non-binary adults are more likely than the general population to experience long-term health conditions, including mental health problems, dementia and learning disabilities, and to be autistic, according to new research.

If you are trans or non-binary, then every time you see a new GP you are forced to decide whether or not to come out to them

Katie Saunders

Karollyne Hubert

Trans Rights Protest London, April 2022

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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Transgender and gender-diverse individuals are more likely to be autistic and report higher autistic traits

cjb250 — Fri, 07 Aug 2020 08:50:07 +0000

This research, conducted using data from over 600,000 adult individuals, confirms previous smaller scale studies from clinics. ̽��ֱ��results are published today in Nature Communications.

A better understanding of gender diversity in autistic individuals will help provide better access to health care and post-diagnostic support for autistic transgender and gender-diverse individuals.

̽��ֱ��team used five different datasets, including a dataset of over 500,000 individuals collected as a part of the Channel 4 documentary “Are you autistic?”. In these datasets, participants had provided information about their gender identity, and if they received a diagnosis of autism or other psychiatric conditions such as depression or schizophrenia. Participants also completed a measure of autistic traits.

Strikingly, across all five datasets, the team found that transgender and gender-diverse adult individuals were between three and six times more likely to indicate that they were diagnosed as autistic compared to cisgender individuals. While the study used data from adults who indicated that they had received an autism diagnosis, it is likely that many individuals on the autistic spectrum may be undiagnosed. As around 1.1% of the UK population is estimated to be on the autistic spectrum, this result would suggest that somewhere between 3.5.-6.5% of transgender and gender-diverse adults is on the autistic spectrum.

Dr Meng-Chuan Lai, a collaborator on the study at the ̽��ֱ�� of Toronto, said: “We are beginning to learn more about how the presentation of autism differs in cisgender men and women. Understanding how autism manifests in transgender and gender-diverse people will enrich our knowledge about autism in relation to gender and sex. This enables clinicians to better recognize autism and provide personalised support and health care.”

Transgender and gender-diverse individuals were also more likely to indicate that they had received diagnoses of mental health conditions, particularly depression, which they were more than twice as likely as their cisgender counterparts to have experienced. Transgender and gender-diverse individuals also, on average, scored higher on measures of autistic traits compared to cisgender individuals, regardless of whether they had an autism diagnosis.

Dr Varun Warrier, who led the study, said: “This finding, using large datasets, confirms that the co-occurrence between being autistic and being transgender and gender-diverse is robust. We now need to understand the significance of this co-occurrence, and identify and address the factors that contribute to well-being of this group of people.”

̽��ֱ��study investigates the co-occurrence between gender identity and autism. ̽��ֱ��team did not investigate if one causes the other.

Professor Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge, and a member of the team, said: “Both autistic individuals and transgender and gender-diverse individuals are marginalized and experience multiple vulnerabilities. It is important that we safe-guard the rights of these individuals to be themselves, receive the requisite support, and enjoy equality and celebration of their differences, free of societal stigma or discrimination.”

Dr Warrier is a Research Fellow at St Catharine's College and Professor Baron Cohen is a Fellow at Trinity College.

This study was supported by the Autism Research Trust, the Medical Research Council, the Wellcome Trust, and the Templeton World Charity Foundation., Inc. It was conducted in association with the NIHR CLAHRC for Cambridgeshire and Peterborough NHS Foundation Trust, and the NIHR Cambridge Biomedical Research Centre.

Reference
Warrier, V et al. Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses and autistic traits in transgender and gender-diverse individuals. Nat Comms; 7 Aug 2020; DOI: 10.1038/s41467-020-17794-1

Transgender and gender-diverse adults are three to six times more likely as cisgender adults (individuals whose gender identity corresponds to their sex assigned at birth) to be diagnosed as autistic, according to a new study by scientists at the ̽��ֱ�� of Cambridge’s Autism Research Centre.

Both autistic individuals and transgender and gender-diverse individuals are marginalized and experience multiple vulnerabilities. It is important that we safe-guard the rights of these individuals to be themselves, receive the requisite support, and enjoy equality and celebration of their differences, free of societal stigma or discrimination

Simon Baron Cohen

katlove

Transgender flag

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Celebrating Cambridge’s LGBT+ scientists and engineers

cjb250 — Wed, 04 Jul 2018 23:00:09 +0000

To mark the event, the ̽��ֱ�� has released a film in which staff and researchers from the ̽��ֱ��, AstraZeneca and the Wellcome Genome Campus discuss their experiences of being LGBT+ in Cambridge – and why it is important to be who you are.

"While we have witnessed an increase in inclusion and equality efforts in STEM organisations and companies, we have to recognise the many challenges individuals continue to face, especially members of the LGBT+ community," said Dr Alfredo Carpineti, founder of Pride in STEM and one of the organisers of the initiative. “That's why we launched LGBTSTEM Day. We hope for this to be a day of celebration, of reflection, and of engagement. LGBTSTEM Day is part of the global push to increase the visibility of minorities in STEM fields.”

̽��ֱ��celebrations highlight the need for more role models to help enable LGBT+ scientists and engineers to be able to express themselves and to encourage others to consider a career in STEM. As Dr Sara El-Gebali, Scientific Database Curator at the European Bioinformatics Institute (EMBL-EBI) says in the film: “Sadly there are very few [LGBT role models in science]. It’s not because we’re not here, it’s because we’re not seen. We’re not officially here.”

Anna Langley, Computer Officer at Cambridge’s ̽��ֱ�� Information Services, was one of the founding members of the ̽��ֱ�� of Cambridge’s LGBT+ Staff Network. She works in an environment where diversity is a problem, but says that things that are changing.

“Working in IT is still a very straight, white, male, cis environment,” she says. “But generally, I think that the university is trying to do the right thing in terms of diversity. It’s trying to ensure that people are treated fairly regardless of their background, their gender identity, their sexuality.”

Having a supportive work environment is essential in helping staff both personally and professionally, says Christopher Fox, Associate Scientist at AstraZeneca/MedImmune: “I don’t think I’d be as confident as I am at work if I didn’t have people around me who were openly gay or openly lesbian, people who are happy to be themselves. It made me feel that I can be myself.”

Elizabeth Wynn, Advanced Research Assistant at the Wellcome Sanger Institute, adds: “I think it’s important to be who you are, to be able to live as your authentic self, because you’re never going to be truly happy or productive or complete if you’re trying to silence or hide some part of yourself.”

For Langley, being ‘out’ at work is important not just for oneself, but to support others. “If you’re not visible as someone who’s LGB or T, intersexual, queer, non-binary, whatever, then you’re making it that little bit harder for other people to be open about their experience too, […] to be comfortable in their skin in the working environment.”

̽��ֱ��film’s contributors all describe Cambridge as being a very positive, open city in which to live and work.

“There’s a real emphasis on ‘it’s what you can bring to the table in STEM rather than who you are’,” says Fox. “It’s about what you can achieve, not what your sexuality is.”

Michael Rivera, a PhD student in the Department of Biological Anthropology, agrees: “With such a diverse, knowledgeable population in Cambridge, I think it’s very likely that you will find many friends to make here with common interests to you. You will find lots of allies who are open to different backgrounds and different sexualities – and maybe you’ll even find someone very special to spend time with!”

For Dr El-Gebali, her move to Cambridge has made a huge difference to her life. “Being in Cambridge has helped me to come out, not just to my friends and family, but also to work,” she says. “It’s the first time in my long career when I can officially say ‘Yeah, here I am and I’m not the only one’. Cambridge has been really, really good to me.”

This year, staff and students from the ̽��ֱ�� of Cambridge, Cambridge Assessment and Cambridge ̽��ֱ�� Press, marched together as they joined thousands of others in the parade at Pride London on Saturday 7 July. AstraZeneca and scientists from the Wellcome Sanger Institute also marched together as part of the Proud Science Alliance group.

Cambridge celebrated the first ever LGBTSTEM Day on 5 July – recognising all those who work in science, technology, engineering and medicine and who identify as lesbian, gay, bisexual, transgender and other minority gender identities and sexual orientations.

I think that the university is trying to do the right thing in terms of diversity. It’s trying to ensure that people are treated fairly regardless of their background, their gender identity, their sexuality

Anna Langley

Celebrating Cambridge’s LGBT+ scientists and engineers

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Global Christian attitudes towards transgenderism “softening”, study suggests

tdk25 — Wed, 02 Dec 2015 00:01:29 +0000

A growing number of Christian denominations, particularly within Protestant traditions, are softening their stance on transgenderism and embracing trans people as congregants and ministers, a new study suggests.

While the Church in general has a reputation for intransigence on questions of gender and sexuality, the research, which mapped the official positions of different denominations around the world, points to “a slow, sometimes grudging, but growing momentum for change among Christians within Protestantism especially.”

̽��ֱ��Church of England, Lutheran denominations in Scandinavia, and numerous Churches in the United States are described as leading the shift towards a state of broad-based acceptance in which trans people are able to minister, teach and marry in their affirmed gender.

At the same time, the study acknowledges that the Catholic and Orthodox Churches remain officially opposed to transgenderism. “ ̽��ֱ��overwhelming majority of the 2.1 billion Christians in the world belong to Churches which are officially unsympathetic to the claims of transgender people,” it observes.

̽��ֱ��research was carried out by the Reverend Duncan Dormor, who is Dean of Chapel and Director of Studies for Theology at St John’s College, ̽��ֱ�� of Cambridge. He undertook the study having been asked to outline Christian attitudes towards transgenderism for a book, ̽��ֱ��Legal Status of Transsexual and Transgender Persons.

̽��ֱ��mapping exercise assessed the official positions of as many major Christian denominations as possible, drawing in particular on any formal statements that these Churches had issued. These were then grouped together by type, in order to provide a sense of which dominant viewpoints currently define Christianity as a whole.

̽��ֱ��results suggest that many Churches have, within the last few years, become far less conservative on transgender issues than is traditionally assumed.

̽��ֱ��study adds: “ ̽��ֱ��ministry and marriage of transgender Christians has as often been grudgingly accepted as positively embraced, mostly within the last decade, and frequently in the face of significant unease of internal opposition. Nevertheless, there is growing momentum for change; for acceptance and welcoming of transgender Christians.”

̽��ֱ��challenge transgenderism poses to some Christian denominations is rooted in “theological anthropology” - in simple terms a faith-based understanding of the human condition and what the difference between the sexes means. Many conservative Christians believe that God created two distinct forms of human - male and female - and that these sexed differences are an essential characteristic of what it means to be human.

In response, during the latter half of 20th Century, various groups emerged on the fringes of mainstream Christianity that not only welcome and affirm transgender Christians, but actively campaign for their rights. These developed into pan-Christian activist groups.

̽��ֱ��new study suggests that ideas from these groups are now percolating through to moderate, mainstream Christianity as well. In particular, Protestant Churches, which focus heavily on pastoral responsibilities in the community and emphasise toleration of difference, are becoming increasingly open-minded towards trans people.

Much of the progress has taken place in the United States, where in 1996 the Presbyterian Church of Atlanta became the first mainstream Christian denomination to allow a religious leader, Erin (previously Eric) Svenson, to remain in post following surgery to change gender. Since then groups such as the Presbyterian Church USA (in 2010) and the Episcopal Church (in 2012) have followed suit, by welcoming the ordination of transgender clergy.

In Europe, change has come about not only from inside Christianity, but also from external legislation changes recognising transgender people, which has obliged Churches to adapt. Scandinavia, which incorporates some of the most progressive nations in the world in terms of the inclusion of LGBT people, also has some of the most inclusive churches, the study says.

̽��ֱ��research also singles out progress made within the Church of England. Even though a clear position on transgenderism has yet to be drawn up by its governing body, the General Synod, there are currently at least eight transgender priests serving within the Church, of whom six were ordained prior to transition.

Equally, while the Church secured an exemption under the Gender Recognition Act of 2004 for clergy who did not wish to solemnise the marriage of transgender people, the survey points out that it also protected the rights of transsexual parishioners to use their parish church.

Further, when the Act was debated in the House of Lords, a number of bishops from the Church of England played a vital role in preventing the progress of an amendment that would have given religious bodies greater power and autonomy to restrict the participation of transgender people in the Church.

“ ̽��ֱ��developing positions of these Churches illustrates that religion’s perspective on transgenderism is less monolithic than is sometimes believed,” Dormor said. “It is important to remember that it is plural and accommodates a diversity of views. It seems highly likely that the developments we have seen over the last decade or so will continue.”

̽��ֱ��report acknowledges that similar developments are unlikely to take place in the Catholic Church, which remains formally opposed to transgenderism. It does, however, suggest that unofficially the Church’s attitude towards trans people may soften under Pope Francis, compared with his two predecessors, John Paul II and Benedict XVI.

“Gender is one area in which Pope Francis to some extent represents intellectual continuity with the previous two Popes, but unlike them he does not see gender in exclusively ideological terms,” Dormor added.

“People or communities who are marginalised or suffering are a priority for him. That means that while the Catholic Church will continue to fight the EU on gender legislation, it may simultaneously become more responsive to groups of people and individuals who need to be supported because of their marginalised status.”

̽��ֱ��study appears in ̽��ֱ��Legal Status of Transsexual and Transgender Persons, published by Intersentia.

A mapping exercise examining the positions of major Christian denominations on transgender identities suggests that a growing number of Churches around the world are taking an inclusive approach towards trans people and communities.

̽��ֱ��ministry and marriage of transgender Christians has as often been grudgingly accepted as positively embraced, mostly within the last decade, and frequently in the face of significant unease of internal opposition. Nevertheless, there is growing momentum for change.

Duncan Dormor

Image by Robert Couse-Baker, via Flickr

Sacramento Pride Parade, supporting the LGBT community, June 15 2013. ̽��ֱ��new study highlights the leadership of many Churches in the United States in shifting the balance of Christian attitudes towards trans people.

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

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