NHS leaflets

This is the range of NHS leaflets available for trans* patients explaining the various aspects of the NHS service –

An introduction to trans* issues
A guide for NHS practitioners treating trans* patients
GIRES guide to your rights to care and treatment under the NHS
A guide to NHS funding and waiting times
A guide to hormone therapy
A guide to lower surgery options and procedures for transwomen
A guide to lower surgery options and procedures for transmen
A guide for families with trans* children or teenagers
nhs

Transition management

There is very little chance that you will be able to keep your transition a secret in Jersey. The island is small and news of your transition will travel quickly around your friends, family, colleagues and, surprisingly, even people who you don’t know! If you want to transition privately, your best option is to leave the island for a city. However, before you take that step, consider the pros and cons carefully:

Pros

  • You will pass more often in a city as your gender rather than as transgender
  • You will have access to a wider range of professionals to support your transition
  • You will have access to support groups where you can meet other trans* individuals
  • You can make a fresh start in your new gender

Cons

  • As well as undergoing the changes to your gender, you will also have to undertake huge changes in your home and work life
  • You will lose the support network you have in Jersey (friends, family, colleagues)
  • You may not be eligible for funded healthcare, depending on where you move to
  • Moving location will add to the cost of your transition

Jersey is a conservative place but it is also, by and large, a tolerant place. The island’s population is a well educated one – our schools consistently get above UK average grades. There are very few hate crimes and people are able to go about their business without interference. Islanders may like to gossip and some of the attitudes you encounter may be a little behind the times but, rarely, are they malicious. The new anti-discrimination legislation due to come into force in September 2015 should improve this situation through education and awareness campaigns. There are worse places in the world to be open about your gender or sexuality.

Telling people

Because news will spread fast in Jersey, you need to plan the order in which you inform people of your transition. You will find that most of your acquaintances will be accepting and supportive of your decision to transition. However, you don’t want to jeopardise that goodwill by people hearing of your news secondhand. We would suggest the following order as a starting point:

  • Your GP and other members of the medical profession necessary to establish that you wish to transition – this is guaranteed to be in confidence and a necessary first step.
  • One close friend or family member in whose judgement and discretion you trust – inform them that they are the only one who knows and that you are not telling anyone else for the moment. They will act as a sounding board for your thoughts and feelings. If you do not have access to someone suitable using an Internet forum specifically for trans* people where you can ask questions of other trans* individuals can provide the same support.
  • You can stop at this point until you are ready to come out as transgender. Once you are ready to come out, the next steps should follow in quick succession (i.e. within days of each other). Make sure that you inform each person you tell of who knows your news, apart from them, and what your timetable is for telling others.
  • Your advocate – this is guaranteed to be in confidence and the first public step you will have to take. Your deed poll should take about a week to process and pass through the Royal Court. It is not one of the Royal Court procedures announced in the Business Brief.
  • Your closest friends and family – try to do this face to face if possible. They will be the ones most concerned by your transition because they love you and the ones who require the most reassurance. Have some sources of factual information prepared for them (e.g. a self-help book, a lists of websites offering advice, a handout of basic facts that you have written, an open letter explaining your journey to this decision) to help with their understanding of what you are going through and to demonstrate that you take your transition seriously and have done your research.
  • Your line manager or, if more suitable, your personnel manager at work – the process for coming out at work is discussed in more detail below.
  • Your work colleagues, extended family members and casual acquaintances/friends – email makes this process much easier than it used to be. On the day that you inform your work colleagues, plan to send an email to your extended family members and casual acquaintances/friends. The email can be relatively brief but be sure to include your new name and the pronouns (he/him/his, she/her/her, they/them/their) you would like people to use from now onwards. You may also wish to explain your journey to this decision and provide some links to websites offering advice. This is the day that you will really feel that you have come out and you will, in all likelihood, find it a positive experience as most people will respond with messages of good wishes and congratulations.

transitionTransition management at work

In the workplace, you should expect the following considerations from the manager that you first approach with the news of your transition:

  • They take a non-judgemental stance
  • They are available if you need to talk
  • They support your plan for coming out to your colleagues
  • They assist in educating co-workers
  • They allow for mood changes caused by hormone therapy
  • They work with you to plan time off for surgery
  • They treat you no differently than they would other colleagues of that gender
  • They always use your new name and gender pronoun
  • They take appropriate disciplinary steps with co-workers who do not respect your gender
  • They remind co-workers that it is not their job to ‘out’ you to new employees joining the company
  • They inform you of anyone else that they are obliged to inform of your news and get your agreement to do so

In consultation with your manager, agree on the plan for telling your colleagues. You should plan to tell colleagues within a matter of days from telling your manager. There should be no reason for the manager to delay:

  • Set a date on which everyone will be told (all at once). Don’t allow the news to spread by gossip.
  • Find a method of telling everyone the same information at once. Email is probably the best way to do this so that staff who work remotely also hear at the same time. Keep the information clear and factual.
  • You may wish to undertake a presentation about gender issues to all staff in which a Q&A can happen. Only the most confident/comfortable trans* individuals are likely to undertake this but it can be a great way to get your colleagues comfortable with your news. Discuss this possibility with your manager.
  • You may wish to take holiday whilst your colleagues get used to your news so that your return to work marks a clear date on which you are dressed as your preferred gender and referred to by your new name/pronouns. Discuss this possibility with your manager.
  • Your manager may wish to offer all members of staff the opportunity to talk to them and air their concerns about the change. This is a good idea as it can stop any negative comments early on and the manager can get a feel for which employees might need anti-discrimination training.

Below is a sample email that can be adapted by you and your manager to send to other employees:

I have been asked by John Bunbury to write to you to inform you that he is starting a process of gender reassignment from male to female.

From [date], his name will change from John to Elizabeth (Liz). Liz has also asked to be referred to by female pronouns (she, her, hers) from this date.

I ask all employees to respect Liz’s wishes and to use her correct name and pronouns. I also ask that you respect Liz’s right to privacy and that you do not discuss this with other employees. Should you wish to discuss the matter, please arrange to see me in confidence.

[Optional] A presentation about gender issues will be held on [date], which all employees are expected to attend. Further details to follow.

[Optional] Liz is currently on holiday and will be returning on [date].

Toilets and changing rooms

One of the areas that gets people into difficulties is communal facilities that are gender segregated. You should expect to receive the following courtesies from your manager:

  • They should ask you which facility you would like to use.
  • They should offer to provide you with a gender-neutral option, but not force you to use one.
  • If other members of staff complain about the arrangements, they should educate them.

If your manager does not get this right, be patient with them because it will be due to lack of experience in dealing with trans* issues. Explain that you are the most vulnerable person in this situation not your colleagues and that using facilities designated for the opposite gender is one of the most daunting aspects of transitioning. Remind them that:

  • Digressing gender norms does not make you sexual predator.
  • The majority of sexual assaults in the world are perpetrated by cisgender (non-trans) men.
  • Even in the gents, you rarely, if ever, see other people’s genitalia when using public facilities.
  • Transwomen are put at risk of being physically assaulted by men when using men’s facilities.

Uniforms

If your organisation has a uniform:

  • Ensure that your manager arranges for a uniform matching your new gender to be provided as soon as possible.
  • The uniform may need to be altered fit. Your employer should offer to fund this for you but check company policy for whether this is covered for cisgender employees. If not, you are unlikely to get it covered either. (Transwomen may be broader in the shoulders, transmen may be shorter in the leg, than standard sizing.)
  • Agree a point in time when you will commence wearing your new uniform.

Health and safety

If appropriate to your work and your transition, you should discuss the following issues with your manager to ensure that they are aware that some of your duties may need to be adjusted as your transition progresses:

  • Hormone therapy brings about physical changes. Be aware that if you are an MtF manual worker you will not be able to lift the weight you used to.
  • Following surgery you may return to work but may not yet be capable of carrying out all your normal duties. Take medical advice about recovery times and appraise your manager of them.

Finally, Jersey does not currently have appropriate legislation to protect trans* workers’ rights. This is due to be introduced in September 2015. However, the States of Jersey appear to be modelling their new law on the UK Equality Act, so be aware that:

  • In the vast majority of cases, the gender of a worker is of no relevance to their ability to do a particular job. However, the Equality Act 2010 does allow for an exception where being of a particular sex is an ‘occupational requirement’ of that post. It might apply where the work necessarily involves conducting intimate searches, or where services are provided to one gender only, such as a women’s refuge.
  • The Equality Act makes it clear that the employer must act reasonably in applying an occupational requirement. For example, conducting intimate searches is unlikely to be a main part of any particular post. The employer must consider whether these tasks could be carried out by someone else. Also, the occupational requirement must be identified at the beginning of the recruitment process and stated in the application pack.
  • If an employee who is intending to transition permanently works in a single sex position or organisation, it is probably best for the employee, the employer and any service users if redeployment can be negotiated. Employers should make sure that options are discussed early on, to reach the best outcome.
  • Don’t forget that a person with a Gender Recognition Certificate is legally of that sex for all purposes.

Guides to managing your transition at work –
UNISON
GIRES
Stonewall
a:Gender
National Institute of Economic and Social Research
The Association of Graduate Careers Advisory Services

Help in Jersey

The first place any trans* person should go for support is their doctor or GP. If you do not think your GP is comfortable handling your case, do not be afraid to change to another GP in the practice or move practices. Your GP is the gatekeeper to many of the trans* services and medical procedures you will need to access so their support is crucial.

For those trans individuals who are going the public healthcare route into the UK system, the Community Mental Health Service (Adult Mental Health or Child and Adolescent Mental Health) at La Chasse is where their GP should refer them and where their psychiatrist will be based. For those wishing to see a psychiatrist privately, there are several practitioners in Jersey who have clinics at The Little Grove, St Lawrence. However, patients will still need to be referred there by their GP.

For those trans individuals who elect to undergo hormone therapy, the Department of Metabolic Medicine at Overdale is where their GP should refer them and where their consultant will be based. For those wishing to see an endocrinologist privately, there is a clinic at The Little Grove, St Lawrence. However, patients will still need to be referred there by their GP.

If you are unsure what you should do and just want to talk to someone in confidence, the Jersey branch of the Samaritans can be telephoned on 725555 or 08457 909090 or contacted by email at jo@samaritans.org

Trans* islanders seeking legal advice regarding their rights in Jersey can get free, confidential and impartial advice from the Citizens Advice Bureau.

Trans* islanders who wish to change their name by deed poll will need the services of a legal practice. Again, as with your GP, ensure that your advocate is sympathetic to your needs and do not be afraid to change if he or she does not seem comfortable handling your case.

help
As a trans* person you may be subject to discrimination or harassment as an employee or as a customer of a business. If you find yourself in this position, Jersey Advisory and Conciliation Service (JACS) can provide you with free, confidential and impartial advice regarding your rights.

Transwomen as a demographic are particularly vulnerable to physical abuse and attacks. In the unlikely event that you have been the victim of an attack in Jersey, you should call the States of Jersey Police (emergency no. 999, telephone no. 612612) as soon as possible to report the crime. If you want to speak to the LGBT community liaison officer, you should ask for PC710 Emma Poulliquen or email the LGBT community liaison team.

If you are in the UK, the Metropolitan Police give this advice for reporting a crime online and, specifically, regarding hate crime. If you are not sure whether you have been the victim of a hate crime, read the City of London Police guidelines.

Finally, when dealing with all these agencies, remember Jersey is a small place and your case may be the first of its kind for the person you are dealing with. Be patient with them and explain clearly what  you need them to do for you. You will find that most islanders are not transphobic and will do their best to help you.

Young People

If you are under 16, there are some specialist agencies in Jersey that can help you. All the agencies listed above will also help you – they are not just for adults.

If you are the victim of harassment, bullying or abuse, at home or at school, because of your gender expression, you should contact The Multi-Agency Safeguarding Hub (MASH) who work with lots of different childcare agencies to keep young people safe. They are based at the Bridge and can be contacted by telephone on 449213 or by email at enquiries-MASH@gov.je

If you just want to talk to someone in confidence about gender issues, you can contact YES by telephone on 08007 350121 (freephone) or 766628 or by email at yes@youthservice.yc.je All calls or emails to YES are treated in the strictest confidence.

Jersey trans* law

Currently, there is only one piece of legislation in Jersey that is directly concerned with protecting transgender islanders: Gender Recognition (Jersey) Law 2010

This law deals with the process of issuing a gender recognition certificate (“GRC”), the legal effect of a GRC on existing marriages and civil partnerships, the general consequences of issuing a GRC, the prohibition on disclosure of information relating to a holder of a GRC, the requirement (or not) to alter public registers and clarification of those agencies exempt from the prohibition on the disclosure of information.

Jersey recognises that it does not have the required healthcare professionals who can make decisions based on appropriate evidence to grant an inidividual a GRC. The island, therefore, looks to bigger jurisdictions to undertake this process for its trans* citizens. Having obtained a GRC from a jurisdiction approved by Jersey, a GRC will then be granted by the Royal Court. Most islanders will, therefore, apply to the UK for a GRC, which can then be presented in Jersey’s Royal Court.

The UK’s Gender Recogntion Act 2004 covers the issuance of GRCs. The granting of a GRC is decided by The Gender Recognition Panel, a branch of HM Courts & Tribunal Service. It is formed from an administrative team and a judicial panel, made up of legal and medical members. The panel needs to be satisfied that the applicant has lived in their correct gender throughout the period of 2 years prior to the date of the application and intends to continue doing so until death. It is a matter for the panel to decide whether the medical evidence satisfies that test. The charity GIRES provides guidelines for applying for a GRC here.

law
It is to be noted that the LGBT Consortium in the UK have recently published a consultation paper stating that the Gender Recognition Act is no longer fit for purpose and requires reviewing.

Advantages of obtaining a GRC:

  • All legal documents, including your birth certificate, can be changed to your correct gender. Note: the States of Jersey will issue driving licences and passports in your correct gender without the requirement of a GRC.
  • A GRC prohibits those privileged with the information that a person is trans* from disclosing it to others. There are, however, quite a number of exceptions to this prohibition.

Disadvantages of obtaining a GRC:

  • If you are married or in a civil partnership, you will need to dissolve or annul the union before a full GRC can be obtained from the Royal Court. Note: this is not a requirement for marriages in the UK since the passing of the Marriage (Same Sex Couples) Act 2013.

New sex discrimination law

The States of Jersey launched a consultation on the next phase of discrimination legislation due to become law in September 2015. It includes gender reassignment discrimination.

This will be the second piece of legislation to directly concern trans* islanders. We therefore want hear your views in order to formulate a response to the consultation.

Please our consultation page to find out more about how you can get involved before 30 May 2014.

Helping trans* teens become who they want to be

Puberty is an awkward time for just about everybody, but for transgender teens it can be a nightmare, as they grow overnight into bodies they aren’t comfortable with. In a heartfelt talk, endocrinologist Norman Spack tells a personal story of how he became one of the few doctors in the US to treat minors with hormone replacement therapy. By staving off the effects of puberty, Spack gives trans teens the time they need.

What it means to a trans* person to be able to be themselves

When fashion model Geena Rocero first saw a professionally shot photo of herself clad in a bikini, she was beside herself. “I thought…you have arrived!” she says proudly. This might not be the typical experience, but, as Rocero reveals, that’s because she was born with the gender assignment “boy.” In a moving and personal talk, Rocero finds that transgender activism is giving her a whole new sense of pride and purpose.

If you look at nothing else on this website, please 10 mins out of your day to listen to Geena Rocero’s talk about what it means to a trans* person to be able to be themselves.

The importance of support for trans* people

In this 5 minute video from the Department of Psychiatry at Columbia University, Walter Bockting, PhD, discusses findings from his latest paper, a national online study of transgender individuals’ mental health and the factors that lower psychological distress. The study, which provides the first empirical evidence that identity pride, family support and peer support can protect against anxiety and depression in the transgender population, was published in the American Journal of Public Health.