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Ruth Pearce @NotRightRuth
, 30 tweets, 12 min read Read on Twitter
I'm now in my second parallel session of the morning: "Services in Different Parts of the World".

First talk is by @PenelopeStrauss from Telethon Kids Institute in Perth, Australia, who is talking about the @Trans_Pathways study. #wpath2018
Strauss: Trans Pathways was a national survey of trans and gender diverse young people and parents/guardians. With 859 young people and 194 parents/guardians participating, it was the largest survey of its kind in Australia. #wpath2018
Strauss: Almost half of the young participants in the Australian Trans Pathways survey identified in non-bvinary terms. #wpath2018
Strauss: Young trans and gender diverse people had very mixed experiences with GPs. ~50% satifised with GP, ~20% dissatisfied. Issues included lack of knowledge as well as occasional hostility. #wpath2018
Strauss: Negative experiences of psychiatrists more common than positive ones among young trans people in Australia. Issues included misgendering, gatekeeping, and lack of knowledge of trans issues and experiences. #wpath2018
Strauss: Therapy often a much more welcome environment for young trans and gender diverse people in Australia. Findings still emphasise the important of therapists having a knowledge of gender diversity. #wpath2018
Strauss: 12.3% of young trans and gender diverse people in Australia reported accessing inpatient mental half services, mostly for suicide attempts. Experiences were overwhelmingly negative, and 34% said staff were not respectful of their gender identity. #wpath2018
Strauss: 17% of young trans people in Australia have been homeless. 39% have accessed crisis accommodation, of whom 43% felt their gender identity was not respected by the service. #wpath2018
More information on the Trans Pathways survey findings, along with recommendations for providers working with trans and gender diverse youth, can be found in the freely available report. #wpath2018…
Next we're hearing from Liberty Glenton Matthyse of @GenderDynamix: "Pan-Africanist questioning and reflections on accessing gender affirming healthcare in diverse African contexts". #wpath2018
Matthyse: Access to gender affirming services is not a priority in Africa. Key priority areas according to a 2014 UN report include peace and security, economic growth and proverty reduction, democracy and good governance and the advancement of basic human rights. #wpath2018
Matthyse: Lack of access to doctors in many African countries. Pan-African perspectives look to collective cross-national approaches to tackling issues such as this. #wpath2018
Matthyse: We can't talk about gender-affirming healthcare without talking about the social contexts that affect trans people's lives. @GenderDynamix are working to build capacity through collaboration across southern African countries. #wpath2018
Matthyse: Gender Dynamix are organising community-led peer-to-peer healthcare provider training. Important to acknowledge exceptional diversity of southern Africa. Healthcare provision and gender recognition must meet people where they are in specific contexts. #wpath2018
Matthyse: It's important that trans healthcare training is led by the community in collaboration with providers. Non-trans providers aren't necessarily fully educated and knowledgeable about the issues. #wpath2018
Matthyse: Important to incorporate Indigenous knowledge and perspectives in healthcare provision. 80% of Africans are likely to access traditional healers rather than Western-style standardised services. To expand affirmative care, educators must speak to this. #wpath2018
You can read more about the work of Gender Dynamics on their website. #wpath2018
Finally in this session we're hearing from Gordon Wilkinson, lead clinician for the Young People's Gender Service at Sandyford in Glasgow, Scotland. #wpath2018
Wilkinson: Scotland is a small country with a population of approximately 5 million. It has five centres that provide gender identity services, in Glasgow, Dundee, Inverness, Aberdeen and Edinburgh. All evolved in an ad-hoc way due to a clinician's individual interest. #wpath2018
Wilkinson: Gender identity services in Scotland funded publicly through the National Health Service. Services have seen improvment since 2010, when the Equality and Human Rights Commission raised concerns about transphobic discrimination in healthcare. #wpath2018
Wilkinson: The protocol for gender identity services in Scotland (…) was pioneering in 2012, but arguably focuses unnecessarily on pathway directed towards surgical outcomes, and rigour of assessment procedures. #wpath2018
Wilkinson: Scottish government requested development of National Gender Identity Clinical Network for Scotland to link health professionals working in gender services across Scotland. "Launched on 1 April 2014 - not necessarily the best date". #wpath2018
Wilkinson: recent report by Scottish Public Health Network highlights difficulties in accessing Scottish services for trans patients, including lack of inclusivity for non-binary people and issues with waiting times. #wpath2018…
Wilkinson: Need to collect more robust data in Scotland to monitor where demand lies and what the current needs of trans patients are. #wpath2018
Audience question about possible extension of gender services for under-18s in Scotland.

Wilkinson: possibility of new service in Lothian, Sandyford keen to support expansion but encountering practical issues. Interested in English approach with single service #wpath2018
Question from Tanzanian audience member. Asks what providers in the Global North will do to support development of services in Africa.

Wilkinson highlights that change has occurred over time in Scotland. #wpath2018
Matthyse highlights economic inequalities between Scotland and southern Africa - not seeing any rapid changes in the latter. "There is a broader question to be asked about economic justice" in terms of relations between Global North and South. #wpath2018
Question from someone based at London's Gender Identity Development Service - has Scotland seen a similarly huge rise in referrals?

Wilkinson: Yes - but there hasn't been a similar rise in recruitment of clinicians, which is an issue. Waiting times 12-14 months. #wpath2018
Wilkinson: Waiting times for young people wanting to access gender identity services in Scotland are unacceptable. Service requires increased investment. #wpath2018
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