Evidence submitted by Press for Change
1. Trans people are a small and vulnerable
minority whose needs have historically been overlooked in legislation,
creating injustices which have taken decades to resolve.
2. Protection for vulnerable minorities
must be assessed before the uploading of any data to the Electronic
3. The uploading of data without patient
consent would leave General Practitioners open to prosecution.
4. If the benefits of the Electronic Patient
Record are as great as the Government claims, then trans people
need to be persuaded of those benefitsnot just omitted
because it would be more expedient.
5. Press for Change (PFC) is the largest
representative organisation for transsexual people in the UK.
PFC was formed in 1992 to "achieve equal civil rights and
liberties for all transgender people in the United Kingdom, through
legislation and social change".
6. The campaign seeks to achieve its objectives
through education and engagement rather than confrontation or
demand-making. Good relations have been established with Ministers
and officials, as Government has addressed the problems faced
by trans people.
7. In 1997-99 PFC took part in consultation
and negotiation with the DfEE as it set out to introduce the Sex
Discrimination (Gender Reassignment) Regulations 1999. PFC
made substantial contributions to the work of the 1999-2000 Interdepartmental
Working Group on Transsexual People.
8. During 2002-04 PFC was involved as the
main stakeholder with the Department for Constitutional Affairs
in the shaping of the Gender Recognition Bill 2004, working closely
with ministers, officials, and parliamentarians of all parties
as the bill progressed. We have since been closely involved with
the implementation and promotion of the Act.
9. Transsexual people, or trans people as
is preferred, identify themselves as members of the sex opposite
to that assigned at birth, and may undergo medical treatment known
as gender reassignment.
10. Trans people are a discriminated against
minority who guard their privacy jealously.
11. A soon to be published report for the
Government's Equalities Review reveals that 20% of trans people
consider their General Practitioner to be trans-unfriendly. Such
attitudes traverse the NHS, affecting not only trans people's
access to gender identity treatments but colouring all interactions
with the "caring profession'.
12. PFC calls for detailed study of this
phenomenon and the development of the appropriate training and
good practice before trans people are requested to consider disclosing
their details in a way that could seriously affect the quality
of their healthcare.
13. Press For Change is concerned that the
Department of Health has made proposals for the medical records
of patients to be uploaded to a central repository without the
express consent of the patient.
14. Whilst we accept that there are good
reasons for medical personnel to have immediate access to a patient's
records in the case of an emergency, we believe that these records
would be available to any person working in the healthcare industryfrom
receptionist upwards, as well as IT professionals managing the
15. Section 22 of The Gender Recognition
Act 2004 makes it a criminal offence to disclose protected information
that has been acquired in an official capacity to a third party.
This would include any medical information that a doctor may possess
regarding their patient as well as the fact of a Gender Recognition
16. Paragraph 5 of the Gender Recognition
(Disclosure of Information) (England, Wales and Northern Ireland)
(No. 2) Order 2005 (Statutory Instrument 2005 No. 916) gives exemption
where the disclosure is made on medical grounds. It does, however,
draw very strict boundaries within which this is permissible.
5. (1) It is not an offence
under section 22 of the Act to disclose protected information
(a) the disclosure is made to a health professional;
(b) the disclosure is made for medical purposes;
(c) the person making the disclosure reasonably
believes that the subject has given consent to the disclosure
or cannot give such consent.
17. The intention to upload the medical
histories of trans people who are in receipt of a Gender Recognition
Certificate without their express consent would therefore fall
foul of at least paragraph 5(1)(c) of the above S.I.
18. Published good practice suggests that,
where the existence or otherwise of a Gender Recognition Certificate
is unknown, the assumption should be that the trans person has
been legally recognised in their correct gender and they should
be treated accordingly.
19. We therefore ask that you protect General
Practitioners from the danger of criminalization by recommending
that all patients are asked for their consent before their most
personal information is uploaded to any central servers.
20. We believe that to compel trans people
to have their most intimate details recorded on the Electronic
Patient Record (or to do it without seeking their informed consent)
would be to condemn those people to the inevitability of discrimination
and second class care.
21. Conversely, we recognise the potential
health benefits that could accrue to anyone having details accessible
in an emergency, so the solution is not to simply exclude trans
people from the Electronic Patient Record.
22. It is not a clear cut case of being
included (with the risk of discrimination) or being excluded (with
the risk of medical professionals not having access to vital details
in an emergency). A lose-lose choice is not a choice. If there
are genuine benefits to be obtained from the Electronic Patient
Record then we want trans people to be able to enjoy those benefits
equally to anyone else; the caveat is simply that adequate research
of the problems currently experienced, and effective steps to
ameliorate them are both necessary before asking trans people
to accept a system that's otherwise guaranteed to disadvantage
every member of our community.
Press for Change
25 February 2007