Contents
1 Introduction
Rotherham, Doncaster and South Humber NHS Foundation Trust (RDaSH) is committed to ensuring that all trans employee’s, and individuals working within the trust (and applicants applying for employment with the trust) receive equitable treatment and protection from discrimination at work. This policy has been developed to ensure that there is a clear process to support trans staff and to ensure that they are treated with complete dignity and respect, and in line with the law.
The aim of this policy is to assist managers and trans employees in RDaSH with practical information on workplace support and guidance and ensure that the provision for Trans employees is responsive to individual need, is prejudice free, and challenges any discrimination individuals may experience.
The trust is committed to go beyond it legal duties to provide protection on the grounds of gender identity and gender expression. Trans people should be protected from discrimination and harassment at all times, not solely when they are transitioning. Although the phrase ‘gender reassignment’ is used in the Equality Act 2010, it is now generally considered out-dated language. Both the Equality Act 2010 and the Gender Recognition Act 2004 are clear that gender reassignment need not involve any medical intervention. However, the phrase is widely misinterpreted to assume that it is a medical process, and this can feed myths and misunderstandings.
1.1 Definitions
‘Trans’ or ‘Transgender’ describes people whose gender identity differs from their sex assigned at birth. They are umbrella terms covering people who:
- are intending to undergo, are undergoing, or have undergone gender reassignment at any stage
- identify as having a gender different from that which they were assigned at birth and are planning or have had medical interventions such as hormones or surgery
- identify as having a gender different from that which they were assigned at birth, but who are not planning any medical intervention
- an umbrella term for a person who does not identify as only male or only female, or who may identify as both’, Stonewall
These are not mutually exclusive alternatives.
Transitioning, the steps a trans person may take to live in the gender with which they identify. Each person’s transition will involve different things. For some this involves medical intervention, such as hormone therapy and surgeries, but not all Trans people want or are able to have this. Transitioning also might involve things such as telling friends and family, dressing differently and changing official documents.
RDaSH recognises there is no right or wrong way to transition and is committed to supporting each individual in their decisions. Please see the glossary (appendix B) for further information.
1.2 Rationale
This policy sets out the trust’s responsibilities as an employer of trans people. Gender reassignment is a protected characteristic under the Equality Act 2010, and the trust has a duty to protect all Trans people and ensure that staff are not discriminated against or disadvantaged by service delivery or prejudice of trust employees, or by any other third party who work in partnership with the trust.
1.3 Principles
As well as ensuring that trans staff are fully supported, RDaSH will demonstrate its commitment to Trans equality in the following ways:
- ensuring that all training courses that are delivered are fully inclusive of Trans people this includes both face-to-face training and e-learning
- marking important dates for the trans community
- including trans people in publicity and marketing materials
- ensuring that all forms and surveys are inclusive of trans people, including non-binary people for both staff and clients
- including trans equality as a core part of the organisation’s equality agenda and objectives
- investigating fully all complaints of harassment or bullying, victimisation or discrimination on the grounds of gender identity, gender history, Trans identity or gender expression
- monitoring the implementation of this policy
2 Purpose
This policy provides guidance for the trust’s employees, line managers and trans people on the expectations and other considerations that may be necessary to improve the experiences and opportunities of trans people. Trans people are protected by the following legislative acts and where possible the trust is committed to go above and beyond to protect employees on the grounds of gender identity and gender expression, to afford full protection to trans employees.
2.1 Equality Act 2010
The Equality Act 2010 (England, Scotland, and Wales) protects against discrimination because of gender reassignment in employment and service delivery.
It bans direct and indirect discrimination and victimisation. The Act makes clear that it is not necessary for people to have any medical diagnosis or treatment to gain this protection; it is a personal process of moving away from the gender assigned at birth to the gender they would prefer. People discriminated against because they are wrongly perceived to be trans, or who are discriminated against because of their association with trans people or issues are also protected.
2.2 Gender Recognition Act 2004
The UK Gender Recognition Act (GRA) enables people aged over eighteen to gain full legal recognition for the gender in which they live. Applications are considered by the gender recognition panel. Once a person receives a gender recognition certificate (GRC), they are legally of that gender for every purpose and have all the rights and responsibilities associated with that gender. Not all Trans people will obtain or seek to obtain a GRC.
Employment rights do not depend on whether a person has a gender recognition certificate. Employers should not ask for a person’s GRC and it should never be a pre-condition for transitioning at work. To make an application for a GRC, a person needs to show they have been living and working in that gender for at least two years.
The Gender Recognition Act gives anyone applying for or holding a gender recognition certificate particular privacy rights. It is a criminal offence to pass on information acquired ‘in the course of official duties’ about someone’s gender recognition, without the consent of the individual affected. ‘Official duties’ include employment, trade union representation, or supply of business or professional services. It is also an offence to pass on information relating to an individual’s trans history or identity as a trans person without their consent, regardless of whether the individual has a GRC or not.
Article 8 of the European Convention on Human Rights provides a right to respect for one’s “private and family life, his home and his correspondence”, subject to certain restrictions that are “in accordance with law” and “necessary in a democratic society”.
- Everyone has the right to respect for his private and family life, his home and his correspondence.
- There shall be no interference by a public authority with the exercise of this right except such as is in accordance with the law and is necessary in a democratic society in the interests of national security, public safety or the economic well-being of the country, for the prevention of disorder or crime, for the protection of health or morals, or for the protection of the rights and freedoms of others.
2.3 Genuine occupational requirements
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. If this is the case for an employee transitioning at work, they will be redeployed into a suitable position.
3 Scope
This policy applies to all trust employees, students, contractors, bank staff, temporary workers, volunteers, lead employer and applicants for employment with the trust, and provides a framework for managers to support staff who identify with a gender other than that assigned at birth.
4 Responsibilities, accountabilities and duties
4.1 The trust
The role of the trust as an employer is:
- to provide direction for managers and staff who are responsible for operating this policy
- to put in place a procedure through which concerns are addressed
- to keep under review the effectiveness of this policy and procedure
- to keep the contents of the policy and procedure up to date and available for staff to view
4.2 Employee
- Engaging with managers and HR around the logistics of transitioning in the workplace.
- Reporting any instances of harassment or bullying, victimisation or discrimination.
4.3 Role of the managers
Every manager employed by the trust is responsible for promoting equal opportunities in practice and, where applicable, for preventing discrimination.
Line managers are responsible for:
- ensuring that all staff are aware of this policy and attend any relevant training
- challenging staff who discriminate and ensuring that the relevant procedures are followed
- supporting their staff to challenge discrimination from patients or the public
- agreeing a plan with a staff member who is proposing to transition to ensure that they are supported throughout the process
- supporting the employee in any way that is necessary and appropriate
- ensuring that colleagues are informed about the employee’s transition, this should be led by the employee
4.4 Role of the equality, diversity, inclusion and participation (EDI and P) workstream
The EDI and P standards workstream is responsible for:
- overseeing the development and monitoring of the trans equality policy
- consulting with members of the LGBTQ+ staff network and transgender community
- reporting to the Board through the people and organisational development committee, on any issues of discrimination or non-compliance of the transgender guidance
4.5 Role and responsibility of individual employees and co workers
All employees and co-workers have a personal responsibility to support the equal and fair treatment of colleagues and to ensure patients are treated consistently in a non-discriminatory manner and in line with clinical practice.
All staff members regardless of grade or profession must:
- adhere to and abide by this policy
- ensure its implementation and uphold the procedures referred to within
- ensure that new staff are appropriately briefed at induction on compliance with this policy
- challenge and report discriminatory practice or language
4.6 LGBTQ+ staff network
- Act as a support network for trans staff in the workplace.
- Take on a wider consultation and advice role to ensure the mental health and physical wellbeing of the wider trans community in RDaSH, is being met by the trust by monitoring policy effectiveness and advising on implementation.
4.7 Further support available
Should the individual require further support they can confidentially contact the trust’s head of equality, diversity, inclusion, and participation or head of recruitment and retention. Contact details can be found on the trust intranet pages.
5 Procedure and implementation
RDaSH has a zero tolerance approach towards discrimination and harassment based on gender identity, gender expression, or gender history. Inappropriate behaviour or language may constitute discrimination, harassment, bullying, or victimisation for example; deliberately referring to a trans individual by an incorrect name, deliberately using incorrect pronouns, disclosing or threatening to disclose an individual’s trans identity without their consent. The Equality Act 2010 covers discrimination including harassment, third party harassment, and victimisation. Managers are responsible for taking timely action where misconduct occurs on the grounds of an employee’s gender identity, in line with the relevant policies and procedures. This will be monitored and followed up.
5.1 Supporting the transition of staff in employment
5.1.1 Employees who are transitioning at work
If an employee states that, they are intending to transition at work, their line manager, in conjunction with other appropriate colleagues, should aim to make this process as smooth as possible. Managers should be aware that it could be an extremely difficult step for someone to approach their manager about transitioning. RDaSH is committed to reassuring all staff that they will be supported and respected. The transition process will be led by the individual concerned.
5.1.2 Process for an employee to change their name and gender marker on workplace systems
Legal name and gender “marker” (for example, “M” or “F” on legal identity documents) changes can sometimes take months or even years to be updated depending on the circumstances. Until then, every effort should be made to use the new name and gender marker on all documentation. (for example, email, phone directory, trust ID or access badge etc.) The only exception is where records must match the person’s legal name, such as on payroll and insurance documents.
Employees with a legal change of name and or gender marker should notify HR. This change should update all internal and benefits related systems. In everyday written and oral communication, the new name and pronouns should be used when the individual is ready.
5.1.3 Sharing or telling colleagues
The manager and employee will discuss the individual’s preferences in relation to informing others, including other managers, colleagues, service users and other relevant contacts. They will agree whether the employee will do this, whether they would prefer the manager or a work colleague to do this, or a mixture of these options. They will also get express written agreement from the employee about when and how this will happen, including the details of the message and whom it will be shared with. Levels of disclosure may vary in detail for different types of contacts and will be agreed in advance.
5.1.4 Uniforms and dress codes
If a uniform is in place for the role, managers will ensure that the trans employee has access to the uniform that best matches with their gender identity and gender expression. Some trans employees, including non-binary employees, may need access to both the male and female uniforms. Managers will be flexible, and will support the preferences of the Trans person wherever possible. Trans staff have the right to comply with any dress codes in a way that reflects their gender identity and gender expression.
5.1.5 Changing facilities, toilets, and other single sex facilities
The use of changing or toilet facilities should be part of the discussion process with the member of staff. An appropriate stage for using the facilities of the new gender is likely to be the change of social gender. Trans people are entitled to use single sex facilities in accordance with their gender. Should there be any objections to this; a manager will deal with the objections in a sensitive and understanding way while not denying the Trans person access to facilities appropriate to their lived gender. For non-binary people, this might mean using gender-neutral or accessible facilities, or using a combination of different facilities. In particular, trans people will never be required to use accessible toilets unless they wish to do so.
It is not acceptable to expect an individual undergoing gender reassignment to use facilities designated for use by those of their birth gender. Following gender reassignment, whether or not this has involved surgical procedures, the individual should be fully supported in using all facilities appropriate to his or her acquired gender.
5.1.6 Updating records
Electronic records will be updated in a timely manner, to coincide with the date on which the workplace transition begins. Care will be taken to ensure that records do not link back to the former name, this may entail creating a completely new email address rather than simply changing the name on the existing one, for instance. The manager and employee will work together to ensure that nothing is missed. New ID badges with the correct name and a new photograph will be issued, without any replacement cost to the trans employee. Paper records will be updated where possible. Those, which cannot be, updated for instance, paper copies of references relating to the employee’s recruitment or documents referencing the trans employees’ previous details will be kept in a confidential envelope on the individuals file clearly marked as only to be looked at by named persons.
5.1.7 Pensions and national insurance
Where pensions, national insurance contributions, or other benefits are dependent on legal sex, trans people will be advised of the different implications of whether they do or do not have a gender recognition certificate.
5.1.8 Professional registration
If the employee’s job involves professional registration, the individual will check whether the registration body has a specific, confidential process for gender transition. Further support and advice can be sought from HR if required.
5.1.9 Patient or service user facing roles
There is no reason why an employee who is transitioning should not continue in a patient or service user facing role. However, some people might prefer a period of redeployment during transition, or as a permanent change. Managers and HR will work with the Trans person to find a solution that meets the needs of both the employee and the service.
5.1.10 Attendance at appointments and time needed For treatment and surgery
Many people have to travel a long distance for appointments, and these may be given at short notice. People may need reduced hours or duties, or other changes to usual working arrangements, for a temporary period following some treatments. Managers will be as flexible as possible to accommodate this.
All employees will be given reasonable time off to attend appointments and this should be facilitated where possible. In addition, Trans staff are entitled to the same sickness absence and pay as other staff in accordance with the management of sickness absence policy.
Time off for medical appointments is addressed in the trust’s sickness absence policy. The sickness absence policy states:
- “employees undergoing medical or surgical procedures related to gender reassignment may require some time off from work. Line managers must allow employees paid time off work to undergo such procedures and it should not be counted towards an employee’s Bradford Factor or associated trigger points. Managers are reminded of the need for absolute confidentiality around an employee’s gender identity”
5.1.11 Support for employees with a family member who Is transitioning
If an employee is supporting a family member who is transitioning, they may need to take time off to attend appointments and treatment or give assistance following surgical procedures. Some of these may be at short notice, and may involve travelling a long distance. Managers will be as flexible as possible to accommodate this.
5.1.12 Sharing personal information
Under Section 22 of the Gender Recognition Act 2004, it is illegal of an individual to share information regarding someone’s trans status unless,
- there is specific agreement to do so by the trans person
- it is necessary for professionals to know someone’s trans status, in which case it is recommended that the trans person is asked to provide permission in writing
Anyone who, in their professional capacity, acquires knowledge of a trans persons history and passes on that information to a third party without the consent of the person concerned can be prosecuted and fined up to £5000 and or be jailed for up to six months. Trans people have no obligation to disclose whether or not they have a gender recognition certificate and do not require one to be able to change their personal details.
5.2 Recruitment and selection
RDaSH encourages applications from trans individuals for all posts across the trust, including volunteers.
Any applicant who is intending to undergo, is undergoing, or has undergone gender reassignment will not be required to disclose their status as part of any recruitment and selection process unless they choose to do so.
If applicants do choose to disclose their status, this must not be used as a reason for not offering the individual employment with the trust.
Where the role requires applicants to complete a disclosure and barring service check (DBS) there is a process, which provides trans individuals the opportunity not to reveal their previous name(s) or gender.
The DBS offers a confidential checking process to protect the privacy of applicants who have undergone gender reassignment. This process provides applicants with the opportunity not to reveal their previous name(s) or gender to their employer, or other organisation, when applying for a DBS check.
The DBS are fully committed to promoting equality and eliminating discrimination on grounds of gender identity and this process ensures that a transgender person’s application is dealt with sensitively and without the need to disclose previous names to the employer, whilst maintaining the integrity of their service.
The DBS provide a designated point of contact for Trans applicants, dedicating a small resource to deal with any queries that are raised, and provide help and support throughout the process. They are also solely responsible for contacting the applicant if further information is required.
If an applicant has a conviction under their previous details, it will show on a completed check. If a certificate is going to show any personal details that the applicant may not wish to disclose, the applicant will be informed of this and they will have the opportunity to withdraw the application.
If an applicant does not have a gender recognition certificate, the DBS advise to still contact the DBS’s Sensitive Applications team who will monitor the application.
For further information, please visit the applicant section of the DBS website (opens in new window). Anyone wishing to use the process may contact the DBS Sensitive Applications team directly on 0151 676 1452. Alternatively, the DBS have a dedicated email address for enquiries regarding transgender applications. It should be understood that withdrawal of a DBS check is likely to result in the applicant no longer being able to be appointed, as not all necessary checks will have been completed.
It may sometimes be necessary for a trans person to disclose their previous identity in order for references from past employers to be obtained. In these cases, strict confidentiality should be applied.
Where the trust has to keep evidence of professional status or qualifications, and this discloses an individual’s status, it should be discussed with the member of staff how this information will be retained so as not to compromise or breach disclosure of protected information.
6 Training implications
The trust is committed to high quality targeted training and effective communication to support this policy document. The objective is to implement this policy document and meet the training needs of staff over time. The focus of trust monitoring will be on this group over the agreed period or lifetime of the policy document.
All staff need to be aware of the key points that the policy covers. Staff can be made aware through the specific training that the trust hosts on ‘working with the transgender and gender diverse communities in healthcare’
7 Monitoring arrangements
7.1 Compliance with policy by all trust staff and volunteers
- How: Review of an grievances or concerns raised via IR1’s or FTSU.
- Who by: Head of EDI and P.
- Reported to: EDI and P workstream.
- Frequency: Quarterly.
7.2 Identification of training needs
- How: Supervision or PDR’s.
- Who by: Managers or supervisors.
- Reported to: Head of learning and development.
- Frequency: As required.
8 Equality impact assessment screening
To download the equality impact assessment associated with this policy please follow the link: Equality impact assessment.
8.1 Privacy, dignity and respect
The NHS Constitution states that all patients should feel that their privacy and dignity are respected while they are in hospital. High Quality Care for All (2008), Lord Darzi’s review of the NHS, identifies the need to organise care around the individual, ‘not just clinically but in terms of dignity and respect’.
As a consequence the trust is required to articulate its intent to deliver care with privacy and dignity that treats all service users with respect. Therefore, all procedural documents will be considered, if relevant, to reflect the requirement to treat everyone with privacy, dignity and respect, (when appropriate this should also include how same sex accommodation is provided).
8.1.1 How this will be met
No issues have been identified in relation to this policy.
8.2 Mental Capacity Act
Central to any aspect of care delivered to adults and young people aged 16 years or over will be the consideration of the individuals capacity to participate in the decision making process. Consequently, no intervention should be carried out without either the individuals informed consent, or the powers included in a legal framework, or by order of the court.
Therefore, the trust is required to make sure that all employees working with individuals who use our service are familiar with the provisions within the Mental Capacity Act (2005). For this reason all procedural documents will be considered, if relevant to reflect the provisions of the Mental Capacity Act (2005) to ensure that the interests of an individual whose capacity is in question can continue to make as many decisions for themselves as possible.
9 Associated documents
- Personal responsibility framework
- Personal harassment policy
- Policy for prevention and management of work related violence
- Policy and procedure for handling of formal complaints
- Incident reporting policy
- Zero tolerance policy
- Freedom to speak up policy
- Policy and procedure for the management of disciplinary matters
- Policy relating to the Management of sickness absence
- Grievance and dispute procedure
- Special leave policy
- Uniform and appearance at work and dress code
10 References
- Equality Act 2010 (and Subsequent Amendments).
- Gender Recognition Act 2004.
- Data Protection Act (1998) and Human Rights Act (1998).
- Stonewall Scotland and Scottish Transgender Alliance “Changing for the Better, How to include Transgender people in your workplace, a guide for forward thinking employers”.
- Department of health (DH), trans guidance for the NHS (2008).
11 Appendices
Appendices A Flowchart
- Step one, member of staff informs manager of their intention to undergo gender reassignment.
- Step two, manager and staff member complete action plan.
- Step three, manager and staff member discuss if this will impact on job role for example, is the current role gender specific?
If yes:- support the staff member to redeploy
- ensure staff member is fully aware of support available from the trust and outside resources if available
if no:
- discuss implications to role, for example, uniform, staff facilities
- agree how and who to inform the wider team
- manager should reinforce the zero tolerance policy to discrimination to the team
Appendix B Glossary of terms
| Term | Definition |
|---|---|
| Ally | A (typically) straight or cis person who supports members of the LGBT community |
| Cisgender or cis | Someone whose gender identity is the same as the sex they were assigned at birth. Non-trans is also used by some people |
| Trans | An umbrella term for people whose identity differs from what is typically associated with the sex they were assigned at birth. People under the trans umbrella may describe themselves using one or more of a wide variety of terms |
| Transgender | Refers to a broad range of people who experience and or express their gender differently from what most people expect either in terms of expressing a gender that does not match the sex listed on their original birth certificate (for example, designated sex at birth), or physically changing their sex. It includes people who are transsexual, cross-dressers or otherwise gender non-conforming. Not all people who consider themselves (or who may be considered by others as) transgender will undergo a gender Transition. use unison definition |
| Gender | Is the social meaning given to sex. A person’s gender role reflects the duties, qualities, and expectations of society based on gender, which includes how we have learned to walk, look, act, dress, what job we choose, what first name we have and so on |
| Gender expression | Refers to all external characteristics and behaviours that are socially defined as either masculine or feminine, such as dress, mannerisms, and speech patterns |
| Gender identity | This is an individual’s internal self-perception of their own gender. A person may identify as a man, as a woman or as having a non-binary gender |
| Bi-gendered | A person who considers themselves to be both male and female at different times |
| Non-gendered | A person who does not identify with any gender |
| Gender dysphoria or gender identity disorder (clinical terms) | A person with gender dysphoria can experience anxiety, uncertainty, or uncomfortable feelings about the gender they were born with. They may feel that they have a gender identity that is different from their biological sex |
| Gender reassignment | Is the term used to describe transitioning from one gender to the other. The process may involve different stages, such as change of name and title, through to surgical intervention |
| Misgender | Is when someone refers to an individual (especially a Transgender person) using a word, especially a pronoun or form of address that does not correctly reflect the gender with which they identify. If this is done deliberately with malicious intent, then it is discrimination |
| Gender recognition certificate (GRC) | By law, a person will be classed as their birth gender unless they apply for a GRC to change it legally. A name can be changed using a statutory declaration or deed poll |
| Transsexual | This was used in the past as a more medical term (similarly to homosexual) to refer to someone who transitioned to live in the ‘opposite’ gender to the one assigned at birth. This term is still used by some although many people prefer the term trans or transgender |
| Intersex | A term used to describe a person who may have the biological attributes of both sexes or whose biological attributes do not fit with societal assumptions about what constitutes male or female. Intersex people may identify as male, female, or non-binary |
| Sexual orientation | A person’s emotional, romantic, and sexual attraction to another person ‘Heterosexual’, ‘bisexual’, and ‘homosexual’ (for example, gay or lesbian) are all sexual orientations. A person’s sexual orientation is distinct from a person’s gender identity and expression |
| Non-binary | An umbrella term for a person who does not identify as only male or only female, or who may identify as both |
| Pronoun | Words we use to refer to people’s gender in conversation, for example, ‘he’ or ‘she’. Some people may prefer others to refer to them in gender neutral language and use pronouns such as they or their and ze or zir |
Appendix C Checklist, action plan for transition
Document control
- Version: 1.1.
- Unique reference number: 593.
- Date approved: 11 January 2024.
- Approved by: Corporate policy approval group.
- Name of originator or author: Amanda Ambler.
- Name of responsible individual: Shirley Kirkland, Head of Equality, Diversity, Inclusion and Participation.
- Date issued: 16 January 2024.
- Review date: March 2024.
- Target audience: All staff.
Page last reviewed: April 12, 2024
Next review due: April 12, 2025