Gender reassignment - administration processes and procedures

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Dear Birmingham Women's and Children's NHS Foundation Trust,

What documentation is provided to be completed by service users who begin, are undergoing, or have completed (including having been assigned a new NHS number) gender reassignment in order to change their details held by the trust?

What systems are in place in relation to handling patient records, both electronic and hard copy, for service users held in a previous and current identity? Including alert systems, quarantining, linking of records, data security, data accuracy, etc.

What systems and policies are in place in relation to services users, new and existing, who refuse to disclose their previous medical history in relation to previous identities and gender reassignment?

What systems and policies are in place regarding service users who obtain a gender recognition certificate?

What systems, reviews and oversights are in place to ensure the trust is reviewing and updating its policies and practices in relation to service users who are or have undergone gender reassignment, those who obtain a gender recognition certificate, and for complying with changes in legal requirements and regulations in relation to gender reassignment?

Yours faithfully,

L-M Nelson (Miss)

Freedomofinformation (BIRMINGHAM WOMEN'S AND CHILDREN'S NHS FOUNDATION TRUST), Birmingham Women's and Children's NHS Foundation Trust

Please accept this email as formal acknowledgement of your request for information.

This request will be processed in accordance with the Freedom of Information Act 2000 and unless you are otherwise informed, your request will be processed within a maximum of twenty working days from receipt.

At this moment we are unaware of any fees, charges or exemptions likely to be applied to your request. However, if during the course of processing your application it becomes clear that fees will apply, we will inform you of this. In the event that costs are applicable, no information will be provided unless the costs are paid within three months of us informing you. In the event that some or all of the information you have requested is exempt from disclosure, we will inform you of this.

We will also contact you if during the process it emerges that we do not have sufficient detail to locate the information or we are unclear exactly what it is that you have requested.

In the meantime if you wish to discuss any aspect of your request please feel free to contact us at this email address.

Yours sincerely

FOI Lead/Publication Scheme Co-ordinator
Birmingham Womens and Childrens NHS Foundation Trust
[Birmingham Women's and Children's NHS Foundation Trust request email]

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Freedomofinformation (BIRMINGHAM WOMEN'S AND CHILDREN'S NHS FOUNDATION TRUST), Birmingham Women's and Children's NHS Foundation Trust

Thank you for your request. This doesn’t apply at Birmingham Children's Hospital as gender cannot be legally reassigned in childhood.

At Birmingham Women's Hospital it is worked through on an individual basis as it is so rare. We don’t have any written policy but the clinicians inform their team and the notes are linked to stop information being lost but to allow the patients prefered gender to be in the records

Publication Scheme Coordinator
Birmingham Women’s and Children’s NHS FT

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Dear Freedomofinformation (BIRMINGHAM WOMEN'S AND CHILDREN'S NHS FOUNDATION TRUST),

Thank you for your prompt reply. I am though very concerned by the reply.

The trust appears unaware that those under the age of 18 are able to update their NHS records, be that their name, NHS number etc. to reflect their preferred gender. For the convenience of the trust please see the following guidance from the Tavistock and Portman Trust who run Gender Identity Services for under 18's on the NHS. https://gids.nhs.uk/young-people
The holding of or obtaining a gender recognition certificate is not a requirement to update records. While a certificate cannot be issued until age 18, the requisite conditions can be satisfied to obtain a certificate before the age of 18, such as holding a passport in a preferred gender, changing name, updating medical records, etc.

I am equally concerned by the second part of your response. I refer for the trusts convenience guidance from the GMC https://www.gmc-uk.org/ethical-guidance/...
The response provided leads to the assertion that full gender history will be disclosed for patients in the care of the Trust. This, if true, likely to conflict with the Gender Recognition Act 2004 and Equality Act 2010. The application of these laws has no bearing on how "rare" the Trust perceives a set of circumstances to occur or not.

I would have hoped and expected the trust had comprehensive policies regarding complying with the Gender Recognition Act 2004 and the Equality Act 2010, as such I am disturbed there are no policies in place to comply with the law.

Yours sincerely,

L-M Nelson (Miss)

Freedomofinformation (BIRMINGHAM WOMEN'S AND CHILDREN'S NHS FOUNDATION TRUST), Birmingham Women's and Children's NHS Foundation Trust

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Dear Mis Nelson

Thank you for your email of 12th February. To put some context around our first response, we use the guidance attached to this email. To date we have not had many requests and where requests have been received these have been managed by each patient on an individual basis. We link in with the patient's GP, so they are aware we are changing the sex as this feeds the national spine and therefore the GP will see the change of sex when they access he patient details. We also link in with the family and the clinician.

We hope this additional information is useful.

Yours sincerely

FOI Lead/Publication Scheme Co-ordinator
Birmingham Womens and Childrens NHS Foundation Trust
[Birmingham Women's and Children's NHS Foundation Trust request email]

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Dear Freedomofinformation (BIRMINGHAM WOMEN'S AND CHILDREN'S NHS FOUNDATION TRUST),

Thank you for your prompt reply and your additional information.

Yours sincerely,

L-M Nelson (Miss)