Improving access to inclusive sexual health services for trans and gender diverse people in the United Kingdom

Trans and gender diverse (T/GD) people in the UK often face barriers to accessing sexual health services, including fear of being misgendered, misunderstood or denied appropriate care. Although professional guidance existed, it was not sufficiently informed by the experiences of T/GD service users.

This NIHR-funded study addressed that gap by engaging 59 T/GD participants through interviews and focus groups to identify practical ways to improve inclusivity. The research showed that simple, low-cost changes, such as using inclusive language, adapting registration forms, displaying visible signs of inclusivity and adopting person-centred clinical approaches, can significantly improve patient experiences.

The findings directly informed the development of the BASHH Trans Inclusive Sexual Health Workbook, a practical resource designed to help clinicians and services become more inclusive. The workbook was disseminated through a national multidisciplinary study day attended by 100 healthcare professionals, extending its reach across UK sexual health services.

The work is already influencing clinical practice by providing clear, actionable guidance to improve care for T/GD people. It supports more equitable access to prevention, testing and treatment services, including interventions such as PrEP and doxyPEP. By helping services become more welcoming and accessible, the research has the potential to increase service uptake, improve early diagnosis and prevention of HIV and sexually transmitted infections, and reduce health inequalities experienced by a marginalised population.

Overall, this work is contributing to a more inclusive, person-centred and equitable sexual health system, aligned with NHS and NIHR priorities for prevention and reducing inequalities.

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