Demographic characteristics, long-term health conditions and healthcare experiences of 6333 trans and non-binary adults in England: nationally representative evidence from the 2021 GP Patient Survey Original research

Objective: To address the lack of data on the health and healthcare needs of trans and non-binary adults, NHS England included gender and trans status questions in the GP Patient Survey (GPPS). Using self-reported GPPS 2021 data, we asked: what are the demographic characteristics, health conditions, and healthcare experiences of trans and non-binary adults in England? Design/setting: Nationally representative, population-based cross-sectional survey in England, data collected January–March 2021. Participants: 840,691 survey respondents, including 6,333 trans and non-binary adults. Outcomes: Weighted descriptive statistics; logistic regression for 15 long-term physical and mental health conditions, and 18 patient experience items covering overall experience, access, communication, and continuity. Results: Trans and non-binary adults were younger, more likely to be from Asian, Black, Mixed or other ethnic groups, and more likely to live in more deprived areas. Age-specific patterns of long-term conditions were broadly similar to other respondents, with some variation by condition. Overall, inequalities were largest for autism (OR 5.8, 95% CI 5.0–6.6), dementia (3.1, 2.5–3.9), learning disabilities (2.8, 2.4–3.2) and mental health (2.0, 1.9–2.2), with variation by age. In healthcare experience, disparities were much greater for interpersonal communication (OR for positive experience across items 0.4–0.7) than access (OR 0.8–1.2). Trans and non-binary adults reported a much higher preference for continuity (OR 1.7, 1.6–1.8), with no evidence of differences in being able to see or speak to a preferred GP. Conclusion: This research provides up-to-date, nationally representative evidence on demographics, long-term conditions and healthcare experiences to inform healthcare improvement for trans and non-binary adults.