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Advocacy Empowers: Gender Identity

Independent Health Complaints Advocacy – Evan’s story, as told by their independent advocate, Helena.


For some years, Evan has wanted to undergo gender reassignment to transition from a man to a woman. Evan is a young person who lives in supported living accommodation and needs help and support with reading and writing due to dyslexia. Over the years, Evan has been supported with mental health issues as feeling trapped inside the wrong body has caused them to suffer from bouts of severe anxiety and depression.


Back in 2016 Evan’s GP referred them to the Gender Identity Clinic, however, as there had been no contact from the clinic, Evan assumed that the referral had not been accepted. It was only during a more recent medical appointment that Evan found out that, in 2016, the Gender Identity Clinic had written to Evan. Unfortunately, due to dyslexia, Evan was unable to process or respond to the letter which led to the Gender Identity Clinic automatically discharging Evan from the service, without first following up on why there had been no response.


Evan was devastated by this and felt that the clinic was not accessible for people with dyslexia and that they were too quick to make assumptions when they should have followed up the referral with a phone call before closing it. Evan felt that as they were discharged through no fault of their own and that so much time had already passed, they should be referred to the clinic without being placed on a waiting list. Both elements formed the basis of Evan’s NHS complaint.


As an Independent Health Complaints Advocate, I supported Evan with their complaint, carefully managing their expectations of what advocacy could achieve and explaining that sometimes NHS complaints take time to be resolved. Evan was understandably frustrated with the clinic which impacted negatively on their mental health so it was important that I took time and built trust so that we could positively progress. An important element of me gaining Evan’s confidence was by using the appropriate terminology and pronouns for someone who wants to undergo gender reassignment.


In order to liaise with the clinic on Evan’s behalf I had to provide a consent form signed by Evan. This was not as straightforward as it sounds. Due to Covid-19 restrictions, the physical assistance Evan needed to be able to sign the form could not be provided which risked even more delays to the process. As Evan’s advocate, I explained this to the Clinic, requesting that they, instead, accept verbal consent via a phone call from Evan. Having initially refused my request, eventually they accepted the reasons as valid.


Thanks to Evan’s verbal consent, I was able to liaise directly with Clinic staff on Evan’s behalf, ensuring that the Clinic had accurate information regarding Evan’s needs.

With my help, Evan wrote to the Trust who runs the Clinic, clearly outlining each aspect of the complaint and requesting that they are not put on a waiting list. I also ensured that the Trust and Clinic communicated with Evan verbally by phone, which empowered Evan to self-advocate and communicate their wishes.


Eventually Evan was contacted by the Gender Identity Clinic to confirm that they had backdated Evan’s referral. Evan was delighted by this outcome and has already attended their first video meeting with the Clinic. The Trust also apologised for the lack of follow up with the initial referral, stating that since 2016 they have changed their policies and now follow up on any referrals that have not been responded to. Evan called me to say how happy they were with such a positive outcome to their complaint, telling me that advocacy really helped them to speak up and be listened to;

“You talked to me, you understood me, and you helped me every step of the way. Thank you.”

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