The role(s) transgender people want primary care services to have in their healthcare: a qualitative study in Southeast England

Background: Transgender (trans) people experience health inequalities, which includes inequities in accessing and navigating healthcare systems. General practitioners (GP) in England have a limited role in delivering trans-specific healthcare. Few studies have explored what is positively working in GP-led primary care settings and how this can be more widely implemented. Aim: To explore the views and expectations of trans people regarding primary care services.Methods: Data were generated using qualitative semi-structured one to one interviews conducted with trans experts by experience who were recruited through purposive sampling. Results were analysed and coded using a thematic analysis framework to identify key themes.Results: Positive and negative experiences of accessing and navigating general practice settings were identified by 16 trans people as experts by experience. An overarching theme was for gender-affirming services to be provided through general practice in order to reduce waiting times for specialist care and to move towards an informed consent model of care.Conclusion: Through demonstrating examples of good practice, general practitioners are advised to take a proactive role in providing positive gender-affirming healthcare for trans people. An informed consent model of care should be implemented to improve healthcare access.