{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T20:25:22Z","timestamp":1783542322221,"version":"3.55.0"},"reference-count":33,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T00:00:00Z","timestamp":1675296000000},"content-version":"unspecified","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["RHZB\/a95"],"award-info":[{"award-number":["RHZB\/a95"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR Cambridge Biomedical Research Centre","award":["BRC-1215-20014"],"award-info":[{"award-number":["BRC-1215-20014"]}]},{"name":"Three NIHR Research Schools Mental Health Programme","award":["MH041"],"award-info":[{"award-number":["MH041"]}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RG\/13\/13\/30194"],"award-info":[{"award-number":["RG\/13\/13\/30194"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RG\/18\/13\/33946"],"award-info":[{"award-number":["RG\/18\/13\/33946"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"name":"EU\/EFPIA","award":["116074"],"award-info":[{"award-number":["116074"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,1,24]]},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In order to address the lack of data on the health and healthcare needs of trans and non-binary adults, NHS England includes questions asking about both gender and trans status in its surveys to support quality improvement programmes.<\/jats:p>\n                    <jats:p>We used self-reported data from the GP Patient Survey to answer the research question: what are the demographic characteristics, health conditions and healthcare experiences of trans and non-binary adults in England?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design\/setting<\/jats:title>\n                    <jats:p>Nationally representative, population-based cross-sectional survey in England with survey data collection from January to March 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>840 691 survey respondents including 6333 trans and non-binary adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>We calculated weighted descriptive statistics, and using logistic regression explored 15 long-term physical and mental health conditions, and 18 patient experience items, covering overall experience, access, communication and continuity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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 parts of the country. Age-specific patterns of long-term conditions were broadly similar among trans and non-binary adults compared with all other survey respondents, with some variation by condition. Overall, inequalities in long-term health conditions were largest for autism: OR (95%\u2009CI), 5.8 (5.0 to 6.6), dementia: 3.1 (2.5 to 3.9), learning disabilities: 2.8 (2.4 to 3.2) and mental health: 2.0 (1.9 to 2.2), with variation by age. In healthcare experience, disparities are much greater for interpersonal communication (OR for reporting a positive experience, range 0.4 to 0.7 across items) than access (OR range 0.8 to 1.2). Additionally, trans and non-binary adults report much higher preference for continuity 1.7 (1.6 to 1.8), with no evidence of any differences in being able to see or speak to a preferred general practitioner.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This research adds up to date evidence about population demographics, health and healthcare needs to support healthcare improvement for trans and non-binary adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-068099","type":"journal-article","created":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T10:34:09Z","timestamp":1675334049000},"page":"e068099","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["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"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3127-3218","authenticated-orcid":false,"given":"Catherine L","family":"Saunders","sequence":"first","affiliation":[{"name":"Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1132-0275","authenticated-orcid":false,"given":"Alison","family":"Berner","sequence":"additional","affiliation":[{"name":"Barts Cancer Institute, Queen Mary University of London, London, UK"},{"name":"Tavistock and Portman NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Lund","sequence":"additional","affiliation":[{"name":"Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy M","family":"Mason","sequence":"additional","affiliation":[{"name":"Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tash","family":"Oakes-Monger","sequence":"additional","affiliation":[{"name":"NHS England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meg","family":"Roberts","sequence":"additional","affiliation":[{"name":"University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Smith","sequence":"additional","affiliation":[{"name":"Lifestrong, Wolverhampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2023-5328","authenticated-orcid":false,"given":"Robbie","family":"Duschinsky","sequence":"additional","affiliation":[{"name":"Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,2,2]]},"reference":[{"key":"2025120518542742000_13.2.e068099.1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1080\/19359705.2014.960990","article-title":"Trans people\u2019s experiences of mental health and gender identity services: a UK study","volume":"19","author":"Ellis","year":"2015","journal-title":"Journal of Gay & Lesbian Mental Health"},{"key":"2025120518542742000_13.2.e068099.2","unstructured":"Government Equalities Office . 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