Recruitment and Retention of Trans Staff

Policy for the Recruitment and Retention of Transgender Staff

INITIATED BY: Workforce & OD Directorate

APPROVED BY: Quality, Safety and Risk Committee

DATE APPROVED: 5th September 2017

VERSION: one

OPERATIONAL DATE: 2nd October 2017

DATE FOR REVIEW: 3 years from date of approval or if any legislative or operational changes require it 4th September 2020

DISTRIBUTION: All Staff via Intranet & Core Brief Message

FREEDOM OF INFORMATION STATUS: OPEN

CONTENTS

1. Purpose 3 2. Policy Statement 3 3. Principles 3 4. Scope 4 5. Legislative and NHS Requirements 4 6. Procedure 5 7. Training Implications 10 8. Review, Monitoring and Audit Arrangements 10 9. Managerial Responsibilities 11 10. Retention or Archiving 11 11. Non Conformance 11 12. Equality Impact Assessment Statement 11 13. References 11 Appendix 1……………………………………………………………. 12 Appendix 2…………………………………………………………………………16 Appendix 3………………………………………………………………………….19 Appendix 4………………………………………………………………………….20 Appendix 5………………………………………………………………………….22 Appendix 6………………………………………………………………………….24 Appendix 7…………………………………………………………………………..27 Equality Impact Assessment………………………………………………………29 Training Assessment………………………………………………………………38

1. PURPOSE

The aim of this policy is to create a fair and equal culture in which staff are protected from discrimination, harassment and victimisation on the grounds of their transgender status.

2. POLICY STATEMENT

All staff shall have the right to work in an environment where they feel equally valued, respected and as supported as other staff, All staff shall be free from harassment and/or behaviour that makes them feel uncomfortable regardless of their transgender status or any other protected characteristic under the Equality Act 2010.

A person has the protected characteristic of gender reassignment if the person is proposing to undergo, is undergoing or has undergone a process (or part of a process) for the purpose of reassigning the person's sex by changing physiological or other attributes of sex.. However the Health Board is equally supportive of staff who do not undergo surgical procedures but identify as trans*.

We also recognise that some staff may be trans* but not wish to disclose and the Health Board respects this. The emphasis of this policy is therefore on staff who do wish to disclose during the recruitment process or during their employment.

3. PRINCIPLES

Dignity and inclusion shall be fundamental to all aspects of Trans* people’s experience of Cwm Taf University Health Board.

Cwm Taf will aim to create an open, diverse and supportive work environment that meets the needs of all Trans* people and supports their aspirations.

We will support staff who have changed their gender identity before joining the organisation where support is needed or requested – this may include during the recruitment process including employment screening, induction and all aspects of ongoing management and supervision.

We will support staff who may be considering changing or are changing their gender identity whilst employed by the UHB. The exact nature of this shall be mutually agreed with the individual but it may include flexible management of leave, specific support in maintaining

3 good working relationships with colleagues and patients, support from HR and Occupational Health, identifying appropriate organisations that can provide help and advice.

We will support transgender staff, their managers, colleagues and all other staff in maintaining a professional working environment that embraces diversity, and promotes fairness and equity for all. Bullying and harassment of staff will not be tolerated.

We have an LGBTQ champion on our Board and they shall promote support for trans* staff at every opportunity. We will encourage role models and mentors should suitable individuals be available. We will also seek out suitable champions..

We will provide general advice, training and guidance to raise awareness and build understanding throughout the organisation around transgender issues and gender reassignment.

We will ensure that we comply with relevant legislation, see Appendix 1.

4. SCOPE

This policy shall apply to all trans* staff i.e. people whose gender identity differs form that assigned to them at birth. Trans* is an umbrella term which includes all transgender, non- binary, and gender nonconforming identities, including (but not limited to) transgender, transsexual, transvestite, gender queer, gender fluid, non-binary, genderless, agender, non- gendered, bigender, and trans man and trans woman. It is important to note that some individuals may vary their appearance on an occasional basis, may change their appearance/identity on a consistent, long term basis and/or may undergo partial or full surgery.

Further information can be found in Appendix 2.

This policy will also apply to trans* staff’s managers and colleagues.

5. LEGISLATIVE AND NHS REQUIREMENTS

Gender Recognition Act 2004 Equality Act 2010 Human Rights Act 1998 and specifically  Article 2 Right to Life  Article 8 Right to Respect for Private and Family Life  Article 10 Right To Freedom of Expression

 Article 12 Right to Marry and Found a Family  Article 14 Prohibition of Discrimination

Pensions Act 1995 Employment Rights Act 1996 Protection from Harassment Act 1997 Data Protection Act 1998 Civil Partnership Act 2004 Marriage (Same Sex Couples) Act 2013.

6. PROCEDURE

Recruitment and Selection

This section outlines specific recruitment issues in relation to trans* staff and should be read in the context of the Cwm Taf Recruitment policy which provides further detail of every stage.

It is important that we take steps to be thought of as a “good employer” within the trans community, take steps to attract applications from suitably qualified trans job seekers; ensure that the recruitment processes do not present barriers to trans applicants; and ensure that appointing managers respond to, and assess trans candidates appropriately. Our website should be positive and encouraging to people from protected groups to wish to work for Cwm Taf UHB and full consideration given to the following issues. It will be essential to clearly establish our trans* friendly stance.

Application forms

Candidates have the option of using the MX title when applying for posts. It would be desirable in due course to include ‘other’ in addition to ‘male’ and ‘female’ but this will depend on enhancements to the Trac system. Information regarding previous names should be managed sensitively and securely stored.

Security and vetting

Candidates shall be informed via the advert and job description where further screening is necessary e.g. Disclosure and Barring Service (DBS) checks.. There is a confidential DBS process specifically for trans applicants, who should contact the DBS sensitive applications line on 0151 676 1452 or email [email protected] for further advice about completing the form.

Genuine Occupational Requirements

Very occasionally, there may be genuine occupational factors that legitimately restrict applicants. This is known as a ‘Genuine Occupational Requirement’ (GOR). Very careful consideration should be given before applying a GOR. Such restrictions are rare and, if wrongly applied, unlawful. The Equality and Human Rights Commission (EHRC) provides advice on the use of GORs (under occupational requirements in the Employment Statutory Code of Practice).

Equality monitoring forms

Equality monitoring is a very important part of a recruitment process because it tells employers whether they are attracting a diverse range of applicants. It also shows whether there are any issues within the process that are preventing certain groups from progressing through the selection process to appointment, or from advancing through the organisation on promotion. This information will be held separately and not shared with Appointing Officers throughout the recruitment process.

Where it is used for monitoring and reports e.g. the annual Equality report, it must be managed sensitively to avoid any breach of confidentiality and accidental exposure of an individual.

Workforce Management staff and Occupational Health will be issued with guidance and/or appropriate training as required and encouraged to provide support to individuals as required.

Interview Process

Candidates may not wish to disclose their trans* status at interview and it is not a question that should be asked in the same way that candidates would not be asked about any other equality characteristic. It is best not to assume someone’s gender simply by their appearance.

In some circumstances, candidates may advise a recruitment panel that it is their intention to transition. In such circumstances Appointing Officers should thank the candidate for their openness, explain that if successful they will support the individual; and remain focussed on the purpose of the interview, i.e. does this person have the skills and experience for the job.

References

When asked for a reference for a trans* person, the usual principles of fairness and accuracy apply. If asked for a reference from someone who has transitioned since leaving your employment (or given a referee’s name from before they transitioned), it is advisable to make direct contact with the ex-employee to discuss the reference. Clearly the content of the reference in terms of capabilities, experience etc. will be the same but care must be taken around the use of pronouns and names.

Birth Certificates

Under the Gender Recognition Act 2004, people who have fully transitioned may have a new certificate and may not be asked to disclose their original one. Birth certificate information must be treated with the utmost sensitivity.

Work Permits and Professional Registration

Care must be taken to avoid any breach of confidentiality in following up this information and again this should be discussed with the applicant in terms of the best approach.

Record Keeping

Any records and information in relation to trans* staff should be treated as sensitive data under the Data Protection Act.

Induction

Any member of staff who has disclosed that they are trans* should have the opportunity to meet, or have a conversation with Workforce Management, Occupational Health and/or their managers in relation to their appointment. It will be important to flag up any concerns that they may have. Many of the issues addressed in the following section will be equally important to staff who are new to the organisation.

Managing Staff During Transition

Cwm Taf is committed to the retention of people who are considering or planning transition, are transitioning or have transitioned. We recognise the positive outcomes and benefits to the organisation that a successfully transitioned, fully supported employee can provide, ie loyalty, positive promotion and longevity of service. Managers need to listen and agree the approach that suits the service and the trans* individual. It is important to remember that many practical issues may arise and no two situations are the same. It is essential for those concerned to be as informed as possible and to make every effort to understand the

7 individual’s needs. It must also be recognised that some staff will wish to de-transition and will also require support and a similar process to that outlined below will be necessary.

Guidance for staff who wish to transition can be found in Appendix 3.

It is very important that staff who are transitioning feel comfortable and in their workplace and guidance for colleagues can be found in Appendix 4.

Before transitioning – making a plan

Because of the general lack of awareness in relation to gender identity issues in the workplace, it can be an extremely difficult step for someone to approach their manager to tell them that they are planning to transition in terms of the manager’s own reaction or the implications for their future role. These concerns can be offset if the employer has an inclusive approach and a culture that values difference.

However, the key issues for managers at this early stage are to listen, show support, discuss levels of confidentiality, to agree to seek advice and agree to work in partnership. The process should be led by the individual as much as possible. It is important to take advice from Workforce Management, the Equality Manager, Occupational Health or one of the specialist organisations.

The plan should be a starting point, should be as personalised as possible and can be adapted over time to meet the individual’s and service’s needs. Levels of communication that are appropriate to both the individual and the organisaiton should be agreed as early as possible. Some people prefer as few people as possible to know about their transition and decide to discuss this with their manager but require no further action. Others may be planning a medical intervention and others may prefer transition that does not involve any medical intervention or surgery. It is therefore essential that the manager adopts an approach that meets the needs of the employee. The manager must agree with the member of staff what steps need to be taken before, during and after their transition. Some people refer to this as developing an agreement or an action plan. Further guidance can be found in Appendix 3. A series of review meetings should be scheduled, at an agreed frequency as part of the action plan, and at any significant stage of the process. All parties must agree where the plan is kept and who shall have access to it.

It is essential to maintain trusting and open relationships between the key individuals. It is important to remember that this is a massive undertaking for the individual and they may experience fluctuations in emotions, confidence and commitment at any stage of the process and may require appropriate support accordingly.

Over time, some individuals may require less contact as they become established following transition. However it is important to provide a range of direct and indirect support for trans* staff through networks, through positive role models wherever possible, through mentoring etc. It is also important that whilst the individual’s status is not disclosed further than what has been agreed, every effort should be taken to train and educate staff and to encourage and open and accepting culture of people from all ‘protected groups’ under the Equality Act 2010.

Guidance on completing a plan can be found in Appendix 5.

Examples of Practical Issues

This list is not exhaustive but may include the following:

Use of facilities Any trans* person should be free to select the facilities appropriate to the gender in which they present. For example, when a trans person starts to live in their acquired gender role on a full time basis they should be afforded the right to use the facilities appropriate to the acquired gender role. Employers should avoid discriminating against anyone with the protected characteristic of ‘gender reassignment’. Gender-neutral toilets and changing facilities can be helpful in reducing barriers for transgender people.

Dress/Uniform Code

Staff uniforms are mostly gender neutral but the individual should be encouraged to wear clothes in which they feel comfortable whilst meeting the standards of the All Wales Uniform Policy.

Absences from work The member of staff may be absent for medical reasons and other appointments associated with the transition process which should be recorded, but not used in relation to any absence management process i.e. they should be regarded as a short- term reasonable adjustment.

Short-term job change

This may be appropriate in some cases. This can only be instigated in agreement with the trans employee and their manager.

Pensions and insurance Financial services organisations will have systems in place to manage data stored about trans contributors. When dealing with other agencies, care should be taken to ensure information is only shared on a “need to know” basis with those responsible for records/policies.

Communication with service users There will be very few instances where a service user would need to know about an individual’s trans* status and each situation should be managed sensitively and appropriately with the full involvement of the individual.

Respect and try to accommodate requests for anonymity where requested. Transitioning can be a difficult process and trans* colleagues may not want any attention, preferring relocation for example. Any change like this must be led by the trans employee working with their employer.

Dignity

Any incidence of bullying and harassment will not be tolerated and will be addressed promptly under the Health Board’s Dignity at Work and Disciplinary policies as appropriate.

There are a number of organisations available for specialist support in all of the above respects ie recruitment and retention, developing a plan and providing support – please see list in Appendix 6.

7. TRAINING IMPLICATIONS

Workforce Management staff and Occupational Health will be issued with guidance and/or appropriate training as required and encouraged to provide support to individuals as required. Cwm Taf will take every opportunity to raise awareness and deliver training throughout the organisation in relation to trans* issues and other groups covered by the Equality Act 2010.

8. REVIEW, MONITORING AND AUDIT ARRANGEMENTS

This policy shall be held on the Health Board intranet site and shall be monitored via the annual Equality report. The policy will be reviewed in 3 years time.

9. MANAGERIAL RESPONSIBILITIES

Managers have responsibility to ensure compliance with this policy and to provide support to any trans* staff that they manage.

10. RETENTION OR ARCHIVING This policy will be retained and archived in accordance with Health Board policy.

11. NON CONFORMANCE

Any instances of non conformance will be regarded as a potential disability issue.

12. EQUALITY IMPACT ASSESSMENT STATEMENT

Currently being actioned – to follow shortly.

13. REFERENCES

Appendix 1

Legal Framework

The Equality Act

The Equality Act 2010 consolidated and replaced several previous existing equality laws into a single Act, including the Sex Discrimination Act 1975. The Equality Act 2010 provides protection from discrimination in respect of people who have what the Act describes as the protected characteristic of gender reassignment. It states: A person has the protected characteristic of gender reassignment if the person is proposing to undergo, is undergoing or has undergone a process (or part of a process) for the purpose of reassigning the person's sex by changing physiological or other attributes of sex.

A reference to a transgender person is a reference to a person who has the protected characteristic of gender reassignment.

The Act defines nine “protected characteristics” which are age, disability, marriage and civil partnership, pregnancy and maternity, race and ethnicity, religion or belief, sex, sexual orientation and gender reassignment. The Act provides protection from discrimination in relation to these protected characteristics in a range of areas including the provision of services and employment.

No employment decision based on one of these characteristics is likely to be lawful (with a few minor exceptions) e.g. relating to recruitment, promotion, pay and benefits, training, discipline and dismissal including redundancy. This means that the same balance that managers apply to decisions relating to gender or disability for example, must also be applied in decisions relating to the recruitment and employment of staff who possess the characteristic of ‘gender reassignment’.

The legislation makes clear that it is not necessary for people to have any medical diagnosis or treatment to gain gender reassignment protection; it is a personal process of moving from one’s birth gender to the preferred gender. Employers can be held responsible for the actions of their staff under the Act (even if it is without the employers’ knowledge or approval). Employees are also individually responsible for their own discriminatory actions.

Direct discrimination

This means treating someone with a protected characteristic less favourably because of their protected characteristic e.g. not selecting them at interview because the manger does not want to work with a transgender person.

Direct discrimination by perception

This means treating someone less favourably than other employees because of a perception of gender reassignment. Indirect discrimination

This can occur where there is a policy, practice or procedure that applies to all workers, but particularly disadvantages a particular protected group such as people who intend to undergo, are undergoing or have undergone gender reassignment.

Harassment

This can occur when unwanted conduct related to gender reassignment has the purpose or effect of violating a person's dignity or creating an intimidating, hostile, degrading, humiliating or offensive environment for that person.

Victimisation

This is the unfair treatment of an employee who has made or supported a complaint about gender reassignment discrimination.

Also, section 16 of the Equality Act has specific provision to protect the right of trans* employees to have time off work for reasons relating to their gender reassignment. An employer will be discriminating against the trans* person if they would treat another person who is absent from work due to illness or injury more favourably.

Public sector duties

The Equality Act 2010 requires that public bodies have due regard to eliminate discrimination, harassment, victimisation and any other conduct prohibited under the Act (including discrimination by association or perception), to advance equality of opportunity between persons who share a protected characteristic and those who do not, and to foster good relations between persons who share a protected characteristic and those who do not.

Service providers

Separate guidance is available in relation to the provision of services. However, employers have a duty to take reasonable steps to protect their trans staff from harassment.

The Gender Recognition Act 2004 (GRA)

This legislation allows trans* people (aged over 18) to change their legal gender. The Act gives trans* people the right to obtain a new birth certificate, affording them recognition of their acquired gender in law for all purposes.

However, whether or not a person has a Gender Recognition Certificate (GRC) should have no bearing on their employment or employment protections, apart from providing an extra layer of privacy. Employers should treat people in accordance with their gender identity, whether or not they have a GRC and should not ask trans* staff if they have one.

The Act requires applicants to satisfy the Gender Recognition Panel (a judicial body of lawyers and doctors) that:  they have or have had gender dysphoria;  they have lived in the acquired gender for two years prior to the application; and  they intend to live permanently in the acquired gender.

Following a successful application, a trans* person will be recognised as being a person of their acquired gender with all the legal implications which flow from this.

The Act also includes important measures to protect privacy. The Act makes it a criminal offence for a person who has acquired protected information (information which relates to a person’s application for a GRC or information which identifies a person with a GRC as transgender) in an official capacity (such as through a recruiting process) to disclose the information to any other person. The offence does not apply if the individual has agreed to the disclosure of such information or in certain prescribed circumstances (such as disclosure being for the purpose of preventing or investigating crime). Section 22 of the GRA sets out the circumstances under which such information may be disclosed lawfully. Not all trans* people apply for a GRC. There may be a number of reasons for this including health, personal and family reasons.

Employment rights do not depend on whether a person has a GRC. Employers should not ask for a person’s GRC and it should never be a pre-condition for transitioning at work.

Exceptions to normal recruitment practice

Very rarely, it is an occupational requirement of a role is that it is done by someone of a particular sex. This is called a Genuine Occupational Requirement. In order to claim this, the employer must show that applying the requirement is a proportionate means of achieving a legitimate aim.

Appendix 2

Glossary

Terms and language regarding transgender people and transgender issues are evolving rapidly and many terms may mean different things to different people. The definitions given here are common, but not universal, understandings of these terms.

Acquired gender The law uses the phrase ‘acquired gender’ to refer to the gender in which a transgender person lives and presents to the world. This is not the gender that they were assigned at birth, but it is the gender in which they should be treated.

Cross-dresser Someone who wears the clothes usually expected to be worn by someone of the ‘opposite’ gender. Other terms include ‘transvestite’ (now becoming a dated term and disliked by some) and ‘dual role’. A cross-dresser is unlikely to have a full-time identity as a member of their cross-dressed gender and typically does not seek medical intervention.

Gender dysphoria Transgender people who seek medical intervention are typically diagnosed with ‘gender dysphoria’ as a first step. Gender dysphoria describes the sense of a strong, persistent discomfort or distress caused by the dissonance between a person’s self-identified gender and the gender they were assigned at birth.

Gender identity A person’s sense of self as a man, woman, non-binary person or other sense of gender. A person’s gender identity is typically expected to follow directly from the sex they were assigned at birth (based on physical attributes), but this is not always the case.

Gender reassignment The process of changing or transitioning from one gender to another, with or without surger

Gender Recognition Certificate (GRC) A certificate issued under the Gender Recognition Act which enables trans people to be legally recognised in their acquired gender.

Mis-gendering A person may be mis-gendered when they are referred to using a word, especially a pronoun or a form of address, that does not correctly reflect the gender with which they identify.

Non-binary person Someone who does not subscribe to the customary binary approach to gender, and who may regard themselves as neither male nor female, or both male and female, or take another approach to gender entirely.

Real life experience (RLE) Sometimes called the Real-Life Test (RLT), this is a period of time in which trans* individuals live full-time in their preferred gender role. The purpose of the RLE is to confirm that the person can function in their preferred gender successfully in society, as well as to confirm that they are sure they want to live in their preferred gender for the rest of their life. A documented RLE is a requirement of some doctors before prescribing hormone replacement therapy, and a requirement of most surgeons before performing gender reassignment surgery.

Transgender (or trans) person A broad, inclusive term referring to anyone whose personal experience of gender extends beyond the typical experiences of those of their assigned sex. Amongst others, transsexual people, non-binary people and cross-dressers may all consider themselves transgender people.

Transsexual person This term is most closely associated with the legally protected characteristic of ‘gender reassignment’. A transsexual person may be a person assigned female at birth who has transitioned or is transitioning to live as a man, or a person assigned male at birth who has transitioned or is transitioning to live as a woman. The law does not require a person to undergo a medical procedure to be recognised as a transsexual person. Once a transsexual person has acquired a GRC, they should generally be treated entirely as in their acquired gender.

Transgender man A transgender man is a female-to-male transgender person who was assigned female at birth but has a male gender identity.

Transgender woman A transgender woman is a male-to-female transgender person who was assigned male at birth but has a female gender identity.

Transition Taking the journey from your assigned gender to the one you know yourself to be. This may refer to social transition (changing name, clothes etc), medical transition (hormones and/or surgery) or both.

Appendix 3

Guidance for staff who wish to transition

If you identify as trans* and wish to transition, Cwm Taf UHB will make every effort to support you in this process and is committed to fully embracing all aspects of trans inclusion.

Please contact your manager or the Equality team in the first instance. You may also wish to speak to Occupational Health, Workforce Management or your staff side representative. All of the above will provide confidential advice and support you during and following your transition. . If role models or mentors are available, we will seek to involved them if you wish.

Your manager will discuss an appropriate plan with you, based on your individual needs, timescales etc. There is no ‘right’ or ‘wrong’ way to transition and each individual’s dignity must be respected. Your plan will be confidential until such time as you are ready to proceed - please see Section 6 and Appendix 3 of this policy with regard to how the plan could be developed and what it may include.

Appendix 4 of this policy lists suitable groups which you may wish to access for additional support.

Post transition, your manager will discuss issues such as data protection, work permits, national insurance, redeployment, pensions, professional registration, references, DBS checks, updating records etc with you. Your staff record will be updated on the Electronic Staff Record system via self service or by your supervisor/manager. Please note you do not need a Gender Recognition Certificate to do this, the same arrangements will apply as for other staff changing their name.

Bullying and harassment is unacceptable to our organisation and if you receive comments or inappropriate behaviour in relation to your transition or gender identity at any stage, please inform your manager or any of the departments listed above to take appropriate action, particularly if you feel unable to approach the individual(s) concerned.

We have established an LGBT staff network which you may wish to join, you would be welcome to attend events or meetings or you may prefer to be a ‘virtual member’ and communicate by e-mail.

Appendix 4

Guidance for Employees on how to support a colleague who is transitioning

The following general guidance has been developed to help staff understand how to respond to a colleague who discloses that they are transitioning, it will be equally relevant to staff who are trans* but do not wish to transition e.g. they may be ‘gender’ fluid or ‘non-binary’ - an explanation of different types of trans* identities can be found in Appendix

 At all times ensure that you protect their privacy and do not disclose their status to colleagues or other individuals without their express permission.

 Respect their confidentiality. Do not tell others about a person’s history. If documents have to be kept that have the person’s old name and gender on them, keep them confidential.

 Listen to the person, and ask them how they want to be referred to. Ask which name and which pronouns you should use.

 Use these all of the time, not just when in the company of the person.

 If you make a mistake with pronouns, apologise, correct yourself, and then quickly move on.

 It is preferable to communicate and make an occasional genuine mistake than avoid the person to avoid the risk of ‘getting it wrong’, however wilful misgendering/misnaming is unacceptable.

 Do not ask what their ‘real’ or ‘birth’ name is. Trans people are often sensitive about revealing information about their past, especially if they think it might affect how they are perceived in the present. Their real name is the one they are currently using.

 Respect people’s boundaries. Consider whether it is appropriate to ask a personal question. Would you ask this to another person? If not, then reconsider asking it. If you do feel it is appropriate to ask a personal question, first ask if it is ok to do so. Personal questions include anything to do with one’s sex life, anatomy, medical treatment and relationship status – past, present or future.

 When someone starts to live as their correct gender, they may be very sensitive to the ways in which their physical appearance differs from others. It is inappropriate to discuss someone’s appearance and it is never appropriate to judge someone by how they look.

 A trans person should have access to ‘men-only’ and ‘women-only’ areas – such as changing rooms and toilets – according to whichever they feel most comfortable with.

This may mean that a person changes the facilities they use at some point throughout their transition.

 If you are aware that they wish to access help, support or advice, encourage them to speak to their manager, Occupational Health, the Equality team or a staff side rep. If role models or mentors are available, it would be positive to involve them.

 If you are aware of any inappropriate, transphobic comments or behaviour from a colleague, visitor or patient; speak to the person if you feel able to, explaining that this is inappropriate and/or report it to your manager. Wherever possible ensure that the trans* colleague is aware that you are doing this, particularly if they wish as few people as possible to know about their situation.

 Transitioning and being trans* impacts on a person’s whole life. You can help them to feel they are supported in the workplace.

Appendix 5

Suggested Checklist

This type of template is a useful starting point to develop a plan. Questions and points to consider:

Communication

Who needs to know? Who will tell them? When? HR Business Partner Senior Manager Line Manager (if not main point of contact) Others (please specify)

Planning the future

Your new name Your role Name of line manager Medical advisor (name/contact details)

Telling colleagues/friends and people you work with/external partners

Who will tell colleagues/partners? Will you be there? When will this take place? Where will this take place? What information will be provided?

Getting ready for your first day back

When will this be?

Change of role? Are you ready? Is your wardrobe/uniform ready?

Are colleagues ready? Additional support for you and/or loved ones? Any media concerns?

Your New Identity

Name badge Business cards Website ‘About Us’ section IT systems Voicemail Intranet address entry Work-based social media Union membership Pensions scheme Uniform stores data Certificates/awards

Ongoing Support Plan out dates for meetings Plan for medical appointments and appropriate arrangements for leave and cover.

Appendix 6

Useful sources of information and advice www.inclusiveemployers.co.uk The UK’s leading inclusion and diversity experts, working with employers to create inclusive workplaces. www.scottishtrans.org The Scottish Transgender Alliance works to improve gender identity and gender reassignment equality, rights and inclusion in Scotland. http://genderedintelligence.co.uk/ Gendered Intelligence work predominantly with the transgender community and those who impact on transgender lives. They particularly specialise in supporting young transgender people aged 11-25. www.gires.org.uk Gender Identity Research and Education Society provides information for trans people, their families and the professionals who care for them. www.depend.org.uk Offering free, confidential advice, information and support to all family members, spouses, partners and friends of transsexual people in the UK. www.gendertrust.org.uk The Gender Trust supports all those affected by gender identity issues. www.clareproject.org.uk The Clare Project is a self-supporting group based in Brighton and Hove open to anyone wishing to explore issues around gender identity. http://ntpola.com The National Trans Police Association exists primarily to provide support to serving and retired Police Officers, Police Staff and Special Constables with any gender identity issue. gender-matters.org.uk Wolverhampton based, Gender Matters provides a comprehensive programme of practical support, counselling, advice and information. www.equalityhumanrights.com The Equality and Human Rights Commission seeks to identify and tackle areas where there is still unfair discrimination or where human rights are not being respected and to act as a catalyst for change. The EHRC also provide statutory guidance on the Equality Act for employers, which can be found here: http://www.equalityhumanrights.com/private-and-public- sector-guidance www.blgbt.org

Supports the LGBTQ community in Birmingham. www.northernconcord.org.uk Northern Concord is a Manchester based transvestite, transgendered and transsexual support and social group. www.translondon.org.uk TransLondon is a discussion/support group for all members of the trans community, whatever their gender identity. www.gayadvicedarlington.co.uk Offers free, confidential support, advice and drop in sessions to trans people at a full time LGBTQ centre. 30 www.transgenderwales.bravepages.com Supports transgendered people in Wales. www.transgenderni.com Supports transgendered people in Northern Ireland.

Government Equalities Office (GEO) GEO is responsible for equality strategy and legislation across government. www.gov.uk/geo

Department for Business, Innovation and Skills (BIS) BIS is the department for economic growth. The department invests in skills and education to promote trade, boost innovation and help people to start and grow a business. BIS also protects consumers and reduces the impact of regulation. www.gov.uk/bis

Equality and Advisory Support Service (EASS) EASS has a helpline that advises and assists individuals on issues relating to equality and human rights, across England, Scotland and Wales. www.equalityadvisoryservice.com/

British Chambers of Commerce (BCC) BCC is the national voice of local business and serves business members across the UK. The BCC is a voice for the interests of business, delivers services that help business grow, and is the private sector source of advice and support for international trade. http://www.britishchambers.org.uk/

Guidance for Workforce & OD Staff Appendix 7

Workforce & OD staff will have a key role in supporting both the individual and their manager throughout the Recruitment process and in all aspects of the transition process and ensuring that the policy is adhered to throughout. This will also include supporting those who have already successfully transitioned but may encounter issues and also those who do not opt for medical re-assignment.

Some individuals may identify as non-binary which means that they do not identify as male or female and although not specifically covered in the Equality Act 2010, should be treated with the same dignity and respect and given appropriate support for their requirements. This also applies to people who are hermaphrodites i.e. they have characteristics of both genders.

It will be essential to ensure that the individual is treated with dignity and respect irrespective of whether they have received medical treatment or not and at any and all stages of their transition and that their confidentiality is protected as detailed throughout this policy.

Workforce & OD Business Partners will advise on the development of an agreed and effective transition plan and advise on practical aspects e.g. name and record changes and any other aspects of the transition plan. They will be responsible for ensuring the completeness and confidentiality of the applicant/member of staff’s record including Gender Recognition certificate, although many trans* people do not apply them for many reasons. It is a criminal offence to reveal a person’s trans* history or identity without their express written permission.

Where specific documents need to be changed or departments need to be notified e.g. in relation to pensions, care should be taken that access to such records should be restricted to staff who require such details on a need to know basis in order to perform their specific duties. This should only include those directly involved in the administration of a process, for example the Workforce officer, or the person who authorises payments into a pension scheme. Management of personal information will be in accordance with GDPR.

Workforce & OD Business Partners can also provide advice in relation to other relevant Workforce & OD policies e.g. Recruitment, Sickness Absence, , Equality and Diversityand the Dignity at Work process.

Workforce & OD Business Partners can ensure that appropriate selectively confidential support is accessed within the organisation e.g. by linking in Occupational Health and Wellbeing, the Equality Team, Staff Side representatives and the LGBT Ffrindiau Network and the Diversity Street helpline.

Occupational Health can advise on whether there are duties within the role that should be avoided at specific times during the process e.g. lifting heavy items, strenuous physical work (for those who are undergoing surgery/medical intervention), temporary work adjustments, discuss the expected timescale of medical and surgical procedures and what time off is likely to be required (where relevant) and issues that should be taken into account e.g. the effect of hormone therapy. In addition to the physiological impacts, cognisance should be paid to the emotional impact of transitioning and transitional medical interventions and their effect on an employee’s stability, ability and efficiency. Reasonable adjustments and/or alternative duties will be discussed and managed in accordance with the relevant sections of the Sickness Absence Policy.

Both departments can advise on practical issues such as gender neutral toilets and/or other appropriate toilet and changing facilities. They can also signpost external support. Transgender workers are entitled to support from their co workers, including discussions and explanations with those co-workers and/or service users. It is the employer’s responsibility to manage their attitudes.

Workforce & OD Business Partners, line managers and Directorate Managers will ensure that unlawful discrimination does not take place through the individual being treated less favourably than other employees e.g. in the way their sick leave is managed. Any leave to undergo treatment or following treatment where individuals are unfit for duty and covered by a self certificate and/or a fit note will be recorded in line with the Sickness Absence Policy and UHB procedure. Where absence is planned this should be discussed and a plan agreed as detailed in the Sickness Absence Policy. Consideration of reasonable adjustments should be discussed with the relevant Workforce & OD Business Partner.

Section 1: Preparation This section must be completed at the beginning of a policy review

Section 1 – Preparation

1. Title of Policy - what are you equality Recruitment and Retention of Trans* impact assessing? staff. This is a new policy. Please state whether it is a new or existing policy?

2. Policy Aims and Brief Description - To provide guidance on the what are its aims? Give a brief recruitment of staff and issues that description of the Policy (The What, may arise during the procedure. It Why and How?) also provides guidance on how to manage trans* staff after they have been appointed or existing staff when they decide to transition.

3. Who Owns/Defines the Policy? - Equality manager. who is responsible for the Policy/work?

4. Who is Involved in undertaking Equality manager in the first this EqIA? - who are the key instance, to be discussed with key contributors and what are their roles in colleagues e.g. Welsh Language the process? Manager, Occupational Health and Workforce Management. Staff side Please note this should be completed and policy group. by the author but the views of other team members, service users etc should be sought.

5. Other Policies - Describe where this It relates to the Equality policy and Policy/work fits in a wider context. the Equality Impact Assessment

Section 1 – Preparation Is it related to any other policy. It is relevant to the Strategic policies/activities that could be Equality Plan and the Equality and included in this EqIA? Welsh Language Work plan and the Is it relevant to the Integrated Medium staff engagement work, networks Term Plan (IMTP) etc. This is reflected in the IMTP.

7. What might help/hinder the There is a significant training need in success of the policy? These could relation to this issue as there is a be internal or external factors. E.g. general lack of awareness and high training, awareness raising. level of discrimination in society as a whole. It is a very sensitive issue and it will be essential to support applicants and staff appropriately.

8. Is the policy relevant to “eliminating It is fundamental to eliminating discrimination and eliminating discrimination and harassment as harassment?” trans* people are one of the 4 groups who experience the most discrimination in society.

9. Is the policy relevant to “promoting It aims to promote equality of equality of opportunity?” opportunity in recruitment and in the workplace generally. If staff are supported, they can perform better and experience greater wellbeing in work.

10. Is the policy relevant to “promoting It seeks to promote good good relationships and positive relationships between trans* and attitudes?” other staff.

Section 2. Impact

Please answer the following Consider and refer to the information you have gathered from census data, relevant organisations and groups, individuals etc.

Do you think that the policy impacts on people because of their age? (This includes children and young people up to 18 and older people). Traditionally people have transitioned when they were older i.e. late 40s or early 50s but this is changing and people are transitioning at a much younger age – from their teens onward and the numbers are doubling year on year. It also impacts on older people who may be more likely to have experienced discrimination particularly when they were younger and may be more reluctant to transition now. Do you think that the policy impacts on people because of their caring responsibilities? I,e, would it affect their ability to care for somebody who is primarily dependant on them? Being trans* can impact on people’s ability to access services which could be difficult if they are caring for other people. Do you think that the policy impacts on people because of their disability? E.g. sensory loss, physical disability, learning disability, some mental health issues. There is a link between gender Dysphoria and autism. People who have a disability already experience barriers and this could increase if they are also trans* There is also a link with poor mental health including anxiety and depression. Do you think that the policy impacts on people because of Gender reassignment? This includes all people included under trans* e.g. transgender, non-binary, gender fluid etc. This policy is fundamental to this group and seeks to protect them and promote their opportunities in the workplace. Do you think that the policy impacts on people because of their being married or in a civil partnership? It is important to recognise that the impact of transitioning can impact significantly on the individual’s existing relationships and as such they may need additional support. Do you think that the policy impacts on people because of their being pregnant or having recently had a baby? As above. Do you think that the policy impacts on people because of their race? (This includes colour, nationality and citizenship or ethnic or national origin such as Gypsy and Traveller Communities.) Certain groups in society may be particularly unwilling to accept an individual’s transgender status

31 because of their religious or cultural beliefs and again this can have specific implications in terms of the support they need. Do you think that the policy impacts on people because of their religion, belief or non-belief? (Religious groups cover a wide range including Buddhist, Christians, Hindus, Jews, Muslims, and Sikhs) As previously in relation to race, individuals could encounter religious objections to their status which may meant additional support at work. Do you think that the policy impacts on men and woman in different ways? Significantly more men than women transition and significantly more male to female trans* people experience abuse than female to male. There may be a greater need for support accordingly as the whole experience could be more challenging. Do you think that the policy impacts on people because of their sexual orientation? (This includes Gay men, heterosexual, lesbian and bisexual people) It is important that a person’s trans* status is regarded differently to their sexuality although their transition can impact on their sexual orientation. This again could have implications on their support needs. Do you think that the policy impacts on people because of their Welsh language? At present Welsh patients are referred to English Trusts where specialised services are available particularly if they decide to transition fully. This would severely curtail their opportunities to communicate in Welsh. However services are being reviewed with the aim of better meeting the needs of Welsh patients and avoiding long distance referrals and local services may be better able to provide Welsh communication. This is particularly relevant when discussing their mental health issues.

The Human Rights Act contains 15 rights, all of which NHS organisation have a duty to act compatibly with and to respect, protect and fulfil. The 7 rights that are particularly relevant to healthcare are listed below. Consider the relevance of your Policy to these Human Rights and list any available information to suggest the Policy may interfere with, or restrict the enjoyment of these rights. The right to life Trans* people are at a very high risk of suicide with surveys indicating that 41% have considered it. It is very important to ensure their wellbeing through appropriate support. The right not to be tortured or treated in an inhuman or degrading way Trans* people are one of the most likely groups to experience discrimination and are likely to experience degrading treatment in many aspects of their life so it is essential that their dignity and respect are upheld at work. The right to liberty There is no obvious link to transgender status. The right to a fair trial Full consideration should be given to their needs and issues in order to ensure a fair experience. Similarly any discrimination they experience should potentially be addressed under the disciplinary policy. The right to respect for private and family life, home and correspondence The right to live in the way that they choose is fundamental here. As highlighted previously, there can be implications for their private and family life and they may require additional support. The right to freedom of thought, conscience and religion As already mentioned, there can be a conflict with some religions. The right not to be discriminated against in relation to any of the rights contained in the Human Rights Act. Any issues could be addressed when planning the individual’s induction or transition support.

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Policy Title: Trans* Staff Policy Organisation: Cwm Taf UHB Name: Liz Jenkins Title: Equality Manager Department: Workforce & OD Date: 30 1 17 Summary of There are a number of significant issues: Assessment: - Risks to mental health and wellbeing with

Please indicate the potential for suicide issues of - High risk of discrimination and unfair significant concern and treatment, name calling, inappropriate changes that will language etc. be made to the policy - Risk of conflict and even abuse at home accordingly. and issues of changed sexuality.

Please indicate All of the above can be highlighted when whether these planning with the individual and appropriate changes have been made. support given. Need to emphasise family

issues and policy will be amended accordingly. We also know that trans* people have difficulty in accessing employment and need to make sure that our recruitment processes and fair and accessible and this will be monitored by the equality team.

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Please indicate N/A where issues have been raised but the policy has not been changed and indicate reasons and alternative action taken where appropriate.

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Monitoring The policy will be monitored via the network, Arrangements: through feedback from staff and managers and it

will also be monitored by the Equality Forum which scrutinises the annual equality report

Review Date: September 2020. This is usually the same as the policy review date. Signature of all Parties:

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Appendix 2

POLICY TRAINING IMPACT ASSESSMENT

1. Will training be required as a result of the policy?

Yes Proceed to question 2 No If no, please state how this policy will be communicated within the HB

2. Please complete the following information relating to training Course/ policy title Recruitment and Retention of Trans* Staff training Course type Classroom/workshop Reference to KSF/NMC Dimensions Target Audience (refers to scope of Workforce Management and policy) Occupational Health staff Course / policy training objectives To enable key staff to support trans* employees Course / policy training content Discussion of policy, trans* individual to share experience, action plan for respective areas Duration of course / programme Half day Name of trainer (or policy lead) Liz Jenkins and Eleri Jenkins Approximate cost of providing Staff costs training Please embed lesson plan, link to e- To be developed. Relevant to learning, presentation or other Treat Me Fairly trans* module relevant learning material

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