BAGIS Principles of Care

The Association
BAGIS is an organisation that works to ensure the delivery of safe, high quality, respectful and evidence-based health and social care to transgender, non-binary and gender diverse people (hereafter referred to as trans) people in the British Isles (Great Britain, Ireland, Isle of Man, Orkney, Shetland, and the Channel Isles) whether directly or through service developments,  strategic change or research.

• BAGIS is a non-discriminatory organisation which condemns prejudice and discrimination in all their forms.

• BAGIS embodies an established, experienced, and expert clinical practice currently working in this field in the British Isles, in collaboration with international expert colleagues.   

•  BAGIS welcomes and recommends further funding and ethical research in the area of trans health, coproduced with trans communities.

BAGIS members experience and believe:
Trans people experience a gender identity that does not conform to societal expectations of the sex recorded at birth.

• Gender diversity is a valuable part of any healthy society, and having an identity which differs from social norms, or sex assigned at birth, should not carry any sort of stigma. The diversity of gender identity is intrinsically part of the human experience; it is not a new phenomenon, rather a well-established phenomenon, and being trans is not a lifestyle choice. Gender identity is a deeply ingrained aspect of who trans people are. It is not a decision, but rather an inherent part of a trans persons’ identity, just like being cisgender.

• Trans identities are valid and do not indicate the presence of any mental disturbance or abnormality.

• Trans people thrive and prosper when they live their lives in accordance with their own sense of themselves.

• There are no interventions that can or should aim to change gender identity or sexual orientation. Conversion therapy practices are unethical, harmful and not supported by any evidence. BAGIS endorses the 2017/22 Joint Memorandum of Understanding to end this practice in the UK.

• Mandatory psychotherapy for trans and non-binary people is not appropriate before any treatments.

Gender Healthcare Services
Gender healthcare services aim to support any person and alleviate gender dysphoria. This may include but is not limited to, psychological, social, or medical support. This supports opportunities to live in congruence with the felt sense of gender, with freedom from restriction, aspersion, or rejection.

BAGIS members support the following statements:
The interventions accessed through healthcare services by trans people to support physical and / or social gender transition aim to move beyond alleviating gender dysphoria, towards enabling trans people to live full lives, and experience the feeling of significant comfort with one’s gender identity or expression.

• Gender healthcare proceeds on the basis that both clinician and patient (or person with parental responsibility involved in the case of Children and Young People) think it is appropriate, beneficial and timely.

• Trans people must have equitable access to the full spectrum of health and social care required to meet their needs and promote their well-being, irrespective of their gender identity or anatomy.

• Gender healthcare is medically necessary and should be comprehensive.

• Gender healthcare across the life span is of established benefit to trans people.

• Treatment pathways must be as flexible as possible within safe clinical boundaries and must be focussed on patient needs. They are based on a comprehensive understanding of the individual’s experiences and not solely on the presence or absence of specific symptoms. Some trans people may need access to psychological support in navigating aspects of physical and social transition, and this should be readily available.

• Physical and mental healthcare for trans people in the British Isles should not be prohibited for reasons of personal finance or any protected characteristic.

Clinicians providing transgender healthcare.
Clinical members of BAGIS:
Meet the patient with respect, care, compassion, and focus on trans people’s expertise in their lives.

• Begin with the premise that the client is truthful, has capacity and is expert in who they are as an individual and what would help them personally.

• Share an understanding that no specific medical or non-medical outcome is favoured over another at the first meeting.

• Discuss and provide information about interventions for the patient, which involve asking relevant and pertinent questions in collaborative consultation of both clinical and lived expertise.

• Collaborate with patients using shared decision making about their objectives through an agreed plan of care, working with multidisciplinary professionals and agencies in a timely and flexible manner, in accordance with current national and international best practice guidelines.

• Promote dialogue which respects a diversity of neurodivergence and access needs

• Make reasonable adjustments in the provision of health and social care, that take into account a broad range of factors that might include intellectual disability, neurodiversity, chronic health conditions, a history of offending etc. Adjustments may include but are not limited to provision of additional support, use of communication aids, adapting treatment guidelines, modifying the clinical environment.

• Maximise their patients’ autonomy and understanding of care and treatment and work within the legislative framework that applies to mental capacity in their jurisdiction, including children and young person’s decision making.

• Support trans people to accessing care, that includes opportunities to explore gender identity without pressure or assumption of any particular outcome. This includes and is particularly relevant to children and young people under the age of 16.

• Engage in research and to have their outcomes scrutinised in line with scientific norms.


BAGIS’ commitment to continuing professional development
• BAGIS requires its members to engage in relevant continuing professional development, including scientific developments in the field, to ensure that they are equipped to provide or support gender healthcare.

• BAGIS promotes collaborative relationships between its members and offers educational experiences to support continuing professional development and reflexive practice.

• BAGIS provides safe, respectful spaces for health and social care staff working with trans people and those in related professions to explore and share their work.

• BAGIS expects members to reflect on their positions or privilege and challenge unconscious bias through continuing professional development which centres the expertise of trans communities.

• BAGIS expects its members to be sensitive to, respectful of and ideally fluent with cultural and subcultural factors, and open to new learning.