Integrating recommendations for transgender and gender non-conforming perinatal care in the NHS - A qualitative exploration of healthcare professionals’ views

Sep 30, 2026

Uploaded by hdkawk

Transgender and gender non-conforming (TGNC) people increasingly use National Health Service (NHS) perinatal care, yet many institutions lack policy, education, and resources to deliver appropriate support. This qualitative study explored NHS midwives’ views on the acceptability and feasibility of existing recommendations for providing pregnancy care to TGNC people. Ten semi-structured interviews were audio-recorded and transcribed verbatim, with analysis guided by queer theory and thematic analysis. Findings formed three main themes: external barriers, safety, and eagerness to learn, with additional attention to internal barriers, emphasizing the need for gender-affirmative, individualized, psychologically and physically safe care.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages22

Reading Time55 min

AccessFree to download

Abstract

Introduction

Legal and policy context (Equality Act and NHS Constitution)

Gaps in knowledge, evidence, and guidance

Evidence from the ITEMS report and maternity surveys

OPEN ACCESS Citation: Brown KM, Swartz A (2026) Integrating recommendations for transgender and gender non-conforming perinatal care in the NHS: A qualitative exploration of healthcare professionals’ views. PLOS Glob Public Health 6(1): e0005684. [https://doi.org/10.1371/](https://doi.org/10.1371/)[ ](https://doi.org/10.1371/)[journal.pgph.0005684](journal.pgph.0005684) Editor: Julia Robinson, PLOS: Public Library of Science, UNITED STATES OF AMERICA Received: March 6, 2025 Accepted: December 4, 2025 Published: January 7, 2026 Copyright: © 2026 Brown, Swartz. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data availability statement: Interview transcripts are provided within the submission as supporting information. Funding: The authors received no specific funding for this work. RESEARCH ARTICLE Integrating recommendations for transgender and gender non-conforming perinatal care in the NHS: A qualitative exploration of healthcare professionals’ views Kathleen Miriam Brown1,2*, Alison Swartz1,3 1 Department of Health, City St George’s, University of London, London, England, 2 Faculty of Health, Science, Social Care and Education, Kingston University, London, England, 3 Division of Social and Behavioural Sciences, University of Cape Town, Cape Town, South Africa * [k.m.brown@kingston.ac.uk](k.m.brown@kingston.ac.uk) Abstract Transgender and gender non-conforming (TGNC) people are utilising National Health Service (NHS) perinatal care services with increasing frequency. Despite this, many healthcare institutions do not have policy, education, or resources in place to provide appropriate care. Research on the experience of TGNC pregnancy service users is limited within an NHS context. This study employed a qualitative approach to explore NHS midwives’ views of the acceptability and feasibility of current recommendations for providing care for TGNC people in pregnancy. We conducted 10 semi-structured interviews with midwives that lasted 25–80 minutes. These were audio recorded, and transcribed verbatim. Transcripts were read, reread and coded by author 1, in discussion with author 2. Analysis was informed by queer theory. Initial codes were then collapsed into themes using thematic analysis. Participants shared their philosophies of care provision and practical integration ideas to assist the implementation of care recommendations in their care settings. Findings were grouped into three main themes: (1) external barriers,(2) safety, and (3) eagerness to learn. Each of these key themes contained overlapping sub-themes. Whilst not a key theme, internal barriers was additionally explored. The research demonstrates a desire of participants to provide physically and psychologically safe individualised care. Participants acknowledged their role within a wider multi-disciplinary team (MDT) in addition to their role within a healthcare institution. Participants felt additional education was required for appropriate care for TGNC service users. The research demonstrates the emotional processes of midwives working within the NHS caring for a minority patient group. Greater support from institutions is required to provide gender-affirmative care. Policy is needed on a national and institutional level to support midwives to provide safe care. Further research may also strengthen existing recommendations and therefore support both midwives and TGNC service users. PLOS Global Public Health | [https://doi.org/10.1371/journal.pgph.0005684](https://doi.org/10.1371/journal.pgph.0005684) January 7, 2026 1 / 22 Competing interests: The authors have declared that no competing interests exist. Introduction In the last decade, transgender and gender non-conforming (TGNC) people have become increasingly visible within wider society [

FAQs

What was the study designed to examine regarding NHS perinatal care?

The study examined NHS midwives’ views on the acceptability and feasibility of current recommendations for providing pregnancy care for TGNC people.

How was the qualitative research conducted?

Ten semi-structured interviews with midwives were audio recorded and transcribed verbatim; transcripts were coded and analyzed using thematic analysis informed by queer theory.

What key themes emerged from participants’ views?

Results were grouped into three main themes: external barriers, safety, and eagerness to learn, with internal barriers also explored beyond the main themes.

Sep 30, 2026

Uploaded by hdkawk