Working with transgender people in physiotherapy practice

This guidance supports CSP members in improving the health of communities, including people who are transgender, through high-quality physiotherapy

The guidance is designed to help you respond to the needs of patients and service users who identify as transgender as they access the physiotherapy services you are providing to them. 

It provides guidance on treating transgender patients to ensure appropriate and fair treatment.

If you have any questions or feedback about this guidance please contact us.

Frequently asked questions about the guidance

Why has the CSP produced this professional guidance? 

The CSP has produced this guidance to support members in improving the health of communities, including people who are transgender, through high-quality physiotherapy. 

Earlier in 2024 the CSP published a position statement on transphobia. An action included in this statement was to develop professional guidance to help support members who may at any time come into contact with transgender people in physiotherapy practice.


Who will monitor whether the guidance is useful and make any updates if required?  

In line with the CSP’s internal publications review process this guidance will next be reviewed in May 2026. Members with any feedback or queries can contact the professional advice service through CSP Enquiries 


Who is the CSP working with to produce guidance on treating transgender patients? 

The CSP professional committee set up a working group to produce this guidance.  

Members of the working group: 

CSP professional committee 

  • Nick Livadas, Chair (until December 2023) 
  • Vicky Reynolds-Cocroft (until October 2023)  
  • Sarah Dewhurst (from February 2024) 
  • Sanchez Davis (from February 2024) 
  • Iona Bateman (until May 2024) 

CSP LGBTQIA+ network

  • Stephanie Land  
  • Shannon Pinnington  

Pelvic, obstetric and gynaecological group of physiotherapists (POGP)

  • Miti Rach  

How were transgender people involved in developing the statement?  

The working group that developed the guidance convened a small focus group (n=3) of transgender people for a focused lived-experience discussion around specific questions which was transcribed. 

The focus group met in September 2023, and with the participants' permission, this guidance includes direct quotes from this meeting. 


Does the CSP advocate for transgender patients being treated on single-sex wards?  

All patients should be treated with dignity and respect. The CSP does not support trans-exclusionary approaches when providing healthcare.  

The guidance states ‘providers should consider the labelling of facilities. Gender-neutral individual spaces may be appropriate. Greater privacy for all patients may be provided by having more individual cubicles, and by having partitions and doors that extend from floor to ceiling. Providers should consider contexts where designated single-sex spaces may be required.’


What legislation or evidence was used to inform this guidance? 

Please see the reference list included at the end of the professional guidance document. 


What guidance have other professions had? 


Will the CSP support me if someone says I've not complied with the guidance? 

As with all professional guidance documents published by the CSP, this is a document to support members in providing safe and effective services, in line with their regulatory and professional obligations. The CSP does not monitor how members use our guidance. 

Members are reminded that the HCPC standards of proficiency were revised in September 2023, and have strengthened the need for members to recognise the impact of equality and diversity on practice, and practice in a non-discriminatory and inclusive manner. 

If you are notified by the HCPC that a concern has been raised about your fitness to practice, then you should contact the CSP for support.


My NHS trust provides guidance for working with transgender patients - which guidance should I follow?

Members should adhere to the guidance that is set by their employer in the first instance - even if it is not specific to physiotherapy services. 

Where guidance does not exist in your workplace or you require guidance specific to the physiotherapy service you are providing the CSP has provided this professional guidance to help members respond to the needs of patients and service users who identify as transgender as they access physiotherapy services.