Trans people in Scotland face significant healthcare inequalities, with long waiting lists for affirming healthcare and a pattern of serious discrimination against trans people seeking treatment in general. Against this background, it has been revealed that a major NHS Scotland regulatory body has a director who has publicly expressed anti-trans prejudice, has links to anti-trans campaign groups and has spoken at the controversial Alba Women conference where anti-LGBTQ+ conspiracy theories were circulated.
Healthcare Improvement Scotland (HIS) are an NHS Scotland regulatory and inspection body. Their role includes regulating independent hospitals and clinics and improving patient safety1. On Friday (9th of April), HIS published a blog post by non-executive director Rhona Hotchkiss about her role2. According to the blog post Hotchkiss has been in this role since 2019 after retiring as a governor in the Scottish prison system. As an non-exec director, Hotchkiss sits on HIS board meetings which have responsibility for overseeing public sector equality duties. Social media posts by Hotchkiss have since come to light showing a history of anti-trans political campaigning, as well as her association with anti-trans campaigning organisations.
On Hotchkiss' personal social media, she has claimed that "being trans is absolutely about conforming to extremely conservative gender stereotypes"3, taken part in publicly belittling a non-binary person discussing their experiences4 and has referred to trans women by the transphobic slur "Trans Identified Men" or "TIM"5. While Hotchkiss has claimed not to be transphobic6, these posts suggest, at best, a deep seated hostility to transgender and non-binary people.
LGB Alliance links
In March of last year, Hotchkiss appeared on the BBC's Politics Live speaking on behalf of the LGB Alliance7, an anti-trans pressure group previously profiled by TSN. Hotchkiss is quite clearly very active in the "gender critical" movement, acting as a spokesperson for a transphobic hate group.
Alba Women Conference
Hotchkiss spoke at the Alba Women Conference on her view that incarcerated trans women should be placed in men's prisons8, despite the high rates of sexual assault and violence suffered by trans women in men's prisons9,10. The newly formed Alba party is led by former SNP First Minister Alex Salmond after he was charged with multiple allegations of sexual assault and attempted rape. This link between transphobic activism and support for Salmond has been noted in previous TSN research.
At the same conference, an Alba Scottish Parliamentary candidate, Margaret Lynch, made false claims that Stonewall Scotland aim to lower the age of consent to 1011,12, perpetuating an age old trope of homophobes and transphobes falsely associating LGBTQ+ people with paedophilia. No evidence exists that any LGBTQ+ organisation in the UK seeks to lower the age of consent; TSN have investigated this conspiracy theory, its origins and its spread in a a recent article.
Alba appears to include transphobic activists at every level: left wing Scottish independence blog, A Thousand Flowers, have documented the history of transphobia, homophobia, racism and anti-choice politics of a number of senior Alba figures13.
I have experienced repeated expression of prejudiced attitudes towards me by mental health service providers due to me being trans, some in NHS and some in non-NHS services. Repeatedly being needlessly outed as trans without my consent by NHS professionals to other NHS professionals despite being transitioned for over 15 years and having a Gender Recognition Certificate. And repeatedly being asked intrusive and completely irrelevant questions by NHS professionals about my transition and other aspects of being trans.
Trans people face serious health inequalities in the UK, not only in terms of an outdated GIC system with waiting times running up to several years (over three years in parts of Scotland)14,15, but also in terms of systemic failures to provide NHS services to trans people, ranging from appropriate cancer screening16 to access to mental health and substance abuse services17. A recent Stonewall Scotland report found that two in five trans people in Scotland have avoided seeking healthcare due to fear of discrimination by staff18. Given this, Hotchkiss' senior role in an NHS regulatory body is of concern to transgender communities, for trans people to be safe and equal, we must have equal access to healthcare.
Scottish Trans: Scottish Gender Identity Services, there are currently four NHS Gender identity services in Scotland, with waiting lists ranging from one and a half to over three years