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Ashgate Hospice > Embracing inclusivity: Reflections on trans and gender diverse end of life care training  

At Ashgate Hospice, compassion is at the heart of everything we do. We strive to provide comfort and respect to everyone who receives our care. However, true compassion goes beyond empathy; it requires us to embrace inclusivity and recognise the unique needs of every person. 

A recent report by Hospice UK revealed a gap in end of life care for transgender and gender diverse individuals. Too often, these communities encounter barriers when seeking care that respects their identities. In response to this issue, several staff members at Ashgate Hospice joined the “Being Ready” training offered by the Gender Identity Research and Education Society (GIRES).

Here, we hear from those staff as they share their experience of the training and the profound impact it had on their understanding and commitment to providing inclusive care.


Heather Maurice-Smith, Palliative Care Support Worker on the Virtual Ward team 

When people are given a palliative diagnosis, the feelings they go through are intense and vary widely from moment to moment. As a support worker, my role is to be there for them and all their people. It is a job I care passionately about, and I want to always be the best that I can be. I also am neurodivergent. As such, I often am told I am too much, too loud, too crass, too involved.

“These two parts of my personality, the neurodivergence and the passionate support worker, saw this course run by GIRES and thought yes, we should know the best way to support our population who are trans and gender diverse in their palliative diagnosis. The course is aimed at all professionals involved, from palliative diagnosis to bereavement care and the funeral.

“Ashgate core values include compassion, respect and inclusion. A portion of our patients and loved ones will be trans or gender diverse. How can we uphold our values without being inclusive to our trans and gender diverse population? In short, we can’t.

“The GIRES training included many discussions concerning language and the words we use. All questions were answered, concerns were listened to, many of the attendees had concerns about “getting it wrong” or ‘offending someone’. As someone who often feels I am ‘getting it wrong’ and ‘offending’ people, it was wonderful to hear that many other professionals felt the same way.

Ash and Ang, the two leaders of the day, were wonderful. Their passion and kindness rang through the whole day. Listening to their experiences and their stories was fascinating and uplifting. Seeing the Ichabodies (special mannequins) and talking through procedures of care, whilst upholding the tenets of care; dignity, compassion, kindness, was educational and fascinating.

By the end of the day, my brain was full, but I was buzzing with all the new information and ideas. Looking out for our gender diverse and trans people in our communities is not just for young people. There were stories about older people 70+ years transitioning. Something as simple as having our pronouns in our emails demonstrates we are thinking about this portion of our population. Representation matters.


Amy Millward, Clinical Skills Facilitator on the Inpatient Unit 

“On Wednesday 24th January, I attend the GIRES Being Ready Training. To be completely honest, I was a little apprehensive before I went on the training as I wouldn’t ever want to offend anyone and the fear of getting things wrong for people who are LBGTQ+ was a worry.

“I arrived far too early and met Ash and Angie, who were running the day. They were so welcoming and put me straight to work helping set up the room.

“The training was so insightful and I learnt a lot around the trans community and how they feel about palliative and end of life care. What really struck me at the training was that they don’t want anything special. They just want what we already provide and that is a safe, inclusive environment to be treated and to be able to die without have any prejudice for being the person they are.

“It isn’t just young people who can be trans. We learnt about a 75-year-old who had started to transition. It is so important that we understand that anyone of any age, race or sexuality can transition and that it shouldn’t be looked at as a ‘young persons thing’ and that ‘it’s just a fad’.

“Another important message I took from the training was it’s ok to get it wrong. We are all learning a new language which is ever evolving with new pronouns and different terminology. If you were to mis-pronoun somebody, just say sorry and move on. Maybe ask them how they would like to be addressed and don’t make a whole song and dance around it as it could embarrass the person you are speaking with.

“Lastly and possibly most importantly, I feel that we should always be kind. We never know how someone is feeling on the inside and it is so important in this day and age where mental health is so rife that kindness is so important.

“Overall, I found the training engaging and I learnt so much.”


Kirstie Cashmore, Learning and Development Manager 

“I was hesitant about what to expect from this training and how relevant I would find it in relation to my role, especially as I am non-clinical and do not provide care and support to our patients and their families. I left feeling so inspired, not just by trans and gender diverse people and the courage they possess to lead their most authentic lives, but also about how we can educate and support members of Ashgate who do have close contact with our patients to understand the difference they can make and how they are agents in ensuring our trans and gender diverse patients can continue to be their authentic selves whilst receiving end of life or palliative care from the hospice.”