Abstract Background Transgender and gender non-conforming (TGNC) individuals represent 0.5% of the United Kingdom (UK) population and often experience stigma, poor health outcomes, and dissatisfaction in healthcare. 1 Inflammatory bowel disease (IBD) affects 1 in 123 people in the UK and carries significant physical and psychological burden. 2 TGNC individuals with IBD (TGNC-IBD) face additional challenges, including the impact of gender-affirming surgery or hormone therapy on their IBD, and compounded mental health risks.3 Focus group work suggests TGNC-IBD patients feel physicians lack relevant knowledge and experience stigma and uncertainty however no studies have explored the perspectives of IBD healthcare providers when caring for this population. Methods A 23-item anonymous questionnaire, co-designed with TGNC-IBD patients, was distributed nationally from June-September 2025 through social media and through the British Society of Gastroenterology. Eligible participants were UK healthcare professionals managing adult patients with IBD. Questions assessed demographics, comfort, knowledge, and institutional facilities. Responses were analysed descriptively. Ethical approval was obtained from City St George’s, University of London. Results 62 responses were collected from a wide range of professionals and geographic locations (table 1) and key findings are summarised below (figure 1). 54 (87.1%) reported having cared for TGNC-IBD patients and 50 (80.6%) felt it was very or somewhat important to know a patient’s gender identity. 27 (43.6%) felt slightly or very uncomfortable discussing gender identity, 37 (60.7%) felt nervous enquiring about gender identity and 32 (51.6%) felt very or somewhat unconfident asking about pronouns. 42 (67.7%) disagreed that they are adequately trained to care for TGNC-IBD patients and the majority felt either very or somewhat unknowledgeable with regards to managing perianal disease in context of gender affirming surgery (n = 49, 79%), bone health in TGNC-IBD patients (n = 55, 88.7%), the impact of gender affirming hormones on IBD (n = 53, 85.4%) or interactions between gender affirming medications and IBD therapeutics (n = 48, 77.4%). The majority of healthcare facilities did not offer gender neutral facilities in endoscopy (n = 42, 67.7%) or outpatient clinics (n = 41, 66.1%). Conclusion This nationwide survey is the first of its kind and shows IBD professionals recognise the importance of inclusive care but report low confidence, inadequate training, and limited systemic support in the UK. These findings mirror broader TGNC healthcare literature and highlight the need for targeted education, curriculum inclusion, and institutional change to improve healthcare provider confidence and build a more inclusive care system. References: 1Colwill M, Jacob K, Pollok R, Seal L, Poullis A. Patient experiences of gender identity and inflammatory bowel disease: a focus group study. Frontline Gastroenterology 2025. https://doi.org/10.1136/flgastro-2025-103103. 2Contemporary epidemiology of coeliac disease, dermatitis herpetiformis, Crohns disease and ulcerative colitis in the United Kingdom 2019. https://www.cprd.com/approved-studies/contemporary-epidemiology-coeliac-disease-dermatitis-herpetiformis-crohns-disease (accessed October 2, 2025). 3Colwill M, Pollok R, Seal L, Poullis A. Impact of gender identity in the inflammatory bowel disease population: an evidence review and practical steps for gastroenterologists. Frontline Gastroenterol 2024;15:401. https://doi.org/10.1136/flgastro-2024-102658. Conflict of interest: Dr. Colwill, Michael: No conflict of interest Seal, Leighton: No conflict of interest Pollok, Richard: No conflict of interest Poullis, Andrew: No conflict of interest
Colwill et al. (Thu,) studied this question.