New guidance for staff caring for transgender people with dementia has been drawn up to ensure patients get dignified and compassionate health care in north Wales.
It includes advice about dealing with people confused between their gender preference and their birth gender.
Betsi Cadwaladr University Health Board (BCUHB) believes it is the first in the UK to develop such guidelines.
It said the advice would help support the “unique, but vulnerable, group”.
Last year, 75 people from Wales were referred for gender identity treatment – roughly a three-fold rise since 2014.
Jenny Burgess, 66, from Connah’s Quay, Flintshire, who had gender reassignment surgery last year, helped draw up BCUHB’s guidance.
She said the advice was key as transgender people with dementia “may wake up one day and they’ll be confused why they’re dressed in a certain way”.
She said: “Take for instance a transgender woman – they may well get quite concerned and disturbed at being in female clothes.
“They may worry why certain parts are missing from their anatomy. So it’s these sort of things that I’d like staff to be aware of. There’s no simple answer… but it really is a worrying scenario.”
Sean Page, consultant nurse for dementia at BCUHB, said it was important the specific needs of transgender dementia patients were met to ensure they were cared for appropriately.
He said: “As dementia progresses a person may not recall their current gender and they may see themselves being pre-transition and be surprised at the physical changes to their bodies.
“This can result in them becoming very disorientated and anxious. They may not understand why they are being referred to as being a certain gender as they cannot recall publicly voicing this preference.”
The guidelines, set to be issued to staff in the coming weeks, offer advice on how to work with families and carers of transgender people affected by dementia.
They also include advice on how to help a transgender person with dementia to maintain their preferred appearance when they can no longer do it themselves.
Margaret Hanson, vice chairwoman and older person’s champion of BCUHB, said: “These guidelines are real proof of what the NHS can do when staff listen to what those we serve truly need and I hope they will bring about real change in how the NHS in north Wales supports this unique, but vulnerable, group of older citizens.”