1. 1 Comfortably Numb Are men THAT hard to reach? Phil Eaglesham, Choose Life Coordinator Inverclyde Council

2. 2 Hello? Is there anybody in there? Just nod if you can hear me. Is there anyone home?

3. 3 Hard 2 Reach? Men don’t appear prominently as a ‘hard to reach’ group in Health Inequalities publication at UK or Scottish levels, despite clinical evidence of greater risks, poorer prognosis and compliance with treatment. (‘Health Inequalities in the New Scotland’, PHIS 2002 / ‘Addressing Inequalities’, DoH 2002)

4. 4 Common Barriers Some people do not understand written or spoken English Some communities are geographically isolated Some people cannot hear or see Some people cannot get into many buildings Some people have no permanent address Some people are living with a long-term illness

5. 5 Further Barriers Some people are out at work all day Some people have less spare time than others, such as retired people Some groups feel culturally isolated from the mainstream of society’s activity Some groups feel alienated from, or even suspicious of, the organisation that is consulting them Some people may just not be interested in being consulted by public bodies. (Community Involvement Strategy, Salford City Council)

6. 6 Come on, now. I hear you're feeling down. Well I can ease your pain, Get you on your feet again. Relax. I need some information first. Just the basic facts, Can you show me where it hurts?

7. 7 Common Responses Better data on social deprivation and exclusion. Target low income and hard-to-reach groups. Target marginalised groups such as refugees and asylum seekers, ensure access to interpreters/bilingual health advocates where needed. Consider satellite clinics, home visits and drop-ins to make services more accessible.

8. 8 Further Responses Target men with health promotion messages – for example, around diet, physical activity and smoking (?MH) Work with community groups and advocates to improve services can be better tailored to their needs. Work with community nurses to access the community budget.

9. 9 Gender Identity

10. 10

11. 11 DEVELOPMENT OF A TRANSSEXUAL SUPPORT GROUP, SCOTLAND, UK Eaglesham, P., Laird, N., MacKillop, C., Carr, S.

12. 12 Intended Objectives Improved access in Glasgow through peer support and community development. Improved quality of service to patients and better health outcomes in transition. Fits with both client’s needs and NHS requirements for involvement and service improvement.

13. 13 Group Development Promotion and recruitment. Attendance rose from 5 to 40 monthly within a year. Trans people travelled from rural Scotland to connect with the group. Facilitation essential for first 2 years to ensure support, continuity and cohesion, gender was significant, but trans status was not. Benefit in the group being mixed FtM and MtF but with regular opportunities to split up for gender specific discussions.

14. 14 Further Findings Demand for separate support group for partners, families and friends. Importance of post- transition transsexual people for peer support and inspiration.

15. 15 Group Achievements Enthusiastic to improve services, within NHS and beyond. Production of improved local and national information resources. Presentations at national and international conferences. Recruitment for national research and trained in facilitation methods. Group now self sustaining, supporting satellite group now emerging in Belfast.

16. 16 “The child is grown, the dream is gone. I have become comfortably numb.” Roger Waters / Dave Gilmour 1980