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Making booking a vaccine more inclusive

The team developing the COVID-19 vaccine booking service changed questions about gender to improve the service for transgender and non-binary people, says Senior Content Designer Laura Hajba.

As we developed the COVID-19 national booking service in Autumn 2020, we became aware that a question that asked users for their gender might be a barrier for some people wanting to book a vaccine.


Someone views the gender questions on their mobile phone as they go through the process of booking a vaccine on the national booking service.

The information was required to allow us to match people’s vaccination information to their GP records.  But the 4 options coming through from the Personal Demographics Service (PDS) data, which was used to do the matching, were problematic: “male”, “female,” “unspecified” and “unknown”.  

We knew that only displaying these options could be alienating and hurtful to people who didn't identify with any of those labels. This lack of identification could then potentially result in people not booking a vaccination.

Our overall aim was to find a solution that would remove the need to ask about gender completely, because there was no clinical or monitoring need for the information.

But the first step was to reengineer the way the question was asked to make it more accessible to trans and non-binary communities.

We looked at how other government entities asked the questions and consulted with non-binary and trans communities. We then worked with technical experts to add new options: "prefer not to say", "non-binary" and "how I self-describe does not match my GP record".

It was about people being able to see themselves in forms they were used to being excluded from and this was all the evidence we needed.

At the draft stage we tested this improved design with trans and non-binary communities and got a really positive response. It was about people being able to see themselves in forms they were used to being excluded from and this was all the evidence we needed.

Once live, we also received positive feedback. One of the people who had worked with us on the new questions told us they had been emailed by a non-binary user who was considering not booking a vaccination due to having to select a binary gender option in their local system.

“After pointing them in the direction of the main system and the work we had done, they got back to say they had managed to book one and thanked us for the inclusive options they could select,”  they said.

Reengineering the question helped in the short term, but the longer term solution was to implement a technical solution that meant we no longer had to ask the question.

Working with our colleagues in the Spine PDS team, we were able to update the API to remove the need for gender to be part of the call.

This will make many future services more accessible to transgender and non-binary people.

Related subjects

David Ibbotson, Operations Director for the Vaccine Programme at NHS South, Central and West (SCW), a key partner in the NHS-wide vaccination programme, shares what he has learnt about what is required to deliver a ‘simple’ letter inviting someone for a jab.
Rob Sinclair, Lead Architect for the NHS website, gives a behind-the-scenes glimpse of how the National Booking Service for COVID-19 vaccinations is designed to deal with major peaks in demand.


Last edited: 19 August 2022 1:51 pm