NHS Shetland Equality and Diversity Workforce Monitoring Report Update 2017

Transcription

1 NHS Shetland Equality and Diversity Workforce Monitoring Report Update 2017 Date: April 2017 Version number: 1 Authors: Lorraine Allinson HR Services Manager Review Date: April 2018 If you would like this document in an alternative language or format, please contact NHS Shetland Corporate Services on

2 DOCUMENT DEVELOPMENT COVERSHEET* Name of document E&D Workforce Monitoring Report Update 2017 Registration Reference Number HRPOL011 (Update) New Review Authors Executive Lead (NHS) L Allinson, HR Service Manager Lorraine Hall, Director HR & Support Services Proposed groups to present document to: Executive Management Team C/S All staff / Area Partnership Forum FIO PFPI / Public Partnership Forum FIO Staff Governance Committee C/S & Approval Date Version Group Reason Outcome By Executive Management Team C/S PRO 1 Staff Governance Committee C/S & Approval PRO 1 Area Partnership Forum FIO PRO 1 PFPI FIO PRO Examples of reasons for presenting to the group Professional input required re: content (PI) Professional opinion on content (PO) General comments/suggestions (C/S) For information only (FIO) Examples of outcomes following meeting Significant changes to content required refer to Executive Lead for guidance (SC) To amend content & re-submit to group (AC&R) For minor revisions (e.g. format/layout) no need to re-submit to group (MR) Recommend proceeding to next stage (PRO) *To be attached to the document under development/review and presented to the group Please record details of any changes made to the document on the back of this form 2

3 DATE CHANGES MADE TO DOCUMENT 3

4 TABLE OF CONTENTS 1. Introduction 5 2. The Legal Context 5 3. Mainstreaming Brief Update 6 4. Equality Outcomes Brief Update 7 5. Employment Monitoring Information Workforce Profile Recruitment Activity Career Progression/Performance Appraisal Numbers of Part-time and Full-time Staff Staff Attending Training Staff Leaving Employment Return to work of disabled employees following sick leave Disciplinary & Grievance Issues Board Membership Temporary Workforce 24 4

5 1. Introduction In April 2013 Shetland Community Planning Partners published joint Equality Outcomes, Mainstreaming Report and Employment Statistics. This was a joint piece of work between Shetland Islands Council, NHS Shetland, Shetland College, Zetrans and Shetland Licensing Board. Updates have subsequently been published in April each year. This report is intended to satisfy requirements under the Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012 to publish an annual Workforce Monitoring Report covering the 9 protected characteristics covered by the act. 2. The Legal Context The public sector equality duty, referred to as the general equality duty, is set out in the Equality Act Under the Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012, public authorities are also covered by specific duties, which are designed to help public authorities meet the general equality duty. Shetland s Community Planning Partners are covered by both the general and specific equality duties. More detail on the general and specific duties it set out in Shetland s Equality Outcomes and Mainstreaming Report Health & Social Care Integration Integration of health and social care is the Scottish Government s ambitious programme of reform to improve services for people who use health and social care services. Integration will ensure that health and social care provision across Scotland is joined-up and seamless, especially for people with long term conditions and disabilities, many of whom are older people. The Public Bodies (Joint Working) (Scotland) Act was granted royal assent on April 1, The legislation meant changes to the law which required NHS Health Boards and Local Authorities to integrate their services resulting in more joined-up, seamless health and social care provision that will improve people's lives. 5

6 On 2nd July 2014, Shetland Islands Council and the Board of NHS Shetland took the decision that the Model for integration of health and social care services in Shetland would be the Body Corporate, known as an Integration Joint Board. Under the Body Corporate model, the Health Board and Local Authority delegate the responsibility, for planning and resourcing service provision of adult health and social care services to an Integration Joint Board (IJB). The IJB has since been formally constituted, confirmed the full membership and approved their Standing Orders, Scheme of Administration, Financial Regulations, Risk Management Strategy, Participation and Engagement Strategy, an Audit Committee and Clinical and Care Governance Arrangements. The IJB does not currently directly employee anyone, therefore does not have a separate monitoring report. There is joint responsibility for delivering integrated services, however employment sits with either NHS Shetland or Shetland Island Council. For 2017, NHS Shetland and Shetland Islands Council will publish a joint Equality and Diversity Outcomes and Mainstreaming Report covering progress during , and a joint report for Equality and Diversity Outcomes setting out its ongoing commitment to promoting and embedding equalities in their service delivery. 3. Mainstreaming Equality Brief Update Mainstreaming equality simply means integrating equality into our dayto-day working. This means taking equality into account in the way we go about our business when acting as an employer, or planning and providing services. Shetland s Community Planning Partners are committed to integrating equality into our businesses, using tools such as impact assessment, and by ensuring that equality features explicitly and proportionately in business planning, committee or other decision-making, and reports and other policy development and review mechanisms. Since publishing Shetland s Equality Outcomes and Mainstreaming Update Report in 2015, we have made notable progress in the following areas in relation to mainstreaming equality in NHS Shetland: 6

7 - Encouraging a mainstreaming approach to equality for joint strategies, such as the Joint Strategic Commissioning Plan consultations. All of those providing feedback were encouraged to consider the proposals from equality/protected characteristics perspective, rather than this coming from the Diversity Taskforce as in previous years. By disbanding the taskforce, more responsibility for equality sits with the authors of strategies and policies to take a mainstream approach. - Items in the organisation-wide briefings and communications covering revised policy and support for cultural events such as Holocaust Memorial Day, LGBT History Month and International Women s Day. - Responses and guidance to staff comments and queries regarding equality. - Equality Impact Assessment of polices and strategies. - Updates to links on intranet and internet pages. Ongoing partnership working approach with local agencies public and voluntary sector partners teaming up to deliver information and events in relation to diversity cultural calendar. For further information see NHS Shetland Mainstreaming Report April March Equality Outcomes Brief Update Equality Outcomes are aimed at producing concrete improvements in people s lives that contribute to a fairer, more inclusive and more prosperous Shetland. Since publishing Shetland s Equality Outcomes and Mainstreaming Report Update in 2015, we have made more progress in some areas than others but will continue to take forward outstanding actions alongside new actions into the revised plan for 2017 For further information see NHS Shetland Equality Outcomes Workforce Information Under the Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012 NHS Shetland is required as a public authority to take steps to gather information on the composition of our workforce and on the recruitment, development and retention of employees with respect to the number and relevant protected characteristics of such persons. 7

8 We must use the information gathered to improve our performance in terms of the general equality duty. By monitoring workforce equality information, we are better able to: - Identify discrimination in any of your employment functions and take action to remedy this - Measure the impact of our employment policies, practices and decisions on people with different protected characteristics - Take steps to meet the needs of staff and potential staff who share relevant protected characteristics - Inform our policies and practices based on evidence - Demonstrate to the public and to audit, scrutiny and regulatory bodies how we are performing on equality - Assess performance against that of similar organisations, nationally or locally. The total number of staff working for NHS Shetland at 30th September 2016, including bank workers, was 853 but for the purposes of this report we use a figure of 683 to refer to staff. The 683 figure includes all permanent and fixed term employees and excludes bank workers, locums, secondees, volunteers, students and those employed jointly with other organisations. The workforce data has been obtained from the national electronic Employee Self Service system (e:ess). Due to the size of the Board and our responsibility for the protection of staff data, we have elected not to disclose staff numbers under five to ensure that members of staff cannot be identified. We want to assure the Board that we do understand the status of staff and groups and are happy to provide this information to the relevant regulatory bodies on demand. 5.1 Workforce Profile This workforce data has been obtained from the national electronic Employee Self Service system (e:ess) and is a snapshot as at 30th September

9 5.1.1 Age The data provides a profile of our workforce in terms of age. Of the 683 staff employed, 40 (6%) were under 25 years of age, 380 (56%) were between and 241 (35%) were aged between and 22 (3%) 65 or over. In previous years we have seen a decrease in younger people and an increase in older people, due to our location, a proportion of school leavers will continue to leave the islands to seek further education, work and lifestyle change. Recruitment data also shows age range of applicants is also lower for those under Under Chart 1 Workforce Age Profile as at 30 September Disability Chart 2 shows our workforce profile by disability. 29 staff (4%) identify as having a disability. This figure has increased slightly since the last reporting period, demonstrating that staff continue to feel more confident to disclose disabilities and/or we are employing more people with a disability. 9

10 2% 4% No Prefer not to say Yes 94% Chart 2 - Workforce Disability Profile as at 30 September Ethnicity Chart 3 shows the profile of our workforce by ethnicity as at 30 September We have recorded 15 (2%) of our workforce that identify as being from an ethnic minority group. This figure shows neither an increase nor decrease from the figures reported in 2015 in staff identifying as being from an ethnic minority group in comparison to previous years. 2% 4% White Background BME Background Not Disclosed 94% Chart 3 - Workforce Ethnicity Profile as at 30 September

11 5.1.4 Gender The Gender profile of our workforce continues to be pre-dominantly female with 83% of our workforce female and 17% male at 30 September This relates to our substantive workforce and does not include temporary cover / locum arrangements. However further work required to review variation across service areas and temporary staff. In Shetland the population is 49% male / 51% female compared with Scotland 48.6% male, 41.4 female 17% Female Male 83% Chart 4 - Workforce Gender Profile as at 30 September Marriage & Civil Partnership Chart 5 shows a slightly higher proportion of our employees who are married or in a civil partnership 60% and those who are not 40%. This is largely unchanged from the previous years. 11

12 Married/In partnership Not Married/In partnership Not Declared Chart 5 Workforce Profile Marriage & Civil Partnership as at 30th September Pregnancy & Maternity All pregnant employees, regardless of length of service, are entitled Maternity Leave. Employees with 12 months continuous NHS service at the beginning of the 11th week before the expected week of childbirth and who intend to return to work following maternity leave are entitled NHS Shetland enhanced maternity pay. 44 employees benefited from maternity leave within the reporting period 1 st October th September 2016, representing 8% of the female workforce a significant increase on the previous year which was Religion & Belief 45% of our workforce identify with a religion of which 44% with a Christian religion and 1% with other religions/faith groups, including Buddhist, Hindu, Jewish, Muslim and other faiths. 39% say they have no religion or faith and 16% chose not to provide details of their religion or faith. These figures show a slight variation from previous year. We have previously received critical feedback from colleagues for not providing a further breakdown of the Christian religions. We therefore felt it pertinent to provide more depth in our monitoring information. Of the 299 people identifying with a Christian religion, 126 identified with 12

13 the Church of Scotland faith, 44 with the Roman Catholic faith and 129 with a Christian other faith Christian Other No Religion Not Disclosed Chart 6 Workforce Profile Religion & Belief as at 30th September Sexual Orientation 80% of our workforce (548 employees) identify themselves as heterosexual, with 1% (9 employees) identifying as gay, lesbian, bisexual or other (LGBO) and 18% (126 employees)preferring not to disclose their sexual orientation. 13

14 19% 1% 80% Heterosexual LGBO Declined Chart 7 Workforce Profile Sexual Orientation as at 30th September Transgender None of our current employees identify themselves as transgender and 50 employees declined to disclose their transgender status. 50 No Prefer not to say 633 Chart 8 Workforce Profile Transgender status as at 30th September Recruitment Activity The following recruitment data has been obtained from the national e:ees system. It covers all vacancies during the period at 1st October 14

15 2015 to 30th September This includes temporary, fixed-term and bank working opportunities as well as substantive positions Age We received 438 applications for employment during this period. This shows a 22 % reduction in applicants from previous year. Of these 78 (18%) were under 25 years of age, 257 (59%) were between 25 and 49 and 89 (20%) were over 50 years of age. Age was not recorded for 13(3%) applicants. We recognise that it is not only essential for us to be able to attract local applicants but also attract from wider resource pools off island to find the relevant skills and knowledge required who are willing to relocate. 297candidates were invited to interview and141 were appointed, giving an overall success rate of 32% out of the total number of applicants, (the same as last year). The success rate for candidates under 25 years of age was 37% with 29 candidates appointed from 78 applicants. Candidates in the age range had a 30% success rate with 77being appointed from 257 applicants. Candidates over 50 had a success rate of 37% with 33 candidates being appointed out of 89 applicants. Therefore success rate was higher for applicants under 25 and over 50 years old Applied Shortlisted Recruited Chart 9 Age Profile of Applicants for Period 1st October th September

16 5.2.2 Disability Chart 10 shows that 35 (8%) of the applications for employment received by the Board during the 2015/16 reporting period were from individuals who identified as having a medical condition lasting more than 12 months. A further 55 applicants preferred not to give details of their medical background. As a Disability Two Ticks symbol holder, we operate a Job Interview Guarantee (JIG) scheme for all disabled applicants who meet the essential requirements for any of our vacancies. Of the 35 applications identifying with a disability, 29 (83%) candidates were shortlisted for interview and 10 were appointed, which is a 29% success rate, slightly below overall success rate. 8% No 13% Yes 79% Not Provided Chart 10 Disability Profile of Applicants for Period 1 st October th September Ethnicity Chart 11 shows recruitment activity, broken down by ethnic group, for the twelve months from October 2015 to September Out of a total of 438 applications received during the 12 month period, 19 (4%) were from applicants who identified as being from black and minority ethnic (BME) backgrounds, a decrease on the previous year. 356 applications (81%) were from individuals who identified as being from White 16

17 backgrounds and 63 applicants (14%) chose not to disclose their ethnic background A total of 297 applicants (68% ) were shortlisted for interview. Of these employment applications, 4% were received from applicants of a BME background, 58% were short listed for interview. A total of 139 candidates were successful in being offered positions with NHS Shetland during the 12 month period, making the overall success rate for all candidates 36%. Three candidates from BME backgrounds were appointed, a success rate of 16%. This tells us that we continue to attract and shortlist a diverse range of candidates for our vacancies, but the success rate for this group of applicants has decreased from last year s 23% but still exceeds the year prior which was7%. 15% 4% Ethnic Minority Background White Background Not Recorded / Disclosed 81% Chart 11 Ethnicity Profile of Applicants for Period 1st October th September Gender Chart 12 gives a breakdown of recruitment activity by gender for this reporting period. 79% of applications received by the Board during this reporting period were from females and 21% from males, similar to previous years. 17

18 The success rate in gaining employment with NHS Shetland was 34% for women and 27% for men. This may differ across different staff groups; we intend to explore this further in order to establish where consideration of positive action may be effective and of benefit Male Female Applied Shortlisted Recruited Chart 12 Gender Profile of Applicants for Period 1st October th September Pregnancy & Maternity Less than 5 of the applicants for this reporting period disclosed pregnancy or maternity leave on their application. Less than 5 candidates were subsequently appointed Religion & Belief Chart 14 shows that 44% of applications for employment received by the Board during the period under review were from individuals who stated that they had no religion or faith; 22% did not disclose their faith. The remaining 34% of applicants identified with Buddhist, Muslim, Catholic, Hindu, Jewish, Church of Scotland or Other / Christian religions. 18

19 Applied Shortlisted Recruited Chart 14 Religion Profile of Applicants for Period 1st October th September Sexual Orientation Chart 15 shows that 15 individuals (3%) applying for employment with NHS Shetland during the twelve months under review identified as Lesbian, Gay, Bisexual or an other sexual orientation (LGBO)similar to previous years. 16% of applicants chose not to disclose their sexual orientation, a decrease on the previous year Heterosexual Not Disclosed Gay/Lesbian/Other Applied Shortlisted Recruited Chart 15 Sexual Orientation Profile of Applicants for Period 1st October th September

20 5.2.8 Transgender None of the applications received were from individuals disclosing that they identified as transgender. 5.3 Career Progression/Performance Appraisal Sixteen (16) members of staff were successful in applying for an advertised post at a higher grade within the organisation during this period. The majority of the promoted staff identified as being from a white background, less than 5 chose not to disclose ethnicity. The majority of employees were female and less than 5 were male. Most promoted staff identified as being heterosexual, with less than five choosing not to disclose their sexual orientation. None of these employees were transgender and less than 5 identified as disabled. Of those promoted, the majority did not identify with a religion, less than 5 identified with a Christian religion, or preferred not to say. The age breakdown of those promoted was between a broad age range off 20 to 50+ with 38 % below the age of 30, 31% age 30 to 39 and 31% age 40 and above. The proportion of those promoted was fairly evenly split between those who were single compared with those who were married or in a civil partnership. Whilst we do not directly monitor pregnancy or maternity leave relating to those promoted, we were able to cross-reference our records to be able to report that none of those promoted were pregnant or on maternity leave at the time of their promotion. As reported previously, we use a number of national performance appraisal processes that have been developed and agreed with trade unions and professional organisations. The majority of our staff are employed under Agenda for Change terms and conditions. As the situation currently stands, none of them either benefit or suffered a detriment as a result of performance appraisal as the results do not affect pay progression. However, each member of staff is required to have a Personal Development Plan (PDP) designed to support their needs in meeting the Knowledge and Skills Framework (KSF) outline for their respective post. KSF outlines specify the levels of 20

21 knowledge and skills that an individual is expected to be able to demonstrate in order to carry out their role effectively. Revalidation procedures will apply to Nursing and Medical staff. Our Executive Directors are rated according to performance and this rating outcome is approved by the Board s Remuneration Committee and verified by the National Performance Monitoring Committee. Consultants employed under the National Consultant Contract participate in job planning and appraisal as specified by their contracts. Progress through the seniority points of their pay scale is on an annual basis with points only being withheld or delayed where the consultant has not met the commitments of their agreed job plan. The purpose of the GP Appraisal system which all GPs are expected to be appraised under - is to provide a confidential and supportive setting in which a doctor is given the opportunity to reflect on their practice, celebrate their expertise and focus, in a structured way, on areas where their expertise could be enhanced or problems addressed. The focus of the discussion between the GP Appraiser and the GP is always on what the individual doctor has learned or identified as a learning need as a result of the gathering and reflecting on that evidence. The Performance of the Board is managed and assessed through the Board s Annual Review and Local Delivery Plan, the annual actions of which are detailed in the Corporate Action Plan. 5.4 Numbers of Part-time and Full-time Staff At 30 th September 2016, 54% of employees were working on a full time contract and 46% of employees were working flexibly on a part time basis, a 2% increase on the previous year s figures reported. Of these 48% of female employees were employed on a full time contract, with 52 % working part time hours. In contrast 85% of male employees were employed on a full time contract with 15% working flexibly part time hours. 21

22 Part-time Full-time Female Male 5.5 Staff Attending Training From the 1 October 2015 to 30 September 2016, NHS Shetland has trained 6792 staff members in a wide variety of training courses. As in previous reports these figures are reported on a twice yearly basis to NHS Shetland Area Partnership Forum. Equality and Diversity data on both training attendances and non attendances is collected and analysis would indicate that there is no direct or indirect discrimination on training access. However as previously reported many staff do not disclose equalities data. As we move to the use of the National HR system EESS, we anticipate the ability to monitor Diversity data will improve. Since the introduction of our Compulsory Refresher Training day 175 staff have completed it within the period 1 October 2015 to 30 September 2016; 214 staff booked onto the training and 39 (18.2%) did not attend initial session booked. This is reported to both Area Partnership Forum and through the Staff Governance Committee. This is also recorded and updated monthly on the Board s balanced scorecard. 5.6 Staff Leaving Employment 115 employees left the Board s employment during the reporting period, including 35 people reaching the end of fixed-term contracts which included 18 trainee doctor s on rotation. 21 % of the leavers were male, 79% female. This is reflective of the gender of the workforce. Less than 5 leavers had a disability. 22

23 3% of leavers identified as being from a BME background and 12% declined to disclose their ethnicity. Less than 5 leavers identified as being gay, lesbian, bisexual or an other sexual orientation, 21% did not disclose. Less than 5 employees left the organisation within two years of taking maternity leave. 8% of leavers identified as being Buddhist, Hindu, Muslim or an other faith, whilst 35% identified with a Christian faith and 57% declared no religion or faith or declined to answer. Chart 18 shows the age profile of employees leaving the organisation during the reporting period Under Chart 18 Age Profile of Leavers 1 October September Return to work of disabled employees following sick leave relating to their disability Information relating to the return to work of disabled employees following sick leave relating to their disability is not recorded in a manner that can be readily monitored and reported on. However, in line with the Promoting Attendance Policy, line managers are required to make appropriate referrals to the Occupational Health service and consider guidance provided for workplace adjustments ( temporary or permanent) to enable successful return to the workplace that improves and sustains attendance. Temporary or permanent adjustments provided to duties and facilities are not currently captured in a structured format for reporting. However the monitoring data in place does show a 2% 23

24 increase to part time contracts in place during compared with data, a proportion of which will be in response to flexible working requests and reduction in hours. 5.8 Disciplinary & Grievance Issues There were 21 formal employment interventions during the reporting period, including allegations and issues raised under the Conduct and Capability Procedures, as well as formal complaints made by employees under the Bullying & Harassment and Grievance Procedures. Given the small number, it is challenging to present meaningful equality information. Of the employees involved, the majority, but not all, were female and heterosexual. All identified as being of a white ethnic background. Less than 5 of the employees had a disability and 52% were married or in a civil partnership. None of the employees were transgender, pregnant or on maternity leave. 43% of the employees identified with a Christian faith, whilst the remainder either preferred not to say, had no religion or identified with an other religion. In respect of age 71% of the individuals involved were 50 and above and 29% below the age of 50. Numbers are relatively low and no particular trend has been identified, it is likely that this is in keeping with our ageing workforce as a whole. 5.9 Board Membership At the time of reporting of those who chose to share their information, five (5) were female and nine (9) were male;8 members identified as heterosexual, the remainder chose not to disclose. No members identified as being disabled or chose not to disclose. All of those choosing to share information identify as being from a white background; five (5) were over the age of 60 and the remainder were in the age range. 43% identified with a Christian faith, or preferred not to answer or had no religion. There has been further changes to the members of the Board that will continue to be review within the next reporting period. We will continue to explore diversity and establish any positive actions that may be considered during future recruitment procedures. 24

25 5.10 Temporary Workforce Our temporary workforce refers to bank workers, locums, secondees, volunteers, students and those employed jointly with other organisations. At present we are able to report equality date in relation to bank workers and volunteers only, though this is something that we will continue to explore as IT systems develop Bank Workers At 30 th September 2016 we had 170 individual bank workers engaged on bank working arrangements. Bank working is used to cover shifts/part shifts where, for example, we have vacant posts or unexpected absence. Bank workers are not guaranteed the offer of regular work shifts / patterns, work is offered when available and the bank worker is not obligated to work the shifts offered Age Chart 20 below shows the age profile of our bank workers; 44% of our Bank workforce are under the age of 30 and 28% are 50 or over Under Chart 19 Bank Age Profile at 30 th September A proportion of the Bank workforce under 25 will be student workers returning home for seasonal work. 25

26 Disability A very small percentage of bank workers have disclosed a disability Ethnicity The majority of temporary bank workers disclosing their ethnicity identified with a white background (96%). 4% were from a BME background or preferred not to say Gender 81% of the temporary workforce is female and 19% male. This is a very similar ratio for our contracted employees Marriage & Civil Partnership 36% of Bank workers are married or in a civil partnership Pregnancy & Maternity We do not monitor pregnancy and maternity in relation to bank workers Religion & Belief Our Bank workers have a higher proportion of people identifying with no religion or faith compared to the substantive workforce, with a minority of non Christian faiths. 26

27 Christian Other No Religion Not Disclosed Chart 20 Bank Workers Religion Profile at 30 th September Sexual Orientation 3 % of the Bank workforce identify they are LBGO, 15% preferred not to say. 15% 3% LGBO Heterosexual Perfer not to say 82% Chart 21 Bank Sexual Orientation Profile at 30 th September Transgender Less than 5 of our Bank workers identify as transgender. 27

28 Volunteers There were 21 individuals carrying our volunteer roles within NHS Shetland at 30 th September It remains clear from the data that the majority of volunteers are young, white, single females, which is indicative of the number of young women seeking relevant experience prior to commencing further education in healthcare Age A large proportion (52 %) of the volunteers are under the age of 20 and the majority of others (29%) under the age of 35. Less than 5 volunteers are over age Disability None of our volunteers report having a disability Ethnicity Most of the volunteers (89%)identify as coming from a white ethnic background, with less than five undisclosed and less than 5 from a mixed background Gender Less than 5 volunteers are male Marriage & Civil Partnership Less than five of our volunteers are married or in a civil partnership Pregnancy & Maternity We do not monitor pregnancy and maternity in relation to volunteers Religion & Belief 28

29 53% of volunteers reported having no religion or belief, less than 5 did not disclose and the remainder identified with Christian faiths Sexual Orientation The majority of volunteers are heterosexual, with less than 5 LGBT, and less than 5 choosing not to disclose their sexual orientation Transgender No volunteers disclosed as transgender. 29