If my time at the BMA has taught me anything it is that understanding the structure of our association and the remit of its relationships and functions is not always obvious or straightforward.

As a membership organisation, the BMA would be nothing without the 185,000 members who make us what we are, and it is our duty to represent each and every one of you as fairly and effectively as we can.

It is incumbent on us to be clear on what our policies are, how these are formed by you, the membership, and why this aspect of the BMA’s work trumps everything else.

It is with this in mind that I want to address the concerns expressed by some members with a recent article in the BMJ, which sought to question the evidence base used in the provision of healthcare to transgender patients.

I am acutely aware of the upset and unhappiness this article has provoked, and how it has led many to question the BMA’s role and position. First and foremost, the BMA is abundantly clear in its belief all patients should be afforded access to ‘appropriate, timely and high-quality healthcare’, while noting transgender and non-binary patients frequently do not receive care to this standard.

In 2020 the association’s annual representative meeting formally adopted policy affirming the rights of transgender and non-binary individuals to access healthcare and live their lives with dignity, including having their identity respected.

Since then, the BMA has continued to call for equality of access and improved standards of care for trans and non-binary patients, and for greater awareness of the health needs of these patients to be incorporated into medical training and practice.

It is also worth noting that, while the BMA and BMJ have a closely linked history and the latter is owned by the association, it operates independently and with complete journalistic freedom. Under this arrangement, the BMJ is entitled to publish work that will sometimes diverge from, or even conflict with, positions held by the BMA and the views of members.

However, it is crucial to remember the policies and positions which direct the BMA’s values, work and campaigns are determined not by editorial judgements within our journal, but through careful and considered democratic processes initiated by our membership – you.

These processes allow for any member who wishes to highlight a particular issue or to change or improve BMA policy, to submit their ideas to a committee of their peers in the form of a motion.

Once added to a conference agenda these motions are then carefully debated, allowing for supportive and dissenting positions to be considered and opportunities for extended debate and amendments made where necessary, before being put to a vote.

At the ARM, voting falls to 633 members drawn from across the UK and from different branches of practice, levels of seniority and backgrounds.

My role as your ARM chair is to ensure each member of the representative body (BMA members attending the ARM) is enabled and supported to make an informed vote.

This process is not perfect but it is so far the best and fairest one available to us. As RB chair, I have sought to do everything in my power to make our policy-making processes fairer, more inclusive and to encourage more of you to get involved – ultimately to increase its democratic value, and I will continue to finesse this approach until my term ends in 2025.

A good recent example of this would be our call for full pay restoration, a campaign which is being fought through the industrial action being taken by junior doctors, but which the BMA believes must apply to all doctors. This motion was prioritised, discussed and debated in June 2022 at the ARM. That is when it became our policy and a priority for the BMA.

I encourage anyone with concerns or complaints regarding content in the BMJ to exercise their right to reply directly to the journal’s readers’ correspondence section.

If you would like to get in touch with me and learn more about how you can get involved, email me or tweet @DrLatifaPatel – DMs always open.

Dr Latifa Patel is chair of the BMA representative body