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As Freedom of Information (FOI) requests, instigated by trans individuals, become publicly available, the true scope of the challenge facing healthcare provision by the Gender Identity Clinics in the UK is becoming clear. The focus must now move to providing meaningful, alternative solutions.

Understanding how GICs are performing is vitally important as it allows those impacted to speak with increased authority when publicly holding the NHS to account on its performance. It allows us to ask why it is that GICs such as The Laurels in Devon, and Chalmers in Edinburgh are seeing less – rather than more – patients per year.

The NHS has a clear commitment to maximum waiting times for non-urgent referrals in England, Scotland, Wales, and Northern Ireland and yet for trans individuals we see that waiting times stretch into years.

The increase in the numbers of trans patients coming forward for help is no surprise. We have been seeing a steady rise over the past 5-10 years. Due to the numbers of people requiring help, this can no longer be regarded as a specialised area of healthcare and the model of care must be adapted accordingly.

Individuals seeking to move forward in their transition have few options available to them:

  1. Wait it out
  2. Seek private care
  3. Self-medicate

As a private healthcare provider to trans and non-binary individuals, we are seeing increasingly large numbers of UK-based trans people coming to us for help.

Providing timely and respectful affirming trans healthcare is one of our core commitments. Patient requests are responded to in a matter of hours, rather than the months and years all too commonly experienced by trans people.

 

We know the model works because we have several thousand active patients, all happy in their care and moving forward with their lives.

 

So how is it that we are supporting more and more patients, and seeing such positive outcomes, while the numbers of patients being seen by the GICs is reducing?

Based on our experience, there are some obvious areas that need urgent attention:

  1. Protocol – current gatekeeping models of care are lengthy, unnecessary and intrusive. Moving to an informed consent model, where the patient is an expert in their experiences, and the medical team are experts in healthcare, can allow well-informed and able people to make decisions in a much more efficient way.
  2. Recruitment – trans healthcare has become so politicised in the UK that recruitment has become a challenge. With no clear guidance or framework, many healthcare practitioners feel ill equipped and unwilling to support this patient population. Guidance is urgently needed.
  3. GP support – Primary Care is the natural setting for trans healthcare, with family doctors being given the additional support and training they need to feel confident in treating this patient population. GPs must be empowered to tackle the majority of cases, which are straightforward.
  4. Telemedicine – Covid-19 has led to the widespread adoption of online medical appointments. This model is eminently suitable to trans individuals who can access the care they need from the comfort of their own homes. Affirmative care must be accessible and telemedicine facilitates this.

There has been plenty of focus on the extent of the problem and challenges facing this patient population. Now a line must be drawn. We have the capability to turn trans healthcare around. This can only be achieved through open conversation and a willingness to tackle the problem.

We’re here to help and be part of that much needed discussion. We believe that our experience of providing trans healthcare can help achieve the important goal of improving the lives of trans people and we welcome any invitations to be involved in meaningful conversations to achieve that end.