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Taking hormones to feminise or masculinise the body is not a decision that is taken lightly. We know from the personal accounts of thousands of trans individuals around the world, that considerable time – months and even years – is spent exploring and understanding their gender identity before pursuing any medical intervention.

As a result of this, when they do make the decision to intervene medically in their transition, transgender individuals often have a keen understanding of what it is that they need and how it will impact them both physically and socially.

Indeed, with understanding around transgender healthcare still lacking in current medical practice, it is frequently the case that the individual in question has a deeper understanding of their own needs than the healthcare professional from whom they initially seek help.

The informed consent model of care in medicine was developed to empower the individual. The patient describes their symptoms and their wishes, and the healthcare practitioner supplies all of the information needed about the proposed treatment plan. The benefits and risks of action are discussed, along with any reasonable alternative treatment options. Crucially, the process also includes the discussion about what may happen if treatment does not go ahead.

A decision can then be made on the part of the individual as to whether or not to progress with treatment, using a combination of their own understanding of their situation and needs, and the medical advice supplied to best inform them.

All of this information gathering is entered into from a position of trust and acceptance. Trust that the individual is indeed experiencing the symptoms and feelings they are describing, and acceptance that the role of the medical professional is to provide the best possible treatment to improve health and wellbeing.

As trans-feminine academic, public speaker, and activist, Florence Ashley, explains in their article published in the Journal of Medical Ethics: Gatekeeping hormone replacement therapy for transgender patients is dehumanising

 

Working under the informed consent model includes discussions of the patient’s expectations, decision-making process, understanding of risks and benefits, support structures and general health, but does not involve an evaluation of their gender or whether they are truly trans (Chang, Singh and dickey, p143).7 The goal is not to assess but to facilitate thoughtful decision-making. The model ensures that the decision was not made in haste without appropriate knowledge and forethought, while preserving patients’ own authority over their experiences and avoiding the dehumanising process criticised in the present article.

 

Although informed consent is standard in all other areas of healthcare and lends itself particularly well to the care of transgender individuals, the ‘gate-keeping’ model of care has historically prevailed when treating this group. This means that rather than being treated in line with what is best suited to help manage the patient’s needs, even the most well-informed patients are required to persuade their doctor that their mental and physical health would benefit from gender-affirming medication. A process which, all too often, involves lengthy and often intrusive assessments.

In their article, Ashley describes this process of assessments, and the requirement to “prove” gender variance as dehumanising. It is this notion that is effectively addressed by the informed consent model which is the reason why it has always been our philosophy at GenderGP.

Thankfully, the informed consent model of care is becoming increasingly applied to trans healthcare in progressive countries such as Australia and parts of the USA, however it is yet to be widely adopted by NHS services in the UK.

True informed consent involves sharing information both ways to help the person come to their own decisions about what is best for them. This is the journey of the individual, which is why at GenderGP, we believe the patient should be in charge, ably supported by our team of experts.

Our new suite of forms represent informed consent in action. The user identifies where they are on their journey by visiting our help page https://www.gendergp.com/choose-how-we-can-help-you/ and completes the form.

Our team of gender specialists then review the information and take the necessary steps to ensure the individual has everything they need to get the best care, at their own pace.

 

To find out more about how we can help you visit: https://www.gendergp.com/choose-how-we-can-help-you/

 

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