Freddy Mcconnell’s Documentary: The State of Trans Healthcare

My name’s Freddie McConnell. I’m from the UK, where for years trans people have struggled to access healthcare. It’s like, you’re stuck

In a limbo and you know what you want and you know how you’re supposed to get it , but you’re not. And there’s no help

When you’re already feeling worn down. You’re given the impression that society doesn’t want you here

While living at the center of a culture war

If anyone can identify as a woman, then what is a woman? We committed the cardinal sin for minority of actually being, being visited. I wanted

To understand why and how trans people here are pushing back. I mean, in your view, is there any, any one that needs to be held accountable for her death. The NHS. We

Allegedly have free health care in this country. And that just isn’t the case for trans

People. This is transnational

Protect trans youth!

Plop, did you hear it? Yeah. As a trans Dad, I’ve had my own struggles to make a life in systems that were never designed for people like me. I wrote a column for Vice about what it’s like to go through pregnancy as a trans man in the UK. And I’ve also had to fight to be listed accurately on my child’s birth certificate. And I’ve experienced the media circus that came with that. But perhaps the biggest struggle for trans people in this country is getting healthcare through the NHS, our national health service. The NHS is designed to deliver free and timely care to everyone. It’s a beloved institution that us Brits take huge pride in, but for many trans people at the NHS, it feels more like a locked gate than a support system. Often people have to wait years for health care they desperately need. Some say they’ve been abandoned between stages of a surgical procedure and others can’t bear the waiting. I set out to hear some of these stories and to explore what it means to live life in limbo. Trans pride is a gathering full of joy and celebration, but it’s also very much a protest. Why is it important to be here

So they can see us because they need to see us. And it’s not just us. It’s all of our allies. It’s about going, but not going anywhere. We’ve always been here. We’re really invisible. And we’ve always been invisible, but we’re not, but that’s today. And that’s why I’m doing this because I bet you can see me

The Tories don’t give a fuck. The British document government does not give a fuck

This is what pride should be. Do you know what I mean? I don’t think I’ve ever been to like a pride that feels quite as radical. Like everyone wave and nod, yeah. And like beep and little ones and stuff like it’s my

Felix Mufti, a 20 year old poet and playwright from Liverpool spent years on wait lists before he could start his medical transition

I came out as trans when I was 14. And so I was quite young. So a lot of people, you know, were like, you’re too young to know you’re trans. And I was like, well, you’re too young to know. You says, you know what I mean? You always thought that you would like to physically transition to some extent. When did you start thinking about that? When I started going through puberty, I realized that I was just really uncomfortable. And since I was going through it earlier than everyone else, it was pointed out a lot. You know, that I was like growing boobs. I wanted to magically transition. I wanted to get puberty blockers when I was 14, 15, but obviously, you know, the waiting times, man, I couldn’t

Puberty blockers are reversible medications that give trans teenagers time to figure out their identities they’re most effective if you start taking them early on in puberty, but because of long wait lists at England’s only youth gender identity clinic, the Tavistock, that’s very rarely an option. So when was the first time you were able to speak to a doctor about

I got referred to the Tavistock clinic when I was 14. I got my first appointment when I was 17

So there was a three year wait from your referral to actually having an appointment and seeing someone

And they were like, you’re too old for these services. We’re going to do an assessment here but referred you to an adult clinic. So I got to wait another half a year to even be put on the list, then got put on the list. Then got my first appointment when I was 19. Wow. I realized that like the damage had been done. Do you know what I mean? It was like irreversible

You would have wanted lockers, if you’d been young enough yeah

And it would’ve saved so much dysphoria and so many years of heat and hating myself, well,

British media has often portrayed gender affirming health care for young people as experimental and rushed. Some journalists imply that doctors are handing out puberty, blockers, like vitamins

Little is known about their long-term effects or what impact they might have on children’s brains and bones. Lives are changed at the Tavistock center. And what happens here has long drawn attention questions about how, and whether children should be able to reassign that gender

The way the media makes it out is like that you come out as trans on the Monday and by the Friday that you completely medically transitioned. Do you know what I mean? Like they don’t realize the waiting times. They don’t realize how much trans people are forced to live in a way they don’t feel comfortable with and a subjected to all that pain for no reason. I think there’s a direct link, definitely between the media’s hysteria around being trans and trans people’s access to healthcare

And anti-trans groups have ramped up calls for restrictions. They had a victory last year when a judge ruled that kids under 16 were not able to consent to puberty blockers and would need court approval to get them even if recommended by a doctor in March. A different case partially reversed that ruling parents can now consent on their child’s behalf instead of having to go to court. But families still face a longer, more complicated referral process than before. What was it like to wait all that time?

It was like heartbreaking. It’s like, you’re stuck in a limbo and you know what you want and you know how you’re supposed to get at, but you’re not. And there’s no help. You just expected to wait in this limbo,

Wait times are long for trans people of all ages, but this isn’t the only issue recently I’ve heard from fellow trans men abandoned between stages of complex surgeries. Until earlier this year, the NHS had a contract with a private clinic to provide phalloplasty and metoidioplasty, the surgeries which can create a functioning penis for trans men. They are the only team in the country. You do these operations, the multi-step procedures were suspended during the pandemic, but when they failed to restart alongside other surgeries, trans men became concerned. Eventually they found out that the NHS had not renewed its contract with their surgical team. I’ve seen social media posts from trans men who are stuck between procedures and dozens more who’ve gone months without hearing from their surgeons. Patients are doing their best to support each other. We’re used to long waiting times, but nothing like this. I spoke to one of them. He didn’t want to give me his name because he was afraid our interview could affect his future treatment

The people on that waiting list that are in pain, like obviously there’s this psychological thing to deal with and dysphoria, but there’s people that have got painful complications, uncomfortable complications, and that just nothing’s been done for them

Who do those people turn to then if they can’t contact their surgical team,

I’ve not managed to get an answer on that. I’d say it’s yeah, very much feels like this group of people that we we’ve just been forgotten about. And we don’t matter

In a briefing The NHS said the contract was not renewed because the private surgical team didn’t have a hospital location for the procedures. They said they expect to award a new contract this summer, but it’s not clear to whom. They also say they’ve now reached out to existing patients. Can you talk a bit about how this has affected you personally?

I mean, between stage one and two of phalloplasty, you’re in a weird situation. Cause you’ve got your penis, but it’s not, like, your urethra is not connected to anything. And you’ve got sort of everything else that you originally had as well. No one would get it if it wasn’t necessary for them, because it’s so major, it was living with dysphoria. If it affects you badly it can stop you leaving the house, stop you being able to go to work. All of those things that people take for granted can affect everything. When you’re already feeling worn down, you’re given the impression that society doesn’t want you. If you’re seeing a lot of social media, if you’re seeing what’s in the press, it can very easily feel alike. People don’t care about us. So this phalloplasty situation is just another example that people don’t care about us. We don’t matter, you know? Um, and it’s hard to push through that sometimes

The NHS constitution says patients have the right to non urgent treatment within 18 weeks. But I check the websites of the different gender identity clinics run by NHS England and getting just an initial assessment currently takes between three to five years. We offered the NHS and interview to understand why. And they provided a one sentence statement, responding to our questions. They said, demand for gender identity services has risen as more people come forward for support and treatment. And that they’ve increased investment to respond to this. They didn’t mention any specific steps they were taking

I think the NHS is floundering. It doesn’t know how to respond. And it lacks any clear leadership on the issue

Julianne Moore is a lawyer who has taken the NHS to court over trans people’s access

To healthcare. I mean, it is extraordinary to me that, um, something which is a private matter between a doctor and a patient has become a subject of political debate. I think it’s made it difficult or impossible for, um, young trans people and indeed for older trans people to get, um, the medical care that everyone else takes for granted

So you do actually see a direct line between the media environment, physical environment and trans people’s access to healthcare? I don’t think there’s much doubt about it. Really. If you are a doctor working in that space, you are subject to harassment. You’re reported to regulators, you’re challenged in the courts. Sometimes if I look around the country at the moment or groups who are being treated as fuel for the fire of the culture war, the trans community is pretty close to the top of that list

Children are, uh, basically being experimented on with, uh, uh, puberty blockers, trans activists would have you believe that there is absolutely no conflict of interest here whatsoever. There are no consequences for biological females. If we go along with the ideology that they promote,

Anyone can identify as a woman and what is the woman. But I feel insulted and offended that you’re calling me a CIS man, when I’m actually a man

Most women aren’t comfortable with calling trans women women, and giving up our rights to men

The media’s obsession with the quote trans debate began pretty recently, moral panic, culture war, call it what you like as a trans person. It feels inescapable and dehumanizing in the UK. The same tone of fear and suspicion is found all across the press and politically on the right and the left. It hasn’t always been like this. I wanted to talk to someone who gives me the long view and that meant leaving London. We’re off to Manchester to meet Christine Burns, a veteran of the trans rights movement in the UK. I want to know what decades of activism has taught her

This is the place for all the work on the gender recognition act is done. So it’s a sort of, it’s a shrine to activism. Ah, here we are. Wow. So is that like an original, this is an original copy from the ministry. Yes, we did our level best to make sure that this was the best legislation available in the world

Christine was one of the first trans people in the UK to campaign visibly for our rights. It’s thanks to that work that trans people won a form of legal recognition in 2004, allowing us to change our legal gender. She is something of a legend

I remember every time we won one of those legal cases, the press went mad for about a week. They would go absolutely ape as though we were wrecking the rest of society, by, by being beastly, by winning, by winning our rights in court, we committed the cardinal sin for a minority of actually being of being visible. There are tremendous similarities between this and the anti-gay moral panic of the eighties. They’re making the same argument that children aren’t safe because of this. That nobody’s safe in a changing room. You know, if this is a formula, just scratch out the words, put a new word in, and that will do

While Christine sees history repeating itself in the media, she also thinks trans people are seeing new possibilities for their lives

So nowadays, if you talk about trans people in the NHS, all anyone can think about is waiting times. Has that always been the case? Waiting times on the NHS have always been difficult. What we’ve also seen of course is a big in the number of people wanting the services that those clinics provide. And that actually is not surprising because you know, when I was young in the 1970s, I could see no future. When I realized I could actually get treatment in Britain, suddenly the door was open. And I think a lot of people, um, seeing trans people on the telly for the first time realized the same thing. So you get a jump and then along came social media, suddenly every trans person had a profile and a picture and something to say, they’ve not been converted by the social media. They’d just been shown a door to go through. The public services on the NHS on the national health service are suddenly unable to cope

For some, the wait for gender affirming care becomes unbearable. Sophie Gwen Williams co-founded We Exist, a community group that raises funds for trans people stuck on NHS waiting lists to pay for their treatment privately. I am on a personal level of know how much it costs, um, to access hormone treatment privately. I’ve been paying since 2016 for my own hormones. Um, I think we really just want to take that burden and that worry away from a lot of trans people. When Sophie moved away from Northern Ireland, she was told she’d be back at the bottom of the waiting list of an NHS gender clinic in London. She took her own life in May. We met her friends as they prepared for trans pride. So tell me about Sophie.

So I lived with Sophie, um, while she was in London, she like bulldozed the way into my life, like by, just by chance. And I dunno, it just very much felt like everything clicked into place for me and her. She was the most important person that I’ve ever met. She was an incredible artist, but Sophie was an activist at heart

There was no community without liberation

She raised 20,000 pounds. She started an organization for trans people and like she made spaces for trans people all while her healthcare weren’t being met, she had to find a way to access hormones and it wasn’t easy for her. By the time Sophie died, she would have been even the only possibility of any treatment was five years later. You know, she would have likely been waiting 10 years for her first appointment. Like, it makes me feel really angry, actually like that. It’s like the overriding feeling that I feel that she was spending so much time raising money for the community that she could have spent on herself to like get the things that she needed. And she declined that. I think it’s kind of that trans people have to be doing this for each other constantly, without being able to collect support themselves. We always have to be constantly supporting each other. So first vigil was the second vigil that I’d been to in a year. Every time we hear of someone from our community who is magnificent and beautiful, and we hear of their passing, we’re not shocked because we know that that’s a reality that any of us could have

I mean, in your view, is there any, any one that needs to be held accountable

For her death? The NHS, the absolute rampant neglect of trans people, specifically trans people with mental health issues, not just in Sophie’s death, but of all of the people that we’ve lost in the community that we know who to blame. We know who the culprit is, and it’s the seat of power. It’s the seat. If this government that systematically disenfranchises, alienates and neglects health care, like we allegedly have free healthcare in this country. And that just isn’t the case for trans people

It’s the only way to honor Sophie is to make sure that no trans person experiences what she did

I want to talk about the woman whose dress I am wearing. Sophie was brave. She was selfless. She was magnificent. She also died age 28 on the 20th of May this year. And she died in the house we shared together because she was trans. Decades we’ve been at this justifying our existence, begging for the basics. We are in a fight for our lives and we need, we should not have to do this by ourselves. We should not have to battle for years on waiting lists at the same time as campaigning for the right to have a job where we won’t be abused. So this is a direct call out to the queer community to step up now for trans people. None of us are free until all of us are free and there is no community without liberation

What strikes me about the younger generation. They’ve grown up without shame. They’ve grown up with the expectation of being treated equally and knowing when they’re not, there’s a question I think about how trans people can thrive in these circumstances. And I think the short answer is although we probably don’t realize it at the time we all thriving by existing and by continuing to exist, this is really about what we are. I think I’m going to cry at this point because you know what, we’re all intuitively as a community fighting for is just to get on with our lives. It comes in the heart, doesn’t it. We’re not here just to piss people off or to fight with them for the sake of it. We’re here because this is who we are. The good thing about our battle is, you know, we can’t do anything else? We can’t say ooh, there’s a bit of opposition there, maybe we’ll stop being trans and get, do something else. You know, this is our life