It is sometimes hard not be confused by advice that is given to trans people about their rights when it comes to accessing healthcare. A lack of clear guidance, mixed with differing personal opinions of healthcare providers, influenced by society’s ignorance and fear, can make it a difficult journey to navigate.
I have heard from people whose NHS doctor has:
- Refused to refer them to a GIC until they have ‘lived as a woman’ for 2 years.
- Refused to prescribe hormones unless the person has undergone ‘real life experience’.
- Refused to believe that they are ‘trans enough’ unless they have legally changed their name, and wear ‘gender appropriate’ clothing seven days a week.
- Denied someone a referral for top surgery because their voice is ‘too high’ and they don’t look ‘male’ enough.
- Set a goal of ‘going full time’ for six months before medical intervention will even be considered.
Real life experience
Real life experience is a concept whereby a person is asked to prove their gender identity by wearing their gender in a particular way. Since there are no set rules of how a woman or a man should dress, speak, talk, look – it is an unachievable goal for anyone, let alone someone who has gone through the puberty that gives them strong social markers of their birth-assigned gender.
Understandably, many trans people find the concept of ‘going full time‘ very scary, and feel that it may leave them open to attack, ridicule and criticism. Wearing female clothing and make-up, before a person has had the advantage of the body reshaping and the skin softening effects of oestrogen, may just seem too daunting. Changing your name before you are ready to do so, simply to get access to the care you need, may be at odds with how you choose to transition.
And yet many people find themselves in a situation where they have to conform to an expectation in order to move forward on their journey.
While trans adults are sometimes forced to reveal their gender variance to the world, children have more freedom to experiment without having to openly disclose their trans identity. Trans children can ‘try out’ their gender through clothes, names, pronouns, toys, friends and activities. Working out their place in life and what suits them best, without too much ’cause for concern’ from the outside world. When a trans child changes their social markers to the gender that they more closely identify with, this is known as social transition.
However, despite anecdotal evidence demonstrating that social transitioning has a positive impact on the mental health of gender variant children, the most recent message from NHS experts is that ‘Encouraging children to ‘socially transition’ gender risks long-term harm’.
It is no wonder we are confused by the advice. Adults are persuaded by medics to change their gender markers socially, while children are actively discouraged from doing so. If an adult doesn’t go full time or socially transition, they are ‘not trans enough’. But enabling a child to do so ‘may enforce an unreal trans identity’.
First hand accounts
We do not have extensive medical research to tell us the right way, but if we listen to the wealth of opinion from trans people who have undergone an enforced real life experience and suffered hate crime as a direct result, or from trans children who have been prevented from living authentically, then we have the anecdotal evidence we need.
Once again, the UK seems to fall behind the USA in their care and support of trans children. Researchers in the USA found that ‘Transgender children who socially transition early are comparable to other children in measures of mental health.’ While here at home we read that ‘UK under-18 gender identity services most ‘cautious’ in world.‘
I have heard the positive reports from parents and youngsters who have supported a social transition prior to undertaking any medical intervention, and I have heard the stories of pain and sadness when a child is prevented from living authentically.
My message to parents is to listen to your child, they need your belief and support, they are telling you how to best help them navigate the tricky terrain.
Transition is a very personal thing – at any age – and as such the needs of the individual should always be placed front and centre.
If you would like to talk through the pros and cons of social transition in childhood or adulthood then our experienced gender-specialist counsellors can help. Please visit our Help Centre to access our team of gender specialists.