Following recent conversations about how available transitioning medication should be for transgender people, we stumbled upon an excellent commentary by Roz Taylor on Twitter, where she compares her HRT medication to the medicine she uses for asthma.
Medications have categories, acceptable risks that just require putting on the label before patient use. All medicines feature informed consent in this manner.
My inhaler, as some of its "1 in 1000" "rare" side effects, lists: rash, itching, bronchospasm, uneven heartbeat.
— RozRaidReborn😈 🏳️🌈 (@RozRaidReborn) July 23, 2019
We asked her if she would write her thoughts as a guest blog for the GenderGP website as it’s such a great comparison….
A study was done on patient records from UK GICs, examining detransition. Skye Davies, Stephen McIntyre, and Craig Rypma analysed records ranging from August 2016 – August 2017.
A summary of the study can be found in the report from the Bienial EPATH Conference on page 118, titled ‘Detransition Rates in a National UK Gender Identity Clinic’
It found that:
In this study there were 3,398 patients, 16 mentioned regret or detransition.
12 attribute this to social pressure, and only 3 de-transitioned with no intention to transition again.
That’s 3 people from a sample of 3,398 trans people.
That’s 0.088% of people sampled. Literally less than 1 in 1000 people seeking treatment to aid transition.
Therefore the successful treatment rate is 99.92% of people treated being trans, and happy with the results of treatment.
Medications have categories, acceptable risks that just require putting on the label before patient use. All medications feature informed consent in this manner.
My inhaler, as some of its “1 in 1000” “rare” side effects, lists: rash, itching, bronchospasm, uneven heartbeat. The 1 in 100 “uncommon” chances of nausea, dizziness, disturbed sleep, increased heart rate, bruising, cramps, and blurred vision.
But this is all perfectly acceptable. All medications have these risks. For every 999 people treated – one may react badly. From my inhaler, and many others, it often even makes the initial symptoms it aims to treat worse.
In every other area of medicine, a 99.92% success rate is incredible. To have no discomfort, no negative effects for that many people, is phenomenal.
Our medications are safe and effective. Start your journey today
Those medications and other treatments are everywhere. Every medication and treatment. Every single one.
But in trans healthcare, and the media that represents it, that 1 in 1000 patient is suddenly the most interesting one.
In trans healthcare, that 1 in 1000 person is the one, incredibly rare, cis person, or, at least it’s interpreted that way.
Being in a body incongruent with oneself is distressing, the system at least recognises this. But, unlike every other healthcare pathway – it treats that 1/1000 fringe case as a higher priority. Better to prevent and delay treatment for 999 trans people, than unintentionally inflict the pain they suffer upon even 1 cis person.
So, treatment is delayed. It’s hidden behind years-long waiting lists and multiple doctors asking intensely personal and invasive questions.
A system ostensibly made to treat an issue, is instead designed to withhold treatment, for fear of causing the very issue it is meant to treat, nevermind the 999 potential patients it discards and condemns to pain and suffering through lack of treatment.
This is the model the UK uses.
The basis of this is transphobia – treating cis people’s lives, cis people’s health, as being at least 1000 times more important than those of trans people.
To reiterate on this: For every potentially cis person saved by the system – 999 trans people definitely suffer.
A 1/1000 chance of adverse reaction / regret of informed treatment is incredible. Imagine proposing that we cancel or delay handing out those inhalers. We forgo treating 999 asthmatics, for fear that 1 could experience issues. The idea is ludicrous.
So. Why treat transgender healthcare differently? The only reason – bias. Bias that needs addressing, and the system changing.
I agree 100% on what Roz is saying… What she states only makes sense. If a person is suffering from Gender Dysphoria, then they should be treated accordingly. If someone decides they want to de-transition, then it’s on the patient. You don’t save one person to let the 99 suffer… That would only be insane
Totally agree with this article, I believe this should be given the publicity it deserves in the media. It would be scandalous if any other collective of people were treated in this manner.
As positively awful the American system of healthcare delivery is, we at least in this area are not this awful. In American models, although there is gatekeeping, most programs today are gender inclusive, which means they believe they are not there to decide who does or does not get services, but to make sure the person is making the best decisions for themselves, that the program then facilitates.
I know of countless stories of years long wait times for even the most basic services in Trans treatment in the UK as implemented by the NHS. How many of these people become a statistic of suicide or self-harm during these waits times? Your system should be immensely embarrassed but this completely adequate system you have designed. It does far more harm than good.
Get your biases towards trans people out of the system and do your jobs, Doctors. So far, you stink!