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This morning (22.09.20) the Government announced its long awaited response to the consultation on the Gender Recognition Act. As a healthcare provider our key focus was on the revelation that the “most important concern” is the state of trans healthcare.

 

To quote directly from the written statement published by Liz Truss

 

Trans people tell us that waiting lists at NHS gender clinics are too long. I agree, and I am deeply concerned at the distress it can cause. That is why we are opening at least three new gender clinics this year, which should see waiting lists cut by around 1,600 patients by 2022. The full benefit of the increases in clinical capacity that we’ve been able to secure will lead to greater patient choice, shorter waiting times, better geographical coverage and easier access. It will also make it easier to fulfil the medical requirements of obtaining a GRC.

 

That Liz Truss has acknowledged the distress caused by the long waiting lists is certainly a step in the right direction, but in failing to mention the experiences that trans people face when they finally do access NHS services, she is only addressing half of the issue.

 

The key to meaningful reform in this area is simple:

empower GPs with the knowledge, skills and attitude required to provide basic care for trans people. This must be twofold, in recognition of their gender and access to gender-affirming hormone treatment.

GPs are already prescribing these medicines for their cisgender patients in Primary Care. We need to end the debate over whether trans people should also be able to access this care, or indeed, that they need some form of medical validation in order to do so.

To pump money and training into more specialist clinics that reinforce the pathologisation of trans people is a backward and dangerous plan for the future of trans healthcare in the UK. It does not demonstrate any real understanding of the plight of trans people whose challenges are far greater than long waiting lists.

Trans people face discrimination, bullying and dangerously poor care, as documented in the 2016 report from the Women and Equalities Committee on transgender Equality. How is it possible that no meaningful progress has been made since then?

It is also disappointing to see that the requirement for a medical professional to “diagnose” an individual as being transgender is still included. This represents a considerable barrier for the community, one which is unnecessary and onerous. At GenderGP we come from a place of respecting the individual’s right to self identify.

 

Comment from Adi Daly-Gourdialsing, Head of Patient Services at GenderGP.

The 2018 government-led public consultation, carried out specifically to gauge attitudes towards reforming the GRA, was vastly in support of Self-Declaration. This was an opportunity for real reform.

It has, however, effectively been kicked into the long grass by a conservative government seemingly intent on ignoring the needs – and voices – of trans people, their families and allies.

With waiting times to a first appointment stretching into years, the lack of access to any form of gender-related healthcare in the interim is shameful. NHS Transgender healthcare is itself on life support.

Meaningful GRA reform would have lessened the physical and emotional burden on tens of thousands of binary and non-binary trans people as well as providing clear guidance to GPs that they can, in fact provide much needed care.

Sadly, the government has ignored the will of the vast majority, in favour of the minority driven by an agenda to which we are not privy.

If such ideolgy can block a change such as Self-Declaration, the idea of NHS GPs ever feeling empowered enough to provide quick point-of-need support, such as bridging hormones, feels ever further away.

 

Author:

Dr Helen Webberley is the founder of GenderGP. A passionate advocate for the transgender community, she continues to campaign for real change in the way that trans people are treated in society and particularly in relation to the barriers they face when accessing healthcare. Dr Webberley believes in gender-affirmative care and that the individual is the expert in their own gender identity.