Last week the Telegraph ran a piece which got me thinking. If what I saw was true then the our great nation needs to start acknowledging the fact that the number of people identifying on the gender spectrum is only going to grow.

James Palmer, the medical director for specialised services at the NHS, believes that in the future up to 3% of the population will be making contact with transgender health services. This means that potentially close to two million people will be passing through their doors – and the NHS had better be ready.

Now, no matter what your feelings are towards transgender men and women accessing support on the NHS, the question you really need to consider is whether the cost to the NHS will be greater:

  1. In the short-term, through the delivery of empathetic care for transpeople which enables them to live a full and prosperous life, or
  2. In the long-term, when a lifetime of neglect and a refusal to accept and acknowledge their existence leads those same patients back to the NHS for support with issues relating to both their mental and physical health.

As a trans woman I really struggle to understand why accessing care and treatment needs to be so arduous through the NHS. All fingers point towards a medical model which is not fit for purpose. It was created when very few transgender patients ever used these services, when the research and evidence was scarce and no one knew anything about the subject.

But, this is no longer the case. The NHS and medical profession need to stop naval gazing and accept that offering transgender people appropriate treatment is very cheap and an easy way of saving the NHS time and money in the long run.

If the NHS believes this falls outside of its duty of care, then there is an alternative. Recognise that clinics, such as GenderGP, that offer an affordable service, thereby easing the pressure on the NHS (and alleviating the suffering on the part of the patient).


The Gender Recognition Certificate process will soon be unmanageable as these numbers grow. We have to simplify the process and acknowledge that the trans community has just as much right to timely care as any other member of society.


A patient load of two million trans people is manageable. Furthermore, it could be turned into something really positive. All we need to do is set aside our prejudice and allow these people to get the treatment they need so that they can flourish as contributing members of society. Leaving them to flounder is not an option that will save money – it will simply lead to suffering and an even bigger cost implication to the NHS further down the line.


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As a fully qualified counsellor, with a post grad diploma in Gender Sexuality and Diverse Relationships, Marianne is our most experienced counsellor in the field of transgender care. She heads up our team of specialist gender counsellors at GenderGP. Marianne combines her own experiences as a trans woman with her affinity for others going through their own gender journey.