Today’s move from the Health Minister, Simon Harris, towards dropping a requirement for some transgender people to have a psychiatric assessment before they can obtain hormone treatment is extremely welcome.
The majority of the patients who have presented to GenderGP have reached a point at which they are ready to take their transition to a medical stage. Many have begun to self-medicate and are looking for a safe way to access the medication they need, along with the necessary monitoring, something they have not been able to access on the NHS in a timely manner.
Key factors which indicate that patients can safely identify their own gender needs, wishes and pathway include – a long history of gender incongruence, good social and family support, a desire to embrace the social role that fits with their gender identity and good knowledge of their gender affirming wishes.
For those who have doubts as to whether undergoing a social or medical transition is right for them, or whether they will be able to achieve their goals, these patients should have access to specialist, and unprejudiced support, psychotherapy and counselling as appropriate. This will assist them in finding the right pathway for them.
Protocols that make it mandatory for all people to undergo psychological assessments and counselling, waste those sparse resources that would be better saved for those who actually need them.
Being transgender is not a mental illness, but people who are transgender may have medical needs. These may be physical, psychological or surgical, and can be a combination of all three.
Care should be individualised, accessible and patient-centred. Patients should make their own decisions on what care they wish to receive and be able to discuss this with their doctor in order to make a living and flexible treatment plan.