In recent years, understanding around what it means to be transgender has increased significantly. This has led to many more people stepping forward and asking for help with their social, medical and legal transition. In many countries, medical services have failed to keep up with demand, with too few healthcare professionals feeling able, or willing to help. A reluctance all too often driven by social, medical and political prejudice. These factors have also driven the wider narrative on trans healthcare with very strong opinions coming to the fore from prominent figures who do not support the notion that trans people exist, much less that they should be affirmed.