We heard from numerous experts about the present and future of trans+ healthcare
BY NANCY KELLEY
Over the last few years, the public conversation about trans healthcare has become so divorced from reality it feels like a hallucination. In the real world of trans people’s lives, waiting lists stretch out beyond the horizon, quality is patchy at best, and a health system that could and should be helping is causing harm every day.
I spent Tuesday evening in parliament at a Trans+ Solidarity Alliance event, listening to experts in trans healthcare. This is what I heard.
Dr Heather Wood spoke about her experience of providing care to trans children at the Tavistock: “Just normal kids who are having a different experience of gender.” She described the profound hopelessness that came in the wake of NHS England’s decision to restrict access to puberty blockers, and her fear for the thousands of children on the waiting list after the Tavistock closes its doors, and hands over to interim services. Many of these children will not see a specialist until adulthood, and for the lucky few children who are seen, care options will be limited.
I listened to Chay, Director at TransActual, talk about the “unmanageable wait lists for assessment and hormones that are followed by unmanageable wait lists for surgery”. He talked about hidden costs of care, commissioning breakdowns and trans patients left in the dark. This is a world where you move house, and your new GP won’t fill your repeat prescription for hormones but is happy to prescribe pills to manage the mental health problem this causes. A world where healthcare of all kinds is a minefield.
As I listened, I heard experts, most of whom were trans themselves, telling me this misery is completely unnecessary. That good quality trans healthcare is achievable and affordable right now.
Michelle Ross, founder of CliniQ described their trans-led, holistic service, pride in her work mixed with anger that some trans people still travel to CliniQ from the other end of the country because local services feel so unsafe. I listened to Michelle and Dr Becky Stephens talk joyfully about their shared work on the Bridge Project, which offers trans healthcare and accessible GP services in Southwark. Becky shared that as a GP she once thought only Gender Identity Clinics could provide trans healthcare, and now she realises that it’s more straightforward than providing care for people with diabetes. Training, support, and the right incentives are all that are needed.
And when I listened to Dr Kate Nambiar, I heard the difference mainstreaming trans healthcare can really make. The Welsh Gender Service works through Local Gender Teams which can initiate hormone therapy and then discharge to primary care using the framework of enhanced GP services. More and more GPs are gaining confidence in caring for trans patients, and wait times are dramatically improved.
The system is broken right now, but as Kate says: “Things can be ok. We can do things in a way that centres the patients we look after and delivers a standard of healthcare that is better.”
We just need to listen more and support the trans experts leading the way.
Nancy Kelley is Director of Lesbian Visibility Week and a member of the Trans Solidarity Alliance team.
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