Steph's Place

The Trans NHS Healthcare Problem.

Guest Blog by Freda Wallace

It’s August 2021, almost one whole year since I first spoke to my GP about my transgender identity and how I want to proceed medically with that. I'd struggled in my own way with this for years, and finally, l knew l had to do something about it. I had been happy to live a sort of double life. Work was in my male identity, and l would live for the weekend to truly express myself. 

Obviously, this was unsustainable. 

This wasn't anything new on my medical record. My mother had taken me to a psychiatrist in my teens. She knew l was unhappy and constantly expressing the desire to live my older sisters life. My mother thought she was doing the right thing, and in her heart, she was following the family doctors advice. 

It was 1993, Bolton and the clinical setting and probing questions in the walls of a psychiatric wing of the hospital only alienated me from my experience of real life. 

I felt like they were going to lock me up if l said the wrong things to the clipboard clutching clinician who looked down his glasses at 17 year old me. 

My experience back then put me off seeking any medical help for a long time. It was damaging - l buried it all for years. 

Fast forward to 2021, and my recent meeting with a GP was positive. She signposted me in the right direction to Gender Identity Services and offered me therapies/support. She was bubbly and friendly and said all the right things. It was a good first contact with a healthcare professional after all those years of fear. 

What happened next was mostly downhill....

There is no other comparable experience in the NHS to trans healthcare. No one else is expected to 'come out' to a Dr and disclose the details of their desires or basic needs in such away. 

It often feels like you are asking for validation from the service that is indifferent or that they get to decide your destiny. They can put your life on hold while they do some invisible calculations on whether you are worthy of treatment. So why is it any wonder people with the ability to pay choose not to wait? 

Why should your self-actualisation be placed in the hands of people who have no understanding of what you are going through? Obviously, they don't and rightly so.

What has become clear to me over the course of this year is that all the trans women l know have had to seek help privately. 

Usually through Gender GP (whose founder is currently under investigation for her alleged - note alleged malpractice) or other private services. I know many people have relied on Gender GP, and l have understood why in the last 12 months. 

It shouldn't be this way at all, and if the case of Dr Helen Webberley says anything, it is that when the NHS fails, trans people will always try to find a way. 

So why make it difficult? 

What we want isn't that complicated or costly? 

It simply comes down to gatekeeping and a sense that people cannot be trusted with their own minds. Minds, yes. That's the crux of it because often, our treatment comes under the remit of psychiatry, one of the most underfunded and stoic areas of healthcare.

It's a sad state of affairs when your own GP surgery is causing you more pain than if you had not have bothered. I even had text messages from them addressing me as 'Mr Freda'. To be honest, l laughed at that at first, then l don't mind admitting to you, l collapsed on my kitchen floor like I had been taken back to square one. As if all my expressed concerns suddenly meant nothing at all. 

In that moment, silly though it seems, my world was breaking apart under pressure like a worn-out spool of tape.

Are we mad? 


Can this 'gender pathway' drive us to anxiety and depression? YES! 

One problem is that the people who choose to go private have stopped putting pressure on the NHS by default. 

This only helps them and them alone, and a lot of people, usually teens, cannot afford care or don't have the support from family to go down this private care pathway. 

So this leaves a huge gap in the service. 

If we are to improve NHS care for all, we need to keep complaining, protesting and holding to account the system that denies the healthcare we are entitled to in the UK. It is only by being heard that anything will be done. 

It is a right, not a privilege.

I work for the NHS myself, so l know what kind of pressures individual trusts are under at the moment. I wear that rainbow pin with pride, yet I have seen the failings of this organisation first-hand. So, I have often found myself diminishing my own needs because I see people with much greater problems. 

l have thought l should be grateful I'm not waiting for oncology or dialysis treatment or on a waiting list for essential surgery, but this is a self-defeating thought process. The NHS is for everyone regardless of urgency.

So yes, things are tough, but this won't stop me battling for myself and other trans people who should be given the same time and support as anyone else. 

I can only speak for myself, and the treatment l have had, and l have to say my experience this year has only made me more determined to improve things for others. 

If I have any ambition at all - it is that no one should have a bad experience and no one should be left behind.

Often we can feel powerless, but our real power is in protest and in numbers, so don't give up on the NHS even if you seek private treatment.

You can do both.

Be visible and know your experience is valid! 

A complaint is good and helps everyone, not just the individual!

A high tide will lift all boats!

Anger can be positive!

We will all get through this!

Authored by Freda Wallace @Freda_Needles

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