In October 2020, reporters for the BBC infiltrated the forums of trans youth support charity Mermaids. What they discovered was desperate parents asking questions and sharing information about how they could help their young people while they navigated long waiting lists and limited access to NHS services.
But instead of using this clear evidence as an opportunity to highlight the shortcomings of trans healthcare in the UK and to give a sympathetic ear to the desperate parents seeking out private alternatives for their loved ones, a large part of the UK media chose to use the information as an opportunity to attack organisations supporting trans youth.
And what did the ‘leaks’ reveal?
That waiting years for help leaves parents and their young people feeling abandoned by the NHS. That (shock, horror) they are desperate for support and that in that desperation they turn to other parents for advice and guidance on how to navigate an incredibly stressful situation.
GenderGP was mentioned “more than 500 times” as a way for parents to access the care they need. This was presented by the media in and of itself as evidence of some wrongdoing, when in fact it merely serves to underline the fact that our service provides desperately needed help that is lacking elsewhere.
GenderGP is a private service providing affordable healthcare to transgender individuals. It does not discriminate on the basis of age, gender or geographical location. The inclusive service has been in operation since 2015, and during that time it has evolved from one GP answering a few emails into a fully-fledged clinic supporting thousands of trans people around the world.
But it hasn’t been an easy ride
Even before the attacks in October, GenderGP has faced hurdle after hurdle. The General Medical Council investigated not one but two of our doctors for operating according to international best practice, and despite no wrongdoing being found issued a conviction for the service which subsequently had to move outside of the UK. This year will see the outcome of Dr Helen Webberley’s five-year investigation into her work with trans youth, the hearing for which is slated to begin in July 2021.
Despite this, the service has stayed strong and its commitment to the trans community has never waivered. And why would it when a very clear problem has been identified and a solution has been found?
In 2016 the Women and Equalities Commission unreservedly found that:
‘The NHS is failing in its legal duty under the Equality Act in this regard. There is a lack of Continuing Professional Development and training in this area amongst GPs. There is also a lack of clarity about referral pathways for Gender Identity Services. And the NHS as an employer and commissioner is failing to ensure zero tolerance of transphobic behaviour amongst staff and contractors.’
Fast forward to 2021, five years later, and we still have:
So, if trans people in need cannot turn to private providers such as GenderGP, where does this leave them?
With outdated protocols and practices that fill social media forums with tales of suffering? With extreme gate-keeping and care that amounts to a postcode lottery? With guidelines created and written by the same consultants who are currently providing the failing care?
The specialist clinics supposed to provide healthcare to trans people cannot possibly handle the numbers of patients requiring assistance. Even getting to a clinic in the first place is hard when GPs and hospital consultants are allowed to deny care to trans patients, or refuse it because of their own fears of sanction. In fact, there are ongoing arguments between the British Medical Association, the General Medical Council, and the Royal Colleges as to whether GPs and hospital consultants should have to provide any level of care at all.
So what is the solution?
There is an URGENT need for mandatory medical training and education, not by the current specialists in the field but by forward-thinking doctors who understand what it means to be trans. Training that takes into account the views of service users, not the gender critics in the media. New protocols must be developed based on evidence-based, published guidance from international centers of excellence.
There need to be penalties for doctors who do not have the basic skills and knowledge to treat trans people. Transgender care is not a specialist area of medicine. Take hormone therapies - this is something that every GP should have a command of in the treatment of cis people, so why should it be so hard when the patient is trans?
Finally, and crucially, trans healthcare service options need to be brought into GP surgeries and local hospitals, so that the healthcare is normalised and trans people are no longer marginalised.
Accusations that there is no precedent, that there is no research, evidence or guidance available are simply untrue. Any healthcare professional looking to better understand this area need only study research issued by more progressive countries to see the extent of the evidence that exists for the affirmative care of trans youth.
GenderGP follows the models agreed on by The World Professional Association of Transgender Health (WPATH), The Endocrine Society Guidelines for the Care of Gender Incongruent People, The Center of Excellence for Transgender Care in the University of San Fransisco, The Specialist Transgender Childrens’ Service of Melbourne, Australia, and the American Academy of Pediatrics.
How can the UK continue to lag behind these centres of excellence and simply ignore best practice?
We need an amnesty for trans healthcare; a clean slate on which we can write a list of what great healthcare would look like. It’s not rocket science:
If only there was a service that was already providing all of this to the trans community?
A service that treated trans folk with dignity, respect and equality. A service that did its utmost to help trans people not just survive, but thrive…
Oh, wait, what was that service I heard about being referenced on a Mermaids forum....
Authored by GenderGP