Longreads has an excellent article by Mailee Osten-Tan about the people who travel to Thailand for gender confirmation surgery. It’s great journalism, based on extensive research and interviewing (there’s a behind-the-story piece detailing it all here) and the story Osten-Tan tells is interesting, insightful and empathetic.

Thailand is famous in trans circles, and the more broken the NHS’s trans healthcare becomes the more people will save or borrow the money to go there. The NHS was already woefully underfunded before COVID; now the waiting lists, already horrific, are many months and years longer.

“The effect of the pandemic has been to exacerbate a problem which already existed,” said James Bellringer, an NHS and private GCS surgeon in the U.K. for over two decades, in an email. But even apart from the pandemic, he wrote, the U.K. lacks trained staff to meet the demand for surgeries. “It’s not just surgeons but the gender specialists working in the clinics. Gender has been chronically underfunded everywhere (not just the U.K.) for years, and the elastic has finally snapped.”

One of the saddest parts of the article for me was this bit.

For those who want but cannot afford surgery, the longer they are made to wait, the greater their chance of developing serious mental health ramifications. These often relate to the chronic high levels of stress experienced by trans people over the course of their lives — also known as minority stress — brought on by factors such as poor social support, discrimination, rejection, abuse, and/or violence.The majority of trans women I interviewed… wanted to remain anonymous out of fear of being doxxed, harassed, or targeted by hate speech.

At the risk of sounding like a broken record here, these are the “transgender issues” we should be talking about. But trans people rarely get to speak: the only people speaking in the trans “debate” are the intolerant, the ill-informed and the ill-intentioned.