One of the more irritating barks of the anti-trans sealions is “what rights don’t trans people have, exactly?” It’s irritating because it’s deliberately obtuse: many of the rights we have on paper are rights that are not enforced, which means they might as well not exist. And the sealions know that but pretend not to.
A good example of that is the right to NHS treatment that most UK nationals take for granted. But Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust has just announced that for the foreseeable future, it will not be accepting any referrals to the Northern Region Gender Dysphoria Service (NRGDS). You cannot get trans-related treatment through the NHS via any other avenue, so the NHS has effectively just scrapped trans healthcare in the region. We know that this healthcare is life-saving for many people, and yet in that part of England it simply isn’t available to anybody who isn’t already on the years-long waiting list.
This isn’t the first time this has happened. In 2021, it emerged that Northern Ireland’s only gender identity clinic hadn’t accepted a single new patient since 2018. The Sandyford in Glasgow stopped taking new patients for its youth services for a while last year too.
Even where new patients are being accepted, the backlog isn’t being cleared quickly enough. According to a freedom of information request earlier this month, trans people in Yorkshire can expect to wait thirty-five years for a first appointment at current clearance rates.
The reason for this awful state of affairs is because there aren’t enough staff or resources to cope with demand for healthcare that remains part of the desperately underfunded and short-staffed mental health division of the desperately underfunded and short-staffed NHS. Despite years of warnings – including in the Theresa May government’s own LGBT action plan – trans healthcare has been starved of resources; rather than follow its own committee’s advice on reforming our healthcare, the May government decided instead to go for the much cheaper and largely un-requested reform of the gender recognition act. Which as I’m sure you know has been a great success.
And to make things worse, the online bullying and press demonisation of trans healthcare providers in a style very reminiscent of the Christian Right’s attacks on abortion providers has made it very hard to fill vacancies. Until recently the Sandyford Clinic in Glasgow had just two psychiatrists, each of whom only attended one day per week, to cover the whole of the catchment area.
The problem with trans healthcare is very simple. Healthcare that could easily be provided by our GPs – the HRT I take is the same HRT cisgender women take; the occasional blood tests I need are the same blood tests cisgender women need; the process for referring trans people to surgery doesn’t need to be any different than the process for knee surgery or back surgery, and so on – is all forced through the gender clinics, where psychiatrists do exactly the same job as your local GP surgery does. But there are far fewer psychiatrists than there are general practitioners, so the waiting lists get longer and longer and longer until healthcare is stopped altogether because the service can no longer cope.
There was outcry in the newspapers a few weeks ago over the news that some 7.6 million people in England were waiting for NHS treatment, and two out of five had been waiting for more than 18 weeks. But that 18-week target doesn’t apply to mental health services, so there’s no outcry when ADHD and autism waiting lists exceed two years (many trans people are neurodiverse) or when trans waiting lists run into the decades, or when all trans healthcare is simply stopped. Officially, we have the same right to NHS treatment as anybody else. But in reality, we really don’t.