Various newspapers report that Glasgow councillor Chris Cunningham has disputed the terrifying 200-years-plus predicted waiting times for Glasgow’s Sandyford clinic, claiming that the waiting time is six to seven years. And that means he’s either ignorant or deliberately misleading people, and so are the newspapers – because the evidence shows that if you’re referred to Sandyford today and the clinic’s desperate, years-long understaffing isn’t addressed, you’ll wait your whole life for an appointment that will never happen.

Cunningham is quoting the text published on the Sandyford’s website, which says:

We are currently allocating appointments to those referred during the following periods:
Adult Gender Service Waiting list: November 2018
Young Person Gender Service Waiting list: November 2019

But the report that he’s disputing isn’t about the wait time for people who joined the waiting list six or seven years ago, some of whom – but not all of whom – are finally getting first appointments. It’s about the wait time for the people being added to the waiting list today.

Thanks to freedom of information requests we know that the Sandyford clinic is barely seeing anybody. It saw fewer than 24 new patients in a year while over 500 new patients were added to a waiting list that now exceeds 4,000 people.

What happens to waiting lists when more people are added than you’re seeing? They get longer.

The core problem here, as with other gender clinics, is desperate understaffing, and that’s something we’ve known about since at least 2016: as The Guardian reported over nine years ago, gender clinics were already struggling to provide healthcare for what everybody knew was only a tiny but fast-growing proportion of the trans population because of a lack of capacity, and of suitably trained and qualified staff.

The charity GIRES said at the time that the most conservative estimate of the trans population would mean around 130,000 people seeking medical assistance from a system already struggling to cater for just 15,000 people; the actual numbers could be much higher, with figures from other countries indicating that roughly 1% of people are trans.

We could have fixed the roof when the sun was shining, but of course we didn’t. So what everybody said was going to happen happened.

I referred myself to Sandyford in 2016 and had my first appointment in 2017, a wait of eleven months.

Had I referred two years later, in 2018, the waiting time had grown from 11 months to seven years – so if I were one of the lucky few, I’d be getting a first appointment round about now.

And if you’re being referred to the same service today?

The 2016 Guardian report cites concerns that some trans people might have to wait 4 years for a first appointment. Today, the average UK wait time based on current clearance rates is 25 years. If you’re referred to Sandyford today and nothing changes, you can expect a first appointment in 224 years.

The NHS waiting list target from referral to first appointment is 18 weeks.

We know the solution to this, because it’s in effect in many other countries: basic healthcare like HRT is prescribed and monitored by ordinary GPs through an informed consent model, not through the bottleneck of overloaded and understaffed clinics. GPs have capacity issues too, I know, but not remotely on the same scale as the gender clinics.

The only difference between the prescription and monitoring of my HRT and that of any other women is that my GP refuses to do it.