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The Bureaucratic Nightmares of Transgender NHS Patients

Transgender people are treated like second-class citizens in the NHS’s archaic series of dehumanizing circus hoops. Here are the stories of three people who suffered through it.

She’d written a will, registered a next-of-kin, and readied herself for the chance that she might not make it out of the operating theatre alive. The surgery that Jane had grimly prepared for was, in the eyes of much of the public, optional. A choice. But she had been waiting for six years, and to her, the alternative meant an even higher risk of dying.

“I knew the thing to do was to make the medical professionals aware just how important it was to me.”

Jane Magnet, 37, is a transgender woman. The gender assigned to her at birth, male, does not match with the one that she identifies as. She had thoughts about this from quite a young age, and came out in June 2010. “Coming out fully, and going full-time felt very scary but great. Ultimately it became a choice of letting my depression caused by not coming out consume and kill me, or take the big step and do something about it.”

A photo of Jane

Jane suffered through many hardships: diagnosis of gender dysphoria (when your gender identity does not match that which it was assigned at birth), receiving hormone replacement therapy, and eventually referrals for gender re-affirming surgery are all possible through the NHS, but are often inhumanely difficult to obtain. “I started reading everything I could about the process and had heard how much hassle it could be. I knew the thing to do was to make the medical professionals aware just how important it was to me. Leave no grey area for them to try and say I wasn’t trans.”

After jumping through clinical hoops with doctors lacking experience with transgender people, she had finally made progress, but this would soon devolve into further problems. “Within about 6 months I was being seen at the Gender Identity Clinic. They were very happy I’d already gone full-time and changed my name and recommended I start hormones. That’s where my doctor started getting obstructive.

“He refused to acknowledge the GIC letters or their authority to recommend I be given hormones. Eventually one of the reception staff at the practice told me he ‘just doesn’t believe in that stuff’ and told me he will never give me hormones. I went to two other GPs with similar results and eventually moved house in a new area. Here they were much more helpful but still caused delays by regularly losing important paperwork. It was about three and a half years from recommendation until I got my hormones.”

“It was about three and a half years from recommendation until I got my hormones.”

After those six long years, Jane finally received a referral for lower surgery, and went into the operating room in January, facing a number of possible complications that could result in serious injury or even death. But, she came out on the other side healthy, happy, and finally at home with her body. Her experience is similar to many transgender people in the UK, but there exist a number of differences dependent on the person.

A route not often taken by transgender people in the UK is private surgery. Due to its high cost, it’s rarely affordable to the average person. Some people, however, find themselves in scenarios that allow them to go down this path, and it’s one that isn’t nearly as time-consuming. Laura Dale, 25, a games journalist with a large following, crowdfunded her private lower surgery.

A photo of Laura

“Private surgery was in many ways a necessity rather than an optional choice, I was five years into what was going to be a seven year wait for surgery, and I was struggling routinely with intense Dysphoria (distress and intense discomfort with one’s own body, prevalent in transgender people as Gender dysphoria).”

“The hypocrisy is maddening.”

Laura’s case is rather unique in that her significant audience meant the raising of the necessary funds was more successful than others, but this came with its own cost to privacy. “I was in the very privileged position of having a large online social media following. I was able to raise 25 thousand pounds in ten days but it meant the state of my genitals becoming very public news which was a tough emotional trade-off to make.” At least for Laura, though, this emotional trade-off was well worth it. “Surgery happened less than six months later, and it meant the world to me.”

A photo of Wesley

But, the majority of transgender people going through the NHS still suffer from a fundamentally broken system, with many doctors who aren’t qualified to deal with it and allegedly shift this problem onto patients. “Being forced to be the only one actively doing anything about my treatment, I’m simultaneously treated as though I’m the only one who doesn’t know anything about it, despite probably knowing more than all the the front line staff I engaged with,” said Wesley Elkins, 21. “The hypocrisy is maddening.”

The NHS, as it stands, needs to improve its ability to facilitate transgender people. How long will it take for the funding, the resources, and the sensitivity needed to treat them as patients? Only time will tell.

Published in Features


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