Thoughts on the NHS Gender Pathway ….and the search for alternatives
I noticed the date this morning – November 6th – and remembered that it would have been my younger brother’s 62nd birthday (he died of a heart attack 2 years ago). Though he died young, he did live his life ‘to the full’ and in his true gender.
Now this post is not about Steve, but was prompted by the recognition that none of us gets younger. Time waits for no one.
The UK has a health service that is exceptional. I was born just after it’s introduction and have benefited from having world class healthcare available when needed paid for by my (and everyone’s) taxes. It pains me that rich folk and international companies seem so happy to avoid paying the right amount of tax, using loopholes to escape contributing to a community they wish to benefit from. It’s what helps make me a socialist.
There are problems in our system of healthcare, but there are problems in every country’s system. Part arises from overwhelming demand and part from outdated approaches. Healthcare for transgender folk is marred by a hangover from the days of ignorance when being trans (as was being gay) was seen as a mental health issue. We all know it is not. Access to gender services in England tends to be via Gender Identity Clinics (GIC). By and large these are anachronistic, under-funded, grossly inefficient with huge waiting times both for a first appointment and for follow ups.
Currently there is a process in place to look again at the way gender care is organised and funded. You can learn more here and I would encourage you (if you are in the UK) to complete this short questionnaire to help inform the structure of future gender services.
At 68, I want to get on and live my life to the full in my true gender. Though I have every belief that I will live to a ripe old age (I am targeting dying a day after my 100th birthday) I really don’t have the patience to wait 14 months for a first consultation with the GIC, another wait of 6/7 months before they begin to consider me for hormones. I am one of the luckier ones who can afford to pay for hormone treatment from a qualified doctor, many can’t. What I need is the assurance that the NHS will cover me for routine monitoring of hormone levels, for the rest of my life.
Together we need to ensure that our NHS is reformed so that transgender people get prompt and efficient access to gender services; we pay our taxes like everyone else. We also need to map out a realistic alternative to the NHS Pathway for those able to pay for private treatment.
I welcome comments as always and would be particularly pleased to hear from you if you have accessed care, including surgery, outside of the NHS. I probably will have to do so, as I can’t ‘hold my breath’ long enough for reform to happen.
Postscript: I noticed this comment on the NHS reform survey I mentioned and wanted to share it. This really needs to be shouted from the rooftops. It really gets to the heart of what is wrong with the Gender Clinics at present. (You can read my contribution to the survey there too)
An obvious truth that is going unaddressed is that most (but not all) gender transitioners are modernly accepted as having no mental disorder whatsoever – and yet the lion’s share of the budget for Gender Identity services goes to psychiatry.
Psychiatry for people who have no mental disorders is a huge waste of money. Gender clinics should be moved from Mental Health services to Sexual Health services with a remit to refer the minority of patients who actually do need psychiatry appropriately.
Not only would this hugely reduce the cost of providing gender services but it would free up psychiatrists to work where they are genuinely needed.