Trans healthcare? It’s up in the air!
by Mx. Adam Khan
QM/BL Trans Representative 24/25
*Content warning for discussion of suicide
Being trans, non-binary and/or gender-nonconforming in the UK in 2024 is a mixed blessing.
Solace and support networks have been created within trans communities and by their allies in response to an increasingly hostile society. The need for solace has been boosted by the ever-growing NHS waiting list times for gender affirming healthcare, which is a postcode lottery, with the longest waiting times, according to Gender Kit, being referrals to Exeter Gender Identity Clinic (GIC) waiting 87 months for a first appointment. These waiting times will continue to rise meaning that more and more trans people will look for other ways to enable their transition into their authentic selves. Some are able to save up to go to private gender practises, but this is a privilege that few in our community have. Others set up crowd sourced funding pages to do this or engage in other means of employment such as sex work to save up. Some also decide out of necessity to self-medicate with hormones obtained in atypical ways.
Unfortunately, these long waiting times mean that many trans people complete suicide, due to having to live for many more years with gender dysphoria, which is exacerbated by lacking trans-affirming approaches within other NHS services, including with Mental Health services which also has seen large increases in waiting list times.
Bolstered by dangerous media narratives and a gender critical minority with loud voices, the government has been stoking up a ‘culture war’, which means that reform of trans healthcare in the UK is a pipe dream for many in our community. By blocking the progressive Gender Recognition Reform (Scotland) Bill, publishing the problematic ‘Gender Questioning Children’ guidance for schools, and the Prime Minister Rishi Sunak openly making transphobic comments in speeches at the Conservative Party Conference in October 2023 and in Prime Minister’s Questions in February 2024, this shifts the media narrative by focussing on the everyday prejudice and discrimination which the trans community faces.
Instead, we should shift focus to creating a narrative which can enable trans healthcare to be at the forefront of saving trans lives.
Physical transition is an inherent part of being trans, and this can of course be in many different forms, not just the current legal, binary definitions. Even though it is an inherent part of transition, gender affirming healthcare is too often left out when considering trans equality, diversity, and inclusion. Indeed, trans awareness training for staff, gender neutral toilets in buildings, and pronouns being normalised are positive steps towards trans equity.
But these acts are only the tip of the iceberg of acceptance for the trans community, as social transition needs to go hand in hand with physical and legal transition. Steps towards addressing the inequalities of accessing gender affirming healthcare can include embedding access into employee benefits, co-creating training pioneered from within the trans community and delivered to everyone, and an overhaul of the current NHS GIC services, which urgently needs funding to help save more trans lives. Most importantly, any work in improving the state of trans healthcare in the UK needs to directly involve the diversity of trans community for it to address the needs of the community, from the planning stages to delivery. Not in consultation, but rather in collaboration.
