Its the weekend and time to think about serious stuff. Like whether it is right and proper to instigate lynch mobs against regretters. Or at very least, to chain them to the tea counter of Fortnum and Mason, where they can be picked up by any passing riot police who happen to be on duty.
Oh, heck! Trans journo in vigilante shock! horror! appeal… I can just see the headlines.
So i’d better assure all and sundry here and now that i am just joking. Honest. And i really, really don’t think we should lynch anyone.
Or maybe just occasionally….
The nature of medical transphobia
Why this sudden attack of misanthropy? Mostly, i guess, its to do with thinking through the implications of a very good exposé posted by Paris Lees on her own blog, about GP(‘s) refusing to treat trans patients.
Context is key. The problem here is transphobia: but it manifests in various different ways and we need to work out what the issue is before we try to apply a solution.
There is the simple transphobia of those in the psych profession who see us all as bonkers and or deceptively homosexual. Or whatever the current bigotry happens to be. Its basically just control-freakery on their part.
There is the equally simple transphobia of GP’s who want nothing to do with us and who stick every obstacle they can in our way in order to prevent access to treatment. As i comment on Paris’ blog, this is a difficult one, since the Equality Act gives us protection once identified as trans…but we need a diagnosis before we get the protection and, in some instances, GP’s are even blocking our access to diagnosis.
But there is a subtler, nastier form of transphobia in the system and this seems, at present, to be infecting a few local health authorities. Camden, for one.
This is the refusal to prescribe treatments, even when they have been recommended by experts such as the good ladies and gents up at Charing Cross. ChX write to the GP stating that the patient ought to be starting hormone treatment: GP declines to go along with same.
An absence of license
So how – and why – do they get away with it?
Two reasons, sadly. First, almost no (drug) treatments for gender dysphoria have been tested in relation to gd. So any GP going along with the diagnosis and recommended prescription is likely to be using a drug for a purpose its not been researched for.
That raises real issues of risk and of ethics. Some GP’s might genuinely object out of concern: others can use this as a convenient excuse for them to shelter behind.
And its hard to tell the difference.
That’s one reason why, diagnosed with possible menopausal symptoms, our local GP just said to my partner: “how about trying hormones for a while?” Whereas in respect of giving me the same hormones, i had to jump through various hoops, including a psych assessment, real-life experience and a final assessment.
The minor op that is grs
And then there’s the issue of grs. Personally, the further away from it i grow, the less i can see what the fuss was about. As i’ve said before, if you’re trans, what on earth is the big deal about genital surgery? It really is a very small thing indeed, in the general run of transition – though simultaneously big in terms of the psych effect it has.
Its about as big, consequence wise, as having (or not having) an abortion, getting married or changing job. Yet we are not required to undergo massive psych assessments for these last.
and the major pain that is regret
But i forget: there are some people out there (though i lose track of how many there are supposed to be or have been) who “regret” their choice. Which is sad. Just as its sad when someone regrets losing a child. Or at the door of the divorce courts, “regrets” the six-figure pay-out they are about to make.
But at the same time: tough! I don’t think it right to make life for every other person in the country made more difficult because some people lack the capability to be responsible for their decisions.
But there’s the rub. Because not only are some twonks incapable of taking responsibility for what they do. They also sue. And because they sue, that makes every health professional in the loop – even those who are “on our side” – highly allergic to the remotest possibility that someone might make a mistake. Might “regret”.
That’s one reason why i had to shell out the best part of £300 on an essentially pointless second opinion just before i underwent grs. Its also why almost everything i do, as a trans woman, has to be copper-bottom backed by “expert” opinion.
Its not really because i’m not responsible. Its only tangentially because i might regret my choices. In reality, its because the health authorities have yet to get round to licensing treatments for gender dysphoria properly and, until they do, every medic in the field runs scared of being sued.
I take it back. Perhaps lynching is too good for them. The regretters, that is…. Castration seems an attractive alternative, were it not for the fact that in most cases, such action would probably be a smidgeon too late.