Pour encourager les autres?

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. 🙂



3 Responses so far »

  1. 1

    One point of detail. You state incorrectly that trans people require a medical diagnosis of being trans in order to come under the Equality Act’s protected characteristic of ‘gender reassignment’.

    One very specific change brought about by the Equality Act is that the provisions are NOT dependent upon medical diagnosis or intervention.

    Although the law has invented a rather counterintuitive redefinition for ‘gender reassignment’ the meaning amounts to self declaration.

  2. 2

    Paula said,

    and then what about these so called “experts” .. seriously.. I have been trands all my life whereas 90% of them are just psychs getting very fat through having a “specialism” which honestly from my experience involves ticking boxes according to some junk written by a yank, for the yank medical system .. 50 years ago!! .. can anybody name me any other branch of medicine which is still run hard and fast to a rulebook written 50 years ago and which takes no account of modern changes to the law (the equality act for example)? .. what other branch of medicine forces the patient into real physical danger before providing any “treatment”? .. and has such a blatant split in the way people are treated between nhs and private??.. it sucks, and it’s not because many people “regret” ..(off the top of my head there has only been ONE person who has ever sued the psych and the surgeon, and he jumped the system to get surgery within 5 months by paying) .. some people may “regret” but it’s usually regret because of the generally poor outcome with the outmoded obsolete and (in my opinion) slapdash uncaring state of uk surgery.. We are forced.. yes forced.. to in most cases accept second best, because choice is denied on a “take it or get stuffed” basis by a small circle of people who run strict to a set of rules (which ANY gp could do in all honesty) having ringfenced themselves a nice little monopoly.. there you have it.. 12 years frontl;ine experience of the NHS system and still waiting.. and am I bitter and twisted now?.. too damn right.. Funny you post this today because it’s the 12th anniversary of my first referral.. and I have now jumped through the same hoops 3 times before and now the 4th time.. discriminated against because there is no work in the locality I live for a trans woman with skills but no ID which doesn’t out me.. and once outed.. theres the door.. I was made unemployed the day I changed my name (done for the RLT!!) and been in limbo ever since.. We need to deal with this abusive discriminatory system and make it patient centered instead of doctor centered… as a priority!!

  3. 3

    katrina2 said,

    Paula,I have every sympathy for you and all others, left like this.
    However, your comment as to the qaulity of grs as, slapdash and second rate,even in your own opinion, is so far off the mark, that anyone would think the nhs employ butchers! Chx have two of the most outstanding MR-s, who also do private work, one of whom I belive, operated on Jane, a Mr Thomas.
    I sincerly hope, that you one day, will get to cross that bridge.

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