Leeds get defensive in Gender Identity FoI response

There have been a couple more answers from Leeds GIC in response to Freedom of Information requests. The first is the “Information for Referrers” leaflet (PDF Link) which details what steps GPs should take before passing someone on to the service. We already suspected the most interesting part of this, specifically: “The GP would need to provide an up to date physical examination report…In addition to the physical examination an examination of the sexual characteristics would be highly desirable.“. I struggle to see how a physical examination of “sexual characteristics” at this stage can be justified, particularly when by a GP who is not going to have the experience to do this sensitively. The only time I had any form of physical examinations were by the surgeon and electrologist, which despite being rather necessary was still, in the case of the surgeon’s visit, rather upsetting.

Most likely the main effect of this is just going to end up being unnecessarily upsetting people trying to access the service. Luckily, I’ve heard of several people that have refused the physical exam and they’ve still been able to get a referral, so this aspect appears not always to be adhered to. It’s inclusion in the referrers leaflet means people that don’t need it or want it may still end up having it however, because they feel bullied into it to access essential medical care.

One sensible aspect is getting the GP to carry out the blood tests before referral. This would hopefully cut down on delays at the GIC due to needing to go away and come back for a test, although I do not know if this is routine practice at other GICs too.

Slightly worrying is the assertion that this is a “a time-limited Pathway of Care for the maximum of three-year duration“. [sic] Having not heard of anyone being discharged from the clinic after three years while still mid-transition, I assume this is not actually enforced.

The other response was asking who had been involved in an FoI response and some rather inaccurate content on their web site, which has since been updated. In it, they start getting defensive about their policies, something I have not seen before in an FoI response. Here’s what they said:

Specifically, our Care Pathway follows the stages laid down within The Harry Benjamin International Standards of Care (this differs from the WPATH guidance), as we believe that hormone treatment is best undertaken after real life experience has begun to ensure that, possibly irreversible hormone treatment is not undertaken without there being a completely coordinated comprehensive care approach which has the ability to meet the changing needs of our service users flexibly and safely. This is paramount to a positive outcome.

Interestingly, they are explicitly rejecting the latest version of the WPATH Standards of Care with this response and reinforcing their view that hormones should only be prescribed after going “full time”. I have no idea if Leeds doctors have ever actually tried anything like talking to their patients, but going full-time is far more irreversible than hormones. Just because it’s social and not chemical/biological does not lessen it’s impact if you are treating the person as a whole.

I have not seen any studies of this, but I also suspect that those going full time before hormones are hugely more at risk of social impacts such as job loss and violence due to not “passing”.

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  1. #1 by Liz Church on 23 March 2012 - 10:58

    Surely, if people are being subjected to intimate examination where it is not required and the person has not consented (and I mean consented without coercion), then it must amount to sexual assault?

  2. #2 by Chiara on 23 March 2012 - 11:59

    Even back in the bad old days of thirty plus years ago, no GP tried this one on me- the physical examination was undertaken by the surgeon, with my consent, a few weeks before I was due to go in and he was as understanding as he could be in the circumstances.

    This sounds to me to belong in the same category as the transvaginal ultrasound stuff causing such a furore over in the US at present.

  3. #3 by Pippa on 16 April 2013 - 19:52

    Thanks for this. The most worrying part for me is still the rejection of the latest WPATH standards in favour of the old Harry Benjamin route. It’s a real catch-22 situation: you can’t get treatment unless you live “as your chosen gender”, but living in your “chosen gender” is made practically impossible due to the lack of beneficial changes from hormones!

    Transition, to me, implies a crossing over, a journey to an unknown destination. It makes no sense to have some pre-conceived idea of the final destination, it is the process of change that’s important… A process which maybe means, someday, we can get to a place we feel at home. I wish Leeds would wake up to this. As you so deftly put it, “going full-time is far more irreversible than hormones”.

    I sincerely hope Leeds staff read this blog.

  4. #4 by Rose White on 4 January 2014 - 22:31

    The problem with the Leeds gang is that the head Beaini is a text book example of the Munchausens Syndrome by proxy as his his sidekick Jo Walkinshaw and both these sickos derive their kicks from causing depression in transexuals.

  5. #5 by Helen Heaton on 9 May 2014 - 16:59

    Fortunately my GP used her own common sense and refused to do the examination herself as she didn’t see the point.

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