EHRC Trans healthcare report

Yesterday, the Equality and Human Rights Commission (EHRC) published it’s report into Trans healthcare. (Word document) It’s specifically Transsexual healthcare, with a GRS focus, because although other issues have been identified it is probably unsurprisingly access to surgery that is the one big thing that is highlighted repeatedly as an issue.

Much of the report will be unsurprising to anyone who has a passing familiarity with the situation: Despite it being unlawful to ban Trans healthcare, (Or do anything that is effectively a ban) there is still a postcode lottery when it comes to services available, with some areas being excellent and others incredibly poor. The EHRC even had problems obtaining the necessary information from the NHS in one region, so what hope do us mere mortals have? (Although one could just FoI it – possibly worth it, just to see if they were trying to hide something…)

The report also claims that Leeds requires just 3-6 months real life experience (RLE) before surgery and in exceptional cases, just one month which seems… unlikely. What is more plausible is that guidelines vary enough that the EHRC struggled to understand them all and compare like with like, and Leeds require 3-6 months RLE prior to hormones.

One fact they have uncovered that is worthy of note is the low number of regretters. It’s claimed that of all the patients that have gone through Charing Cross in the past 20 years, only three have “reverted to their original gender”. The exact definition here is unclear, but appears to be where someone has undergone surgery and then changes their mind, legally changing their name back. This certainly puts paid to claims of vast hordes of regretters out there and is in line with what I would expect: When pushed for names and sources, the “regretters” tend to be the same small handful of people we see over and over again, not all of whom have “reverted”.

The aim of the document was to identify possible future directions for NHS gender care after the upcoming reforms. The main point they make is that there will be more centralised oversight and control of policies for specialist items such as GRS, so that the regional lottery of care should at the very least be substantially reduced. It’s suggested

And finally, there’s some talk of holding GPs “accountable” (A code phrase for initiating complaints against GPs unwilling to treat Trans patients) and continuous professional development, i.e. ensuring GPs that graduated decades ago are up to date on what is available.

1 comment

  1. Interesting report, which I’ve only just started to digest.

    Certainly when I was at Leeds (3-5 years ago now), which also coincided with quite a lot of change (and to the positive) in that time, it was still working on 2 years RLE prior to surgery. That said, I did 18 months RLE myself before getting my first referral, although it would have been 2 years by the time I got my second.

    I then waited another year and a bit because of the issue of complex commissioning arrangements at the time – specifically, CHX refusing to honour referrals from Leeds and Sheffield – although I understand this may have been resolved now. Really, it’s commissioning and the internal marketisation of NHS service that causes the problems IMO, frustratingly progressed by the last Labour government and possibly pushed through to the conclusion by this one I fear.

    I’m pretty sure that the 3-6 month figure must relate to HRT after commencing RLE – although again when I was there that was ‘official’ HRT through them – I’m not whether this has changed but they did not force me to cease my self-medding when I entered their pathway.

    Certainly, more power (consistency) over GP care and support would also be welcome. My GP (in fact, the whole practise now) has always been incredibly supportive and informed over referring trans people, share-care, etc. For those that don’t have such a positive relationship or understanding GP, this really can prove extremely difficult.

    Finally, the ‘regretters’ thing has been used so many times by detractors against the provision of gender reassignment, especially on the NHS, but ultimately when challenged, such claims don’t hold up.

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