Via @quarridors, it appears as if Nottinghamshire are blocking Trans patients from accessing HRT and in the process rather unnecessarily burning money.

Late last year and rather quietly, a number of GID-related medications including Testosterone, Estrogen and Goserelin were added to the “Red list” of drugs which cannot be prescribed by GPs. This came to light when one GP refused (Or was unable) to prescribe Testoserone to one Transman.

The intent here seems clear. It’s not just that GPs require specialists to recommend the drug, as otherwise it would be on one of the “Amber” lists. Instead, any prescription must be written by the Gender Identity Clinics.

This has two effects. In the short term, the GIC has no prescription budget so can’t prescribe and patients are not getting the treatment they need.

Secondly is what happens post-surgery. Typically, a patient would be looked after by their GP, who will write a prescription. In the case of transwomen this will often make the NHS money, as Estrogen costs less than the NHS Prescription charge.

Under Nottinghamshire’s rules, it appears that patients will need to continue seeing their GIC to get prescriptions, at a cost of a couple of hundred pounds a time. There is an FoI request in the pipeline to try to find out why this has happened, but I cannot conceive of any clinical reason. It does seem that Nottinghamshire are trying to save money and are not only risking patients health but have not thought through the consequences of their actions and will end up costing themselves more in the long run.

(The other option is that they’ve read too much Daily Mail and are just trying to block Trans treatment at all… but no PCT would act unlawfully to do that now, would they…?)

For those who have followed the Paddy Power issue, approval for the advert has now been withdrawn by Clearcast, the body that approves broadcast adverts in the UK. It now cannot be aired on any UK broadcast or Video on Demand service.

Here’s what ClearCast have said:

Last week we approved a tv ad for Paddy Power featuring references to transgendered people. When making our decision to approve the ad, we took into account the fact that the advertiser had sought a view from the Beaumont Society (a body run by and for those who cross dress or are transsexual) which did not find the script idea offensive.

However following a number of complaints over the last few days, it appears that the ad has caused offence and in consultation with broadcasters, it has been decided that the ad should no longer run on their TV or VoD services in its current format. We regret offence that may have been caused.

Updated: Paddy power now have a post on their web site in which they’re completely unrepentant on the issue. (And being rather shitty about it too) Apparently it’s all OK because they consulted a Trans organisation (Apparently unaware that BS is predominantly TV/CD) and some Trans folk were going to appear in it. No clue if the the Trans folk who would have been featured were Transsexual or Transvestites.

Featured on Liberal Democrat VoiceA Parliamentary Early Day Motion – the MPs method of saying “down with this sort of thing” – has been started. It was proposed by Caroline Lucas (Green) and seconded by Julian Huppert (Liberal Democrat) and Mark Durkan (Labour) so has cross-party support already, with the topic being the Sun’s attempts to hunt down the trans man who recently gave birth.

It’s very timely that it’s been released today of all days, with the Metro running a front page story on a 5-year-old child diagnosed with Gender Dysphoria. (A story complete with photo, full name and the names of her parents!)

You can help – Please write to your MP if they have not signed it already and ask them to support this. If you do not know who your MP is, you can use Write To Them to find out. More signatures will not just increase the pressure on the press to act responsible towards the Trans community, but also to act responsibly across the board.

Anyone remember CIX, AOL or Compuserve from the early-to-mid 1990s? You’d log on and have a nice, safe (But expensive) set of forums and chat rooms isolated from the chaos of the mainstream internet.

Whatever happened to them?

Well, they died. A long time ago. I don’t think many mourned their passing, really. AOL became just another dialup ISP, famed for those free shiny coffee coasters they put through everyone’s door. CompuServe were bought by AOL. CIX just became specialists in conferencing.

Now a “cybersecurity expert”, Professor Alan Woodward, has reinvented the wheel. And the BBC think it’s news.

Yes, he’s proposing that in the name of security, we reinvent those walled gardens of the 90s. The ones that died because they were expensive and couldn’t innovate at the speed of the internet.

Because, of course, if we rip it up and start again the hordes of programmers who wrote the current systems, replete with security holes, are not just going to make exactly the same mistakes again and recreate the same problem.

I’ve seen far too many “Security Internet” and “Internet Two point Oh” proposals over the years. Unsurprisingly, none of them have come to anything and those that survived have done so simply by becoming another ISP or web hosting provider. It’s no wonder we’re in a mess, if this is the best we get from an expert in the field.

Those lovely folk over at Stonewall have published a draft same-sex marriage bill. The clue is in the name – it’s just same-sex marriage, not equal marriage. It’s telling that the real content is just two sides of A4, with lots of space on the page. I think the Trans community’s version would be longer, just for the basics.

Brainstorming, what would people like to see in a proper equal marriage bill?

For starters, here’s what I have:

  • Same-sex marriage, both civil and religious
  • Opposite-sex civil partnerships (Emma Brownbill points out that this is also a Trans issue, due to stealth concerns)
  • A process for converting historical Marriages/Civil Partnerships (Only those before passage of the Bill) to the other form
  • An end to requiring divorce/annulment to obtain a Gender Recognition Certificate, (GRC) and by extension, ability to obtain updated marriage/divorce certificates when you also get a GRC.
  • Legally (Including in contract law) regard all marriages annulled under the Gender Recognition Act and then re-entered into as being continuous. (This has implications for pensions and similar)
  • Some recognition of poly relationships to be able to get the same rights and responsibilities as others? (I have no idea how one would write this as primary legislation!)

I have probably missed loads…

An “update” from Ofcom landed in my Inbox yesterday that has me a little worried, as it’s pushing a report by “ParentPort”, of which they’re a member as well as other media organisations such as the BBC. The headline is “Revealed: How parents control children’s access to adult media” with the lead-in stating “of those parents surveyed whose children watch films at home, 40% had allowed their children to watch a film classified above their age” and that this “reveals the challenges and pressures parents face when it comes to keeping the media their children see age-appropriate.

Shock horror! Near half of kids are watching inappropriate adult content!

But hold on a second – we do not have the actual survey results or know exactly what questions were asked. Do they really mean adult content, I.e. films rated R18? Probably not, but they’ve still put it in an attention grabbing headline.

My eldest is 10, but all three of my kids have seen all of the Harry Potter series of films. All but the first three films are rated 12 or 12A, so by ParentPort’s definition this is somehow “revealing” that I’m facing pressures “keeping the media they see age-appropriate”. I don’t think I am, because (In line with BBFC guidance!) I saw the films with them at the cinema.

Actually, I mostly saw it at the cinema with them because I wanted to see it too. I’d have had no problems with them going to watch it on their own and I suspect many parents adopt the same view.

I am not sure if this is poor headline writing by someone at Parent Port or if they are trying to push some agenda, but I’m sure this will be seized upon negatively by some who want to campaign for their own brand of control and censorship.

In terms of my own approach, I don’t let the kids watch/play just anything. They’ve been allowed to play some of the Grand Theft Auto games only under rather close supervision, because they are permitted to do the driving around but not the storyline missions. They’re completely uninterested in sex, but they lack the appropriate knowledge to put some of the plot and dialogue in context and it’s understanding the context that’s my main concern with any sex-related media, rather than wanting to keep them away from sex completely.

For those not following on Twitter, a Transcript of Helen Belcher’s oral evidence to the Leveson Inquiry yesterday on behalf of Trans Media Watch is now online (PDF Link) and worth a read. Her evidence begins on page 10 of the PDF, page 37 in Leveson’s own numbering, and there is also a plain text version available.

The written submission is also available (PDF Link) but Helen’s responses to the oral questions make a more accessible and quick-to-read summary of the situation.

Edited to add: Trans Media Watch noted that only part of the written submission is available. Large amounts of harrowing first hand evidence submitted has to remain confidential.

Further to last week’s post on Leeds GIC not understanding what they’re diagnosing, they’ve responded to further “clarify” their position in response to a follow-up by Emma Brownbill.

They’re still pretty confused.

Firstly, they apparently retract any claim to follow the DSM-IV: (this is despite it being listed on their web site)

Your example above follows the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV (TR)) which makes a differential diagnosis coding based on current age (302.6 Gender Identity Disorder in Children, 302.85 Gender Identity Disorder in Adolescents or Adults).

However, as a provider of Adult Mental Health and Learning Disability Services, our Trust follows the current edition of the ‘International Statistical Classification of Diseases and Related Health Problems’ (ICD-10), published by the World Health Organization, which has five different diagnoses for gender identity disorder (F64 Gender Identity Disorders) as follows:

It then goes on to quite the ICD… which does not list a diagnosis of “primary transsexualism”, the subject of the original FoI request, anywhere. But wait! Later on in their response, when it’s pointed out to them that WPATH and HBIGDA are the same organisation, they apparently change their minds:

WPATH is a worldwide organisation that provides “Flexible Clinical Guidelines” – (stated on page 8, version 7). As previously explained, our Trust follows the guidance and recommendations from a number of clinical publications and these may influence our practice however these are guidelines and are used as such.

So, they might use other publications? Or do they? Further down, when asked to provide a copy of any “guidance, policies or procedures” in use:

As explained above, our Trust follows the current edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), published by the World Health Organization, for diagnoses of Gender Identity Disorders (F64).

So it’s ICD-10… but when asked if they plan to adopt the latest version of the WPATH SoC, and despite it having already been pointed out that this is the same organisation as the HBIGDA: (My emphasis)

As previously explained, our Trust follows the guidance and recommendations from a number of clinical publications, which includes the World Professional Association for Transgender Health (WPATH), the Harry Benjamin International Standards of Care, the Royal College of Psychiatrist standards (currently in draft format), Nice guidelines etc. However, these are guidelines and are used as such.

So, glad that’s been cleared up then?!?

I have recently switched from using dircproxy as an IRC bouncer to ZNC and it is turning out to be a better piece of software. (Not least of which is decent SSL support and a handy web interface that allows easy reconfiguration) However, it suffers from the same problem as many other bouncers – it doesn’t log Private Messages when you’re online. This is annoying because I may have left some machine somewhere connected that I might not return to for a day or two, or I might be on a mobile device that’s prone to losing it’s connection due to train tunnels etc. (Which results in ZNC thinking the device is still connected until it times out and messages are lost completely)

So, for anyone who uses ZNC who finds this similarly problematic, you can download a copy of the logging module I’ve worked on here. It compiles cleanly against the Debian version of ZNC 0.202 cleanly using just “znc-buildmod pmlog.cpp”, and you can install it simply by coping the resulting file to ~/.znc/modules and enabling it from the web interface.

There are no configuration options yet so it’s rather rough and basic and should be regarded as Beta-quality code at best, but time permitting I should add more soon. When you connect, it will simply play back inbound/outbound private messages sent since you loaded the module.