My life truly began the moment I was able to transition. But it took me years to get here, and most of that time was spent waiting. And it’s not just me. I put out an open call for trans people’s experiences with NHS gender identity clinics (GICs) and I want to share their experiences anonymously.
To see a GIC, you have to go through your GP for a referral first. This can be a huge hurdle if your GP is not already clued up on anything trans related – and many aren’t.
Many shared with me how difficult it was to get referred in the first place, sometimes requiring multiple attempts. One person told me, “There have been times I haven’t been referred because my doctor didn’t agree with me. Or because it was a touchy subject.”
Another said, “I was refused a referral to the GIC because I ‘wasn’t a lesbian’ so there was no way I could be a man.”
The shortest wait time for a first appointment at any of the seven NHS adult gender identity clinics in the UK is 37 months. The longest is 60. Five years. The wait for new referrals increases every year.
I can’t even begin to describe the negative impact my three-year wait to see a GIC had on my mental health. There was no correspondence, no support. It was the darkest time of my life. When you do finally get there, you’re met by a vastly cis majority of gender clinicians, who seem to be expecting you to meet their standard of gendered traits to be deemed “trans enough”.
Multiple experiences were shared with me echoing this: “I got asked so much about the toys I played with as a kid. They were so insistent on me giving them an example of playing with a ‘boy’s’ toy.”
Another said, “I’ve been waiting for five years. I’ve had three appointments and they still won’t prescribe testosterone for me. They kept asking about signs from childhood which I didn’t have because I was (and still am) pretty feminine. They told me I wasn’t trans enough.”
Is a cis man who expresses himself in a feminine manner inherently less of a man than those who are masculine? Why are trans people being treated in a medical setting as though their expression and their identity are intrinsically linked, when we know that this is not the case?
We’re only scratching the surface of unnecessary and inappropriate lines of questioning during GIC appointments. I understand practical questions about fertility preservation. But there is no reason for a doctor to know sexual details and preferences in order to decide if you are transgender.
I was once asked by a GIC doctor if I “don’t like having my genitals touched” sexually. Really, I wasn’t asked, so much as told. The obvious discomfort aside, I want to point out that the presumptuous manner of asking that, as if he already knows that I don’t, tells me that as trans people we are expected to hate our bodies in order to be deemed trans enough.
With these experiences in mind, here is my opinion. I feel that we should be asking ourselves if cis doctors should be given power over an adult trans person’s physical transition, when some don’t even seem to know how to interact with us like regular human beings in their personal lives.
Most of us have been asked invasive and upsetting questions which seem to serve no real purpose other than to check that we’re uncomfortable with our bodies – as if we’re always supposed to be.
I support informed consent. It would mean that adult trans people only need to be made fully aware of the consequences and potential side effects, negative and positive of any aspects of physical transition in order to obtain a hormone prescription directly from their GP (or referral for a consultation for surgery — note that wait times for surgical consultations on the NHS are incredibly long too).
At the crux of the issue is the lack of funding of NHS gender identity services, and this is unlikely to change. To have more than one GIC appointment with multiple different doctors, with several months buffer in between each at a service that already takes years to get into, is logistically incomprehensible. For those who cannot afford to go private, it risks lives.
Cut out this obstacle entirely, and instead have the service operate primarily as a provider of therapy for trans individuals and additional hormone and health monitoring. Gender dysphoria is not a mental illness, so why are we being diagnosed in mental health clinics as if transness is a checklist of symptoms?
The current system mandates that cis doctors make judgements on trans peoples’ identities and bodies. We shouldn’t have to prove ourselves to cis people. We are essentially begging to be believed.