#The current system for trans care in the uk is broken

[bluebird325]

A Brief Summary of Scotland's Anger

Some of you may have heard that England has blocked Scotland's gender reform bill. Others may have seen the demands for dissolution of the union as a result. Please allow me to sum up the anger as impartially as I can:

Historically, the Scottish hate the English for a variety of reasons: see the Jacobite Uprisings and the Clearings. But this is about modern politics, so let's start there.

Essentially the SNP, the ruling political party in Scotland, have been trying for YEARS to get a referendum result where the Scottish people vote to leave the United Kingdom. In 2014, David Cameron (the then prime minister of the UK) gave permission for a referendum to be held, and 55% of the population voted to remain in the UK. Some of the reasons for staying was the economic stability from using the pound sterling currency and being able to stay in the EU, as well as access to funding from the rest of the UK (the arguement being that Scotland could not afford to support itself without help from Westminster).

Since then, the SNP and some of the other, smaller parties have argued that the initial result of the 2014 referendum was not strong enough, and that the initial promises made to the Scottish people are no longer valid (see Brexit and the recent economic crisis for the big examples, but there are others). Recently, the SNP has even taken the matter of the right to hold a second referendum to the Supreme Court, the highest court in the UK and one that deals mostly with English cases. The court ruled that, based on the current laws and treaties, Scotland needed permission from Westminster to hold another referendum. This has angered many people, regardless of if they want to stay or remain, and this latest action against Trans Rights could put more pressure on Parliament.

Scotland, as a country, has always been slightly more to the left of the political spectrum than England, which has led to many political conflicts where England just pulls rank to 'resolve' the issue. For example, Scotland HATES having nuclear weapons, and the UK's nuclear submarines are based on the west coast of Scotland. Another example is in the NHS, where prescriptions are free in Scotland but a flat rate in England. Nicola Sturgeon (leader of the SNP) had wanted to put Scotland in lockdown earlier than England and had even set up a different way out of lockdowns that was more gradual, but it ended up being watered down into 'Scotland had to wear masks for longer than England'.

Now, the Gender Recognition Bill removes many barriers for trans healthcare, such as how long an individual has to self-identify as a different gender to the one they were assigned at birth, lowering the age at which an individual can change the gender on their birth certificate to 16, and removing the need for a gender disphoria diagnosis. The gender disphoria diagnosis is one of the biggest barriers for trans healthcare in the UK at the moment, as a referal to even get the chance to be diagnosed can take years, and people have died on the waitlist just for a first appointment. For a more in-depth look at the issues surrounding trans healthcare in the UK, I recommend Abigail Thorn's video essay titled 'I Emailed My Doctor 133 Times: The Crisis In the British Healthcare System' (https://www.youtube.com/watch?v=v1eWIshUzr8). Fair warning, it will make you furious.

The Gender Recognition Bill was passed by the Scottish Parliament, also known as Holyrood, by 86 votes to 39. That's pretty good for a bill like this, but the UK Parliament has prevented this bill from receiving 'royal assent', which is required to make the bill enforcable. This has angered a lot of people, as it could be seen as England blocking the will of the Scottish people. Unfortunately, Scotland cannot leave the UK without permission. This is why there has been so much emphasis on a referendum, as the result could put pressure on the UK Parliament. England is reluctant to give permission, and one of the main reasons floated for this are the oil fields in Scottish waters.

TLDR: Scotland has always been annoyed at England, and the latest action to block this bill could tip those bad feelings over into full on anger, revolt and revolution.

[probablyasocialecologist]

The Cass Report is fatally flawed in its methodology, and as a result, its recommendations are harmful. Speaking on behalf of TransActual, Keyne Walker said: “It undermines the legal competence of both children and adults to access medical treatment and dismisses almost all existing clinical evidence on trans people’s healthcare by applying impossible evidence standards which, if applied to other medicines would invalidate more than three quarters of the existing treatments used in paediatric care which, like puberty blockers, are currently being prescribed off-label.” The report’s primary conclusions rest on excluding 98% of the relevant evidence on the safety and efficacy of puberty blockers and hormones for lack of blinding and controls. What this means is that they require studies in which some patients are given the treatment, and others are unknowingly given placebos. This is not only a clear breach of medical ethics and monstrous suggestion, but also impossible due to the obviousness of the impacts of puberty blockers and hormones.  The report also strays far beyond its scope and competence in recommending a review of adult services and in suggesting that young people ought to stay under the care of children and young people’s services until the age of 25. The latter is based on highly questionable understandings of brain development which have been repeatedly debunked as an oversimplification of the constant changes in human neurology over the course of our lives.  This recommendation, especially in a context of an already broken system of care for both adults and children, has the potential to have a significant negative impact on the lives and wellbeing of trans people in the UK.  Underpinning this report is the idea that being trans is an undesirable outcome rather than a natural facet of human diversity. This is clear not only from the recommendations but also from the exclusion of trans researchers from the design of the review process and the links individual members of the research team have to anti-trans groups, which the Cass team were warned about. Download the full briefing

[oidheadh-con-culainn]

I mean you're probably right about the published numbers but I think the nhs is outsourcing to private hospitals or something, my friend got an nhs top surgery in under a year. He might have said he was a bit more suicidal than he actually was, idk if that affected it. So like it's shit, but don't give up?

tbh i already went private for surgery and am probably going private for hormones (with shared care arrangements to minimise costs, but i am being fucked around somewhat in terms of how many hoops i'm having to jump through to see an endo) so the post was more of a general statement about the absolute state of things right now rather than about my personal situation

because i think a lot of cis people, or trans people from outside the uk, don't realise exactly how bad the nhs waiting lists are, and there's a general vibe of "yeah but if it's free isn't it worth waiting?" that i see sometimes online. which may well be true for the majority of people when it's 2-3 years. but when we're counting in DECADES? yeah that stops being viable real fast.

the 25 year figure would be for people newly referred today, they're currently seeing people referred in 2018. the waiting lists get longer all the time, so it used to be that you'd be seen within a year or two, and then within two, and then five... i was referred early in 2019, so i'm guessing i might get a call from them in two years' time, if the system hasn't completely broken by then

but also these are only the figures for initial appointments, and not for care after an initial appointment (whether that's hormones or surgery referrals). there are lots of delays there too where they can make you wait a year for a second appointment before they'll give you a referral and stuff but i can see things being a lot more variable at that end once you've got past the first hurdle

there are also some parts of the UK where there trans healthcare pilot schemes for people in particular areas, or who meet other criteria (such as being registered with specific sexual health clinics before a certain date), which can help people access care quicker if you happen to be eligible for one of those. unfortunately there are none of those open to me, but it sounds like it could be that your friend was able to get onto one of these schemes?

(a lot of the surgeons do both private and NHS treatment but it's just... how you get there that would be different.)

however if your friend went through the standard GP -> GIC -> surgery route any time in the last few years i feel like there are definitely missing pieces in this story because as far as i can tell it is simply not possible to do that specific process that quickly. (but i know there are policies for breast reductions on the NHS that can include mental health grounds so maybe the were able to take that tack? truly it is only once they put the word Trans in front of things that everything requires ten zillion hoops to jump through)