Hostility towards trans people is damaging their healthcare, warns charity

Hostility towards transgender people and “scaremongering” on social and traditional media outlets is having a negative impact on trans people accessing NHS healthcare, a charity has warned.

Cleo Madeleine, Gendered Intelligence communications officer

Gendered Intelligence, a charity that works to increase the understanding of gender diversity and improve the lives of trans people, also says that trans people are being “turned away from their primary care providers” due to misinformation and a lack of expertise.

For example, some drugs which are readily available on the NHS and proven safe for some conditions are not available for treating transgender people.

This includes drugs such as estradiol, which is used to treat menopausal and perimenopausal women, and finasteride, which is used to treat hair loss. These drugs are prescribed privately to trans people in Scotland, but trans people say they cannot get hold of them through their GPs – causing huge financial burden.

“The one thing that doesn't get talked about so often is the impact that's having outside of specialist gender identity services,” said Cleo Madeleine, a communication officer at Gendered Intelligence.

“Being able to access the necessary support to medically transition - if that's what your healthcare needs are - is really important.

“But we're seeing trans people being turned away from their primary care providers because they don't feel confident caring for a transgender person at all.

“We're seeing all sorts of misinformation spreading to care institutions about who is allowed to use what services, we're seeing transgender men getting cervical cancer because they're not invited for screenings.

“There's a much larger healthcare crisis outside the scope of gender identity clinics, and it has political roots.

“Ultimately, it stems from this hostility towards trans people that has been promoted.”

Previously, The Scotsman reported how transgender people in Scotland are being forced to raise money for “lifesaving” surgery on the internet, due lack of available treatment on the NHS and long waiting list times,

On sites such as GoFundMe and JustGiving, pleas for help can be found from both trans men and trans women, driven to desperation by waiting times measured in years, not months.

Young trans people in Scotland are also being forced to take out large loans or deplete their life savings in order to purchase private treatment, due to “completely unsustainable” waiting times for gender-affirming surgery and hormones.

“There is a sort of gulf when it comes to cis and trans healthcare,” said Madeleine.

“Medications associated with gender identity services are safe, widely available for other uses and have a long history of use in the specific field of gender identity services.

“For instance, Estradiol, one of various different hormone replacement therapies which have been used for a long, long time in menopausal and perimenopausal cisgender women.

“And I feel like a lot of the barriers to access that are put up come from political causes, rather than from medical evidence and research.

“I think there's a perception that comes from the way that trans issues are discussed in the media, and by the governments of all the UK nations, that trans medicine or gender identity services specifically are something that is new or unresearched, or somehow unsafe, but that couldn't be farther from the case.

“The practice, as we know it now, has been around in Europe for around 100 years. And in England there has been a specific pathway for decades.

“The NHS Gender Identity Development Service itself is 30 years old and individual transitions have been happening since the 40s and 50s.

“There's nothing particularly novel going on here, but I suppose the way that transgender issues get talked about, has this scaremongering effect.”

Nelly Connor, a 24-year-old trans woman from Aberdeenshire, has been waiting for years.

Connor first reached out for help when she was living near Glasgow, and was put on the waiting list for the Sandyford Gender Identity Clinic (GIC) in December 2019.

When she moved to Aberdeen, the clock was reset, and she was moved to the waiting list of the Aberdeenshire GIC – which currently has a waiting list of two years.

Like many trans people in Scotland, Connor has been forced to seek private treatment, at great cost.

“The main frustration I have is with the medication,” said Connor.

“So if you're a cis woman going through menopause, you can get it, or if you're a cis man who has an enlarged prostate and needs medication for that, you can take finasteride. But if I go to my doctor and say, I want these medications, and I've been prescribed them through my private GP, can I get them? I get told no.

“I've been told no by about five different GPs. And it's like, the medications is there. You're already giving out to people. And I literally have a private doctor. saying that this is the care I need, but the NHS refuses that for some reason, and it just seems like barriers upon barriers are being put in place for literally no reason.”

Gendered Intelligence, claims that trans people are being denied their human rights by being denied access to healthcare that is available for other conditions.

“The point that organisations like ourselves are trying to make isn't that every transgender person should have access to whatever medication they want right now, or that what we want is for everybody to transition,” added Ms Madeleine.

“At the end of the day, being trans isn't about a certain medication or a certain pathway. It's more of a human rights issue.

“Everybody is ultimately entitled to age appropriate, accessible, good quality health care, and we find ourselves in a situation where the trans community at large, when they do need that, aren’t getting it. That's a really serious human rights issue.

“We're really keen to make clear that this is not about whether you approve of transgender people or not, whether you approve of medical transition or not. It's about a human right to health care.”

Access to healthcare would help make trans people “more comfortable” in their bodies, added Connor, which everyone should get to experience.

“The entire point of existing,” according to Connor, “is to have positive energy and to enjoy life for what it is.

“Can’t we just do that? Can’t we find a way to maximise that for the most amount of people possible?

“Even if it’s just tiny changes, like increasing access for healthcare that already exists.

“With trans issues, so many people focus on what people consider the big things, like surgeries and stuff like that, but for the majority of trans people that I know, and I can only talk from my lived experience, one of the most important things is a starting block to help in a transition.

“It’s those little things that make you more comfortable in your body. And I feel like being comfortable with who you are is such a special thing, and I feel like more people should get to experience that.”

A spokesperson for the Scottish Government said: “We expect everyone to be treated fairly and with respect when seeking healthcare and that all health boards have policies in place to fulfil their duties under the Equality Act 2010.

“NHS staff should make every effort to ensure that the privacy and dignity of all patients are maintained.

“The Scottish Government is committed to advancing equality for all LGBTI people, and promoting, protecting and realising the rights of every trans person in Scotland.

“Everyone who requires cervical screening can receive it in the NHS and there are defined processes in place to ensure call and recall services are available to all.”