Please Hold

By Ray Munn

Being a transgender person in the contemporary age is a complicated experience of existence for a multitude of reasons, too many to possibly list: needing to ‘prove’ your gender to people, trying to work out whether it’s safe to come out (whether this is at work, school/university or in public settings) and the legal issues surrounding processes such as name changes.

Transgender people globally will face a variety of different experiences and attitudes, whether this is influenced by their culture, legal system in the country they are residing in, religious factors or other important elements. Though Britain is not the best for protecting the rights and liberties of the transgender community (I mean, look at the Tory party conference in 2023…), I must acknowledge that I am fortunate enough to have had safe spaces and been elevated to a platform from which I can see numerous opportunities for me - such as being one of the very few trans athletes to compete in BUCS whilst I was in my undergraduate studies, not something offered to all trans athletes. It opened many important conversations at University. This platform is also a privilege for me to have. I am not at threat of being sent to prison for who I am, for example, an issue faced by marginalised trans+ communities in other countries. However, this does not mean existing as part of that community in the UK is easy - a number of aspects significantly impact on the lives of people like me. There have been many initiatives and attempts to suppress the rights, freedoms and liberty of transgender people in the UK, but one which has stuck with me was the decision of the highest court in the United Kingdom, in a legal challenge against the NHS: the subject of the waiting times faced by people in the UK for gender-based healthcare.

In January 2023, the High Court ruled that waits in excess of 18 weeks from receipt of referral for NHS run gender clinics in the United Kingdom was lawful: despite an NHS pledge to ensure that 92% of patients are seen within this 18-week target. There are thousands of people in the UK on these gender clinic waiting lists, and the wait is soul-destroying. I myself am on the longest waiting list in the country, The Laurels in Exeter - which in 2020 was found to have seen just two new patients, and even stopped initial assessments for most of 2023, despite individuals referred in 2016 still waiting. When I was referred at last, it took them two months to send me a letter - it arrived with my deadname on, despite my GP making sure my true name was on the referral, and simply stated “do not contact the clinic” due to very high waiting times. This was before the COVID-19 pandemic, which has since devastated further every aspect of NHS care in the United Kingdom. In August 2022, more than 26,000 adults were waiting to be seen by one of the handful of NHS gender identity clinics, or ‘GICs’ - I am one in more than 26,000.

A group of courageous and brave young transgender people testified to the High Court in November 2022 that the ‘extreme’ waiting periods experienced by almost every single person referred were causing dire mental health problems onto individuals already struggling with their sense of identity. I am no stranger to this.

When I heard of the high court decision that the extreme waiting times - which I can expect to be in excess of 7 years for the Exeter clinic - I couldn’t stop myself from breaking down into floods of tears. To know that the legal system in this country can actively support this, and not make any effort to kickstart a solution, made me sick to my stomach. The NHS is failing across the board and it is services that others see as non-essential which are suffering. And I know as a patient and as a member of staff - just recently I began working in the NHS as an administrator and have seen first hand the destruction across all areas which has been inflicted by the Conservative government.
Many people close to me have asked me whether I have decided to medically transition - and when I tell them of these incredibly long and painful waits, they almost always ask, “Is there any other option?”. Well, theoretically, yes. Many people in the UK have been forced into paying for private treatment to alleviate the physical and psychological toll gender dysphoria has on an individual - often paying thousands upon thousands. It should not be this way, and it is a disgrace this has been ruled lawful. It is my firm belief that nobody, regardless of their country or nationality or employment status, should have to pay for essential and life-saving healthcare. And transitioning IS lifesaving - though not a medical requirement and many trans people make the decisions not to medically transition for a whole host of reasons, there is substantial proof that transitioning and even having the assistance to socially transition is extremely beneficial for the mental and physical health of young transgender people. Others will unfortunately be unable to afford the private healthcare needed - for a host of reasons - and I personally hope that I will never come to that, but I have to accept that I might.
Two thirds of transgender individuals will experience depression, which bring a host of mental and physical symptoms which are exhausting and difficult to face - further, an estimated 12% of transgender individuals have made an attempt on their own life, compared to 2% of individuals who identified as LGB or queer, with 64% feeling as if ‘life is not worth living’. For BAME and Global Majority individuals, Stonewall found rates of depression amongst LGBT individuals were higher. For some of us, it comes too late - the inquest into the death of Alice Litman found she ended her own life and it was directly linked to the inexcusable waiting lists she was on, with zero support in the meantime. How many more people like Alice have suffered tremendously due to this?
In the run up to the general election on 4th July, I cannot help but think about what the next government will do about trans issues and the wider NHS issue - I currently work in the NHS and we are on our knees as it is. Can the next government truly promise to improve the NHS across the board without tackling the GIC issue?

It cannot be ignored that these waiting times and the refusal of a legal body or an NHS inquiry to acknowledge and put resources into these facilities have only thrown fuel onto the bonfire. I can’t expect to be seen before I am 30 - I’ve already been waiting four years, and I’m 22 now - without investing significant amounts of money into private healthcare. A two tier system has been formed: those who can afford it, and those who can’t. Healthcare should not be a two-class system. Living freely should not be a two-class system.

https://www.stonewall.org.uk/system/files/lgbt_in_britain_health.pdf

https://www.bbc.co.uk/news/topics/cwlw3xz01lxt

https://www.theguardian.com/world/2022/nov/29/nhs-england-waiting-times-gender-dysphoria-patients-unlawful-court-hears-trans-claimants-nhse

https://www.dpt.nhs.uk/our-services/gender-identity/waiting-times


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