Four trans people are taking legal action against the NHS over its failure to offer a first appointment at a gender clinic within the legal timeframe.
The NHS has a legal obligation to ensure that 92 per cent of patients referred to NHS services by GPs are offered a first appointment within 18 weeks.
However, the waiting lists for the NHS’s gender clinics are so long that most trans people end up waiting years for an appointment at one of England’s seven clinics for adults.
The average waiting time is currently 18 months for a first appointment for minors, which means that many trans youth end up going through puberty before puberty blockers can be prescribed. There is just one gender clinic in England for trans people under the age of 17 – the Tavistock Gender Identity Development Service in London.
Eva, Alex and two minors who cannot be named for legal reasons are taking legal action over the lengthy delays. They are being supported by the Good Law Project, a non-profit organisation that uses the law to achieve a better world.
In a pre-action protocol letter to NHS England, solicitors working on behalf of Eva and Alex noted that 2,985 people were waiting for an initial appointment at The Laurels, a gender clinic in Exeter, in August. The last people to have an initial assessment were referred to the service in June 2016.
The trans community’s mental health is suffering due to lengthy waiting lists
Eva, who is on the waiting list for The Laurels, said that she has been waiting four years for a first appointment with the clinic.
“After spending so much of my life coming to terms with who I am, this wait is such a letdown,” she said.
“I’ve not even been offered any mental health support in the meantime. I’m not getting any younger, yet NHS gender clinic waiting times are getting longer – and that’s before the pandemic even started.”
She added: “Being trans isn’t a choice. Let’s face it, who would choose to be hated, attacked discriminated against? We are just people too. But the lack of support does’t make us feel included, especially when it comes to healthcare. It’s like we’re an afterthought in a service that’s become complacent to its own astronomical waiting times.”
Alex said thousands of trans people are “suffering in silence” because they can’t secure vital healthcare through the NHS’ gender clinics.
“Thousands of us are stuck in limbo with no idea if or when we’re going to get support or medication. We can’t take on the entire trans health care system alone, we have to just deal with what we’re given – which really, is not much at all.
“Our mental health is so affected by this. I believe we deserve better. This case is important because it represents the struggles that I, and our community, have to deal with every single day.”
The four claimants are being supported by the Good Law Project in their action. The non-profit organisation has launched a crowdfunder with the goal of raising £30,000 to assist in the case.
Jolyon Maugham, executive director of the Good Law Project, said the law is “abundantly clear” that trans people are entitled to a first appointment within 18 weeks of a referral.
“The trans community has been asking the NHS – pleading with the NHS – for many years to take these issues seriously, and the NHS does not,” he told PinkNews.
We are taking major legal action to address the ideologically driven neglect of trans health care: both adults and adolescents. Healthcare is for everyone.
Please support here. https://t.co/Q7H6aNipeR
— Jo Maugham (@JolyonMaugham) September 30, 2021
Most people would not “choose legal proceedings as the right way to resolve these issues”, but the trans community has been left with no other choice, Maugham said.
“The thing about puberty blockers is that they’re a very time sensitive treatment, and if you don’t get them during your puberty they’re of no use to you at all.”
The result is that trans teenagers are left in a helpless state as they watch their bodies change in ways that are destructive to their health and wellbeing.
Many trans people who find themselves on waiting lists for years end up purchasing medication through the dark web. Some who can afford to do so pay for treatment privately, while others go abroad.
However, Maugham is keen to point out that all of them have a legal right to treatment through the NHS’ gender clinics.
In the background, the far-right is weaponising trans issues to add fuel to Britain’s transphobic culture war. Maugham would prefer if the discussion could instead focus on the ways in which trans people’s needs are not being met by the public health system.
“I think people need to find their humanity and realise that whilst they’re having a splendid dinner party debate, the trans community is dying,” he said.
In a statement, NHS England said: “The NHS is working hard to tackle the COIVD backlogs that have inevitably built up during the pandemic across a range of services.
“Demand for gender identity services continues to rise as more people feel able to come forward for support and NHS investment is creasing to meet the extra demand.”
Almost all trans people think the NHS’s trans healthcare offering is inadequate
News of the legal action came just hours after Trans Actual, a trans-led organisation in Britain, published the damning results of a survey conducted in January 2021.
Trans Actual surveyed trans people living in Britain about their experiences of discrimination in their daily lives and in the healthcare system.
A whopping 98 per cent of respondents said transition-related healthcare available on the NHS was not completely adequate, while 47 per cent said it is “not at all” adequate.
In January 2021 we asked trans people across the UK to tell us about their lives. The results are in and today we're proud to present the Trans Lives Survey 2021 report.
There aren't any surprises but the results are shocking.
— Trans Actual (@TransActualUK) September 29, 2021
Meanwhile, 40 per cent of respondents said the lack of access to healthcare through the NHS’s gender clinics had impacted on them “very much”. Just 12 per cent said it had not impacted on them at all.
Trans people continue to face endless hurdles in accessing basic healthcare in the UK and across the world. Transphobic culture wars and oppressive systems mean that many trans people end up paying out of pocket for treatment online, while others opt to go private.
Those who cannot afford to do so often report being left stranded in limbo, often waiting years for vital healthcare.