talkhealth Blog

As a surgeon who’s treated many patients transitioning from one gender to another, I know there are myriad complex reasons behind that decision, reasons which are not yet fully understood by science.

But what we do know is that those in the trans community often suffer greatly just to get to the point of surgery.

So it’s vital we don’t make their journeys any harder than they need to be.

When it comes to trans struggles, we’re certainly living in more enlightened times, and there’s a growing acceptance of the problems here in the UK.

It was, then, disheartening to say the least to see news coming from America in recent weeks which could have huge ramifications for trans people all over the world.

A US Government proposal, leaked to the New York Times, suggested that human gender should be defined as the sex recorded at birth and based on visible genital formation.

Any changes to the gender recorded at birth would be restricted, via new regulations.

And while there’s no such regulation in place in the UK, it’s my view that this could spread doubt and fear among many of those grappling with their own gender issues, and the rest of the world needs to take a stand on this issue.

Let’s look at the scientific facts.

As the World Professional Association for Transgender Health (WPATH) has rightly pointed out, sex and gender cannot be determined solely by birth anatomy or chromosomes.

I often talk with patients who say they knew they were not male, or not female, from as young as four or five years old. They suffer through their puberty, as gender features they never wanted in the first place begin to materialise.

And anyone undergoing gender reassignment is in the middle of a very difficult struggle.

These are normal people just like you and I, but their plight is often ignored as they become isolated from the rest of society.

What we should all be doing – both here in the UK and elsewhere – is continue to create sympathetic dialogue about a sensitive issue which affects those from all walks of life, from care workers to truck drivers.

Let’s also not pretend that everything is rosy in Britain, either.

Those suffering with gender dysphoria and who contact the NHS are typically referred to a Gender Identity Clinic (GIC).

At a GIC they’ll receive mental health support, cross-sex hormone treatment, speech and language therapy, hair removal treatments, particularly facial hair, as well as being introduced to peer support groups.

If a patient wants to have genital reconstructive surgery, they’ll usually first need to live in their preferred gender identity full time for at least a year.

Only then will they be considered for surgery.

Yet there are huge waiting lists – up to two years and a half years – on the NHS just to have an initial consultation at a GIC.

The patient may have known from their early teens they weren’t comfortable in their own skin, yet they’re forced to wait many years until they can do anything about it.

If they’ve sought private help, armed with their all-important GIC referral, they may also have had to wait many years until saving enough money to afford the surgery.

And then there’s the discrimination.

In January this year, research from YouGov and LGBT charity Stonewall showed two in five trans people have experienced a hate crime or incident because of their gender identity in the last 12 months, while four in five anti-LGBT hate crimes go unreported.

All of this proves we need to make urgent strides in trans care.

Divisive developments across The Pond don’t just represent a hurdle, they could be a huge step back for us all.

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Christopher Inglefield

Christopher Inglefield is a highly experienced Consultant Plastic and Transgender Surgeon and Medical Director of London Transgender Clinic. He is a member of the World Professional Association for Transgender Health, the UK Association of Aesthetic Plastic Surgeons and the International Society of Aesthetic Plastic Surgeons.