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Caitlin Hart

Is Transgender Healthcare Classist?


© Illustration by Ryan Crane - @artbycrane


This Transgender Day of Visibility, INJECTION looks at the costs of trans healthcare.


lnternational Transgender Day of Visibility is an annual event on March 31st each year. It is to celebrate the achievements of transgender people and raise awareness of the discrimination that they face worldwide.


In the UK, one of the areas where transgender people are often failed is the healthcare system.


The NHS offers a wide range of services for those transitioning, such as hormone treatment, surgery such as removal of breasts or construction of a penis or vagina, as well as counselling and other support services. However, with these services comes a long waiting list.


The NHS Gender Identity Clinic (GIC) currently receives around 400 referrals a month and all together there are 10,648 people on the waiting list. The waiting list for a first appointment with the clinic is nearly four and a half years, with those referred to the clinic in December 2017 only being able to have their first appointment this month.


Tom Powell, 25, is a transgender man who has spent time on the NHS waiting list and has opted for private healthcare whilst he waits.


© Tom Powell, a transgender man who has 2 years left on the NHS waiting list.


“Trans healthcare is awful and there just aren’t enough gender specialists out there. I am on the NHS waiting list but still haven’t heard back from them. I think I have another two years to wait until I’ll be seen by them.


“I went private due to the waiting times and needed to just be myself sooner rather than later. I went with Gendercare and have spent roughly £800 and will need to pay £150 a year until I'm seen by the NHS. And although that is a lot of money, I work full time and can thankfully pay for it.”


For some transgender people like Tom, using private healthcare to access hormones and gender surgeries is not ideal, but a viable option. For many others however, taking a paid route is just not possible.


Transgender healthcare is inherently classist, with little funding and long waiting times, trans individuals who cannot afford to go private are simply forced to experience years of dysphoria before they are even considered for hormones or surgery.


Experiencing gender dysphoria without the appropriate help and healthcare can lead to so many mental health issues such as anxiety disorders, schizophrenia, depression, substance abuse disorder, eating disorders, and suicide attempts. Without adequate NHS funding for transgender healthcare services, lives are at risk, and other NHS services will simply become more stretched.


Gender-affirming healthcare can be life-saving and more needs to be done to ensure that it is improved and can become a priority for the NHS. There are a wide range of support organisations aiming to improve healthcare and support transgender people, they can be found here.




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