When it comes to making decisions about people’s healthcare, it’s important to focus on the facts. Everyone’s body is different, and decisions about the care they receive should come from an informed discussion between the individual themself and the healthcare professionals looking after them. But when it comes to healthcare for trans people, all too often it can seem as though it is the gallery of public opinion, rather than the experts who know best, who think they should decide what happens.
As a person who has navigated the NHS gender identity care system myself, who talks to trans people all over the country, and who works with services to try and improve the care trans people receive, it is concerning to see so much misinformation and misunderstanding about trans healthcare in the media. The attention would be welcome if it focused on making sure trans people can access the healthcare we need, but the picture that is painted is often far from one that I recognise.
So often left out is just how important and meaningful accessing healthcare is for the vast majority of trans people, and how much it can improve our lives. I totally get that it might be hard for those who don’t need to access this kind of healthcare to understand how it feels for those of us who do. But that’s exactly why it should be trans people ourselves, and the people looking after us, making these decisions, just as you would expect in any other area of medicine.
Trans people tend to describe the treatments that are right for us as “gender-affirming”: we choose to take hormones, or have surgeries, to feel more at peace and comfortable in ourselves. For lots of us, this sense of finally having a body that feels like home is genuinely life-changing. I know that’s been my experience. And more and more studies show very few people regret their decisions.
Of nearly 3,500 trans people attending the UK’s largest clinic in London just 16 of them – 0.47 per cent – had any regrets. And an analysis of studies from around the world found a regret rate of one per cent for gender-affirming surgeries. It is hard to compare different interventions (as I say, we’re all different) but, as a yardstick, the regret rate for knee replacements is 17 per cent and for hip replacements five per cent.
But despite knowing how important and effective this vital healthcare is for trans people, there are still problems. At the biggest service in Scotland, providing transition care for more than half of Scotland’s health boards, people can currently expect to wait a minimum of four-and-a-half years for a first appointment – simply to start discussing their options. And every trans person living here has to travel to England for any surgeries they have, which can make an already stressful and exhausting process that bit more difficult.
I would hope that we can all agree that everyone deserves to live a happy and healthy life no matter who we are, with access to high-quality care we need, when we need it. There is work underway but still much more to be done to try and make this a reality for trans people in Scotland.
Vic Valentine is manager of Scottish Trans