Trans Health Matters

Context of study on COVID-19 and interruptions to trans related healthcare

In June 2020 I began researching barriers to health care for trans and gender non-conforming adults and young people in the UK. Between June and December I recorded interviews with adults in England and Scotland about their experiences of the Covid-19 pandemic and access to public and private healthcare throughout this period. I also did ethnographic analysis of peer-led social media platforms.

The specific healthcare needs of trans and non-binary individuals (hereby referred to as Trans collectively) undergoing transition related healthcare (including cross-sex hormone treatment, gender affirming surgeries, mental health and psychotherapy, sexual and reproductive health)are often not included in responses to public health epidemics. Trans* individuals can be especially vulnerable to the impacts of epidemics and additional stress on health systems due to existing inequities and social exclusion. For example, Gender Identity Clinic (GIC) waiting times are the longest of any specialist NHS care due to enormous over-prescription and being under-resourced. While NHS England has confirmed that the 18-week referral-to-treatment time standard does apply to GICs, in worst instances some patients have reported a wait of 3-5years for a first appointment. From assessment-to-treatment there can be a further wait of an additional 2-7 years dependent upon the treatment required. As of yet, the impact of the COVID-10 pandemic on waiting times is unknown.

Preliminary Findings

The extent to which the UK NHS GICs have offered services during the COVID-19 pandemic has varied. All face to face appointments have been suspended until further notice and most GICs are not accepting new referrals. There are no transition related surgeries taking place and all waiting lists are on hold. General practitioners have been encouraged to continue essential injections, including hormone and blocker injections. However, in practice and particularly at the beginning of the UK outbreak many individuals have reported problems accessing injections or the necessary blood tests that are required prior to hormone injections. Many Trans individuals describe these transition related interventions as life saving in terms of their mental health and quality of life. With cross-sex hormones there is a paucity of research into the long-term health impact of changing doses, types or ceasing temporarily and this factor in itself causes anxiety and stress for many patients.

Additional findings include: the loss of vital support networks during lockdown, experienced barriers to accessing hormone medication and had long awaited surgeries cancelled indefinitely. Despite this, online peer support networks focused on healthcare have increased during the pandemic. PLEASE CONTACT ME IF YOU WOULD LIKE FURTHER INFORMATION ON THIS PROJECT


Trans Youth and Barriers to Healthcare

The waiting times and barriers to transition related care and support are equally as troubling for trans children and trans youth. The last 18 months have proved particularly challenging for young people and their families due to an increase in the public platform of the gender critical movement together with the use of the English legal system. In 2020 I wrote and spoke about one particular case as it was unfolding (Bell Vs Tavistock). Though this was not initially the focus of my research and scholarship, my role in LGBTQ+ activism and privilege of position led me to discuss the complexities of this high level of discrimination towards young people and their families:

Over the Rainbow Podcast – Trans Youth and Broken Healthcare Systems (Feb 2021)

I also wrote about this issue for the Conversation in December 2020

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