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For the first time in the 78-year history of the United Kingdom’s National Health Service (NHS), leaders have decided to move with haste.
Last week, the government agency notorious for endless waiting lists and red tape surrounding transgender people’s health care opted to shutter the surgical wing of Wales’ only state-run gender clinic, at least for now, in what appears to be the latest politically charged attack on providers. Other services, such as hormone replacement therapy and psychotherapy, remain intact. Youth care is unaffected as the clinic only serves adult patients.
This comes after an anti-trans blogger, Nick Wallis, alleged that the clinic was committing misconduct, purely because it may refer patients for surgery at significantly higher rates than other NHS institutions.
But this isn’t inherently a sign of a problem.
In fact, it may very well signal that the Wales clinic is simply operating more efficiently than other NHS institutions, which are infamous for putting trans patients on decades-long waitlists and forcing them through bureaucratic labyrinths before they are allowed to receive gender-affirming health care.
But because of conservative gender ideologies and medical philosophies that seek to curb the number of transgender people who can access care, this fact was treated as a smoking gun. Natasha Asghar a right-wing politician, who said she had been “working on” the story with that writer, then successfully lobbied to pause the clinic’s surgical operations while a state investigation plays out.
It is unclear how long such an inquiry will take. However, the impacts on patients have been devastating. Existing gender-affirming surgeries on the books were cancelled for the foreseeable future. Some patients were informed of this mere hours before they, themselves, were scheduled to go under the knife. Some had already been admitted to the hospital when news broke. People who had waited years for this care, rearranged their lives, took time off work, and traveled to the clinic from all over the country are now stuck in a medical purgatory.
TransActual, a UK-based advocacy group, said in a public statement that it was “deeply concerned” about the decision by the NHS Wales Joint Commissioning Committee (NWJCC) to suspend care.
“Trans people using their service are now left without any NHS pathway to receiving the surgical care they need, in an extraordinary violation of NHS Wales’ duties as a provider of care,” the statement read.
“This decision appears based on the assumption that WGS referring a greater number of patients than their English counterparts must be indicative of a problem—before any real investigation has taken place, and despite the obvious failures in the English provision of transition care. Given the predictable harms this will cause, and in the absence of any better justification, it’s difficult to understand this as anything other than caving to ideological pressure.”
It concluded that “making this harmful decision without extremely compelling evidence to support it is an appalling failure of governance and demonstrates a clear disregard for trans patients’ wellbeing. This fits a familiar pattern of political attacks on trans healthcare being camouflaged in ‘concerns’ that demonise our healthcare, holding it to standards not applied to other areas of medicine.”
The sheer speed and totality of the care stoppage appears to be unprecedented in the context of this kind of complaint. It stands in especially stark contrast to the agency’s handling of Dr. Ian Paterson, an English surgeon who performed over a thousand botched or unnecessary procedures, largely mastectomies, on patients. It took over a decade for the NHS to shut him down.
On Monday, Aug. 31, TransActual was joined by We Exist, Trans Aid Cymru, and other UK LGBTQ groups in a demonstration at the base of the Aneurin Bevan statue in Cardiff. Bevan is credited as the creator of the NHS.
The direct action group Bash Back further condemned the NHS care stoppage, characterizing it as a “nakedly cruel policy” that will “force patients into months of limbo that massively disrupt their lives, while NHS higher-ups take their sweet time to cook up yet another sham ‘investigation.’”
“The Welsh gender care system, while not perfect, is one of the best in the UK, and delivered for trans people by collaborating with the community,” the Bash Back statement continued.
“This massive U-turn comes under pressure from the Welsh Tories, whipped into a frenzy by a terf blogger and Murdoch rag ‘The Times’, which claimed that Wales having higher surgery referral rates than England somehow proves that harm is done. That’s all it took to obliterate healthcare for hundreds of trans people.”
(Note: In this case, The Times refers to a UK-based publication, not the New York Times.)
The Wales clinic controversy is bitterly familiar. For some, it invoked painful memories of the Tavistock clinic affair. Tavistock was a gender clinic for youth operated by the NHS. Following a politically charged investigation and litigation from a “detransitioner,” the clinic severely restricted and rolled back care. In the aftermath, data indicates trans youth suicides skyrocketed, with 22 trans kids taking their own lives in the year following.
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