Exclusive: NHS trust stops referrals for transgender treatment
An NHS trust has been criticised for temporarily stopping treatment referrals for transgender people.
NHS West Kent is also ceasing referrals for gastric band surgery and couples seeking IVF but trans campaigners say people with these conditions do not have a high suicide rate, unlike trans people waiting for treatment.
Transgender patients wishing to attend a gender dysphoria clinic for hormone treatment and surgery will have to wait until March 31st at the earliest to be referred for further treatment and the delay is expected to cause backlogs.
“Urgent” cases will still be referred but it is not clear which cases will be given priority.
Michelle Bridgman of the Gender Trust, one of the UK’s largest transgender charities, attacked the decision.
She told PinkNews.co.uk: “We predicted this might happen when George Osborne began wielding his scalpel. West Kent PCT have announced that they will be deferring funding for any new referrals but that they will be advising GPs that ‘urgent’ referrals are to be continued. We see this as undue delay.”
The PCT’s decision, which comes into effect immediately, was made despite repeated government assurances that NHS services would be protected from public spending cuts.
But Daryl Robertson, NHS West Kent’s deputy chief executive, defended the move.
He said: “We regret that we are currently asking GPs to defer referrals for some treatments and appreciate that this may cause further distress for individuals. We have not made these decisions lightly, and have considered a range of treatments where a delay in referral will have least clinical impact.
“However, where there is a compelling clinical need for treatment patients will not miss out. This is not a permanent position and referrals will be made as normal in April.”
Mr Robertson added: “No urgent referrals are being deferred, and we are working closely with GPs and specialists to make sure that where patients’ needs are pressing, these can be met as soon as possible.”
NHS West Kent is currently responsible for the healthcare of 655,700 people, though the official number of trans referrals for the area is not yet known.
Bernard Reed OBE, of the Gender Identity and Research Society, estimates that the funding cuts could affects hundreds of people.
He said: “Within that area there will be about 7,000 people who have experienced some degree of gender variance. Of that number we estimate that about 175 have so far sought medical help and that figure will be increasing by 19 per annum.”
The Gender Trust is now calling for an independent review. Ms Bridgman said: “When will funding commissioners get past the misguided notion that trans people are opting for a lifestyle choice rather than a pressing clinical need?”
Describing the news as ‘the thin end of the wedge’, she said the money-saving measure did not take into account the true cost to the NHS of denying gender treatment.
“GPs rarely have sufficient knowledge and yet again PCTs are deferring treatment without any proper impact assessment. I asked what they would do for the inevitable increases in cases of depression and even suicide: there was no response,” she said.
The high suicide rate among trans people is well documented, with recent research showing that 41 per cent of transgender people in the United States have attempted to kill themselves.
Additionally, the cost of mental health support averages around £4,000 per year – compared to the cost of gender treatment at £9,000-12,000 on the NHS.
One trans woman currently awaiting referral for surgery in North Wales said she “wouldn’t have been able to go on” without a prescription for hormone therapy from her GP.
Emma Bailey, who runs transgender support website T-Form, said: “I think health authorities forget that the surgical treatment is a life-saving thing for many people. They need to factor in that there are people sat at home waiting for the surgery so they can get back on with their lives. For many, this is a matter of life or death.”
Ms Bridgman says that PCTs may fall foul of discrimination laws if they cease funding for trans people. She said: “We don’t see them cutting funding for any other major surgeries, and we fully encourage disappointed patients to challenge NHS West Kent on the legality of their decision. The Gender Trust will be at the forefront of challenging PCTs like this who see trans people as a soft target”.
According to legal experts, the law in this area was set by A.D.& G vs North West Lancashire Health Authority in 1999.
The appeal judges agreed with an earlier High Court ruling that the NHS had to fund gender reassignment surgery like any other legitimate treatment – and policies amounting to a blanket ban were deemed unlawful.
Following the ruling, the Department of Health issued guidelines warning care providers that discriminating against people in this way is illegal.