Today’s blog post is written by Fire, a Q42 Producer. The opinions expressed in this post represent Fire’s own personal experiences, and highlight the increasing need to improve access to necessary healthcare for trans young people. We start with a powerful poem, and then move into a critical piece expressing Fire’s experiences in the past and hopes for the future.
(Image by spadenightmaren on Redbubble)
Why must I put myself in danger,
Based on the whims of an unknown stranger?
Why must I prove to you how I hurt inside,
When you should be my goddamn guide?
Why must I want to die,
Because of the system that should literally be saving my life?
Won’t even be my ally.
Why must I make my GP learn;
To be given what I yearn?
Why must I go through hell;
When it would be so easy for you to make me feel well?
Why must my GP be an “expert” for me to get one kind of pill?
But when it comes to my overall mental health, I don’t even have to see her for a refill.
Why must I meet your requirements,
Your bullshit process was decided by tyrants.
Why are you gatekeeping?
Do you even understand what you’re asking?
On top of the emotional labour you’re putting me through,
In what is clearly your trans debut.
You’ve forced me to spend yet more money.
But don’t worry, my justice will taste sweet like honey.
This was written when I had just won the fight with my then-GP to get on a hormone bridging prescription, approximately 2 years to the day, in 2018. It is a compromise to benefit the individual (as much as the NHS permits) before the gender clinic is able to provide a prescription themselves. The requirements for getting on that is 1) the patient is already self-medicating or is highly likely to start, 2) the prescription is to reduce risk of self-harm or suicide, and 3) the doctor has been advised from an experienced gender specialist, and the lowest dose is given. At the start, I was under a different practice. I left because the GP showed no interest in listening to the NHS’s own information, nor the GMC’s, and forget lgbt+ charities, websites etc. The GP I saw at the new one wasn’t any better. She struggled to understand the same official guidance even though she claimed to have read it. There are only 3 basic requirements that people who want to use the measure must understand to follow it, and so someone who has qualified as a GP, has been for a long time, and is in charge of thousands of patients, some of whom will want the same as I, if not be in equivalent situations, should be required to have a strong understanding of these requirements. I was being supported by an organisation with professionals who actually wanted to help me, and they provided the necessary guidance as well, in addition to evidence, and up-front reassurance that she was allowed to do this. Unfortunately, I feel like none of that was enough for her. She even claimed she’d read over 200 pages of information on the subject in addition to what had been offered (unclear on whether this was medical, legal, both, or mumsnet). When she finally gave me the magical paper it was after I explained to her (not for the first time), that she wasn’t taking any risk, she is allowed to do it, her licence wouldn’t be revoked, and I’m the only one taking any chances.
The cistem (cisnormative system) allows for GPs to mistreat trans people, especially trans young people. It gives easy opportunity for GPs to make decisions of their own accord, because of their own beliefs, about the lives of people who just want basic healthcare. If they want to, they are able to deny us our needs just because of their personal wishes. There is no adequate education which teaches professionals about why a trans person would need HRT. There is no mandated training on what either side of the table can or must do. The information is out there (whether it’s legal/medical, written by the organisations involved, scientific research, or from the trans community telling society our needs, it exists, is accessible by anyone with a device and internet,) so why isn’t it compulsory for the people we must see for our medical care, from prescriptions to referrals, to know about it? Why are we en-masse educating them in their place of work? They aren’t even expected to be somewhat aware, but we have to be experts to navigate the structures designed to make things excruciatingly difficult and painful.
The NHS is 72 years old. The medical field is much older. It’s had a long time to understand us, then create policies, procedures, and guidelines to look after our lives. There are centuries worth of trans and non-binary people saying what is necessary for our survival and happiness. The conclusion is that for trans healthcare, the service we rely on is either incompetent or transphobic.
Cisgender people shouldn’t be constructing the foundations of healthcare that doesn’t affect them. Anyone unable to understand what we need (or who oppose what we need) shouldn’t be responsible for ensuring our access to healthcare.
Give up your power and privilege.
We want our rights.