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Is Gender Reassignment Surgery Available On The Nhs Online

LONDON — Doctors are "failing to help patients with gender dysphoria," a leading British doctor has warned in the British Medical Journal

The need for hormone treatment has never been higher, but “as many as one in five GPs won’t prescribe for people with gender dysphoria, even after expert advice from an NHS clinic," according to James Barrett the President of the British Association of Gender Identity Specialists.

SEE ALSO: ‘She was only called Ms. after she died’: Transgender women in British prisons

The NHS defines gender dysphoria as a "condition where a person experiences discomfort or distress because there is a mismatch between their biological sex and gender identity." 

The Office for National Statistics does not produce estimates of the number of transgender people living in the UK, but trans rights organisation Press for Change estimated there were around 5,000 post-operative transgender people in the UK in 2014. And, the combined wait list for the UK's 11 gender identity clinics is in excess of 5,000 people, says Barrett, citing NHS England figures. 

Conservatism is at the heart of GPs' refusal to help patients, says Barrett, who is also a consultant psychiatrist at Charing Cross Gender Identity Clinic in London. 

"Currently, however, in the experience of those of us who work at gender identity clinics as many as one in five GPs won’t prescribe for people with gender dysphoria, even after expert advice from an NHS clinic," he writes. 

Barrett says that reasons GPs have given for refusing to treat patients with gender dysphoria range from it being against “deeply held Christian beliefs,” to statements like “we are trained to treat illnesses, not to change nature," as well as concerns about it being dangerous, difficult, expensive.

This refusal to provide care contravenes NHS England guidance, however. Barrett says that NHS England’s guidance stipulates that: “GPs are expected to care for people with gender dysphoria just as for any other group with an uncommon condition easily managed with a joint care model.”

“Patients are still [...] referred to by their old title or legal sex, sometimes years after hormone treatment or gender reassignment surgery.”

LGBTQ rights organisation Stonewall has also found widespread evidence of a lack of confidence among doctors when it comes to treating trans patients. 

"Our research found that a quarter of health and social care practitioners with direct responsibilities for patient care are not confident in their ability to respond to the specific care needs of trans patients and service users," a Stonewall spokesperson told Mashable.

"In fact, only one in 10 practitioners with direct responsibility for patient care said they received training on the health needs of trans people," they continued.

Stonewall says training providers at medical institutions, as well as schools and universities should provide teaching on how to be LGBTQ-inclusive. 

There are also serious issues with the way in which transgender patients are treated by doctors, according to Barrett. 

"Their transgender can be viewed as a psychiatric illness, which it never was, and can feature in every medical consultation and referral even if not relevant to the ailment in question, in a manner that would be unacceptable if the issue was that they were gay or black," writes Barrett. 

“People with gender dysphoria aren’t freaks. They are teachers and accountants, police officers and doctors, parents and taxpayers, and — importantly — patients as deserving of respect and decent, routine NHS care as anyone else. It’s about time they started getting exactly that.”

All registered UK medical practitioners will receive an email from the GMC (General Medical Council) with a document containing updated guidance for doctors on treating transgender and non-binary patients, according to a blog post by the Chair of the NHS England Gender Task & Finish Group, Will Huxter, on Thursday. 

The document: "reaffirms previous guidance published by NHS England on the responsibilities of GPs in the prescribing and monitoring of hormone treatment for transgender people."

We've reached out to the NHS for further comment.

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Sex change ops on the NHS have trebled... since the procedure became a 'right'

By Stephanie Condron for The Mail on Sunday
Updated: 01:11 GMT, 28 June 2009

The number of people having sex-change operations on the NHS each year has almost trebled since the procedure became a ‘right’.

More than 1,000 people have had the surgery in a decade, costing the taxpayer up to £10million.

Eighty per cent of the operations are to change a man into a woman.

In addition to surgery, transsexuals can also get psychotherapy and hormone replacement therapy on the NHS.

'It's our right': Demand for sex changes on the NHS has soared with more than 1,000 people having the surgery in a decade

But critics argue that sex-change operations are a waste of valuable NHS resources when people are dying and suffering because of healthcare rationing.

Opponents also cannot understand why people need a sex change for what they interpret as a psychological malaise.

Sex changes on the NHS became a right in July 1999 after the Appeal Court recognised that those who believed they were born into the wrong body were suffering from a legitimate illness.

In 1999, the year sex changes became free, 49 people had the operation on the NHS in England.

But last year that figure had increased to 137, according to the latest figures from The NHS Information Centre.

Since 2005, between 135 and 145 people have had the surgery each year. Justifying the figures, a Health Department spokesman said: ‘When individuals are denied treatment, psychological distress and depression are common and suicides have been reported.’

All change: Critics argue that sex change operations are a waste of valuable NHS resources

Before the change in the law, if transsexuals could not afford the basic £10,000 cost of surgery, it was down to the local health authority to decide if an operation would be funded. If applicants for grants were unsuccessful, they would have to go private.

In addition to the NHS figures, Bernard Reed, from the Gender Identity Research and Education Society charity, estimates that last year at least 150 Britons had their sex-change operations privately, either abroad or in the UK. He said: ‘Gender confirmation surgery is absolutely essential. It is an innate condition. People who are born with this condition have no choice.

‘It is not that they suddenly wake up one morning and say, “I would like to be a woman”. That is what most people do not understand.’

The surgery can comprise more than one procedure – conducted during the one operation.

For a man wanting to become a woman, surgery involves the removal of male genitalia and the creation of female genitalia.

Breast enlargement is not normally carried out on the NHS, although some breast tissue is formed ‘naturally’ as a result of hormone doses which are given during a sex change.

For a woman to become a man, the breasts, uterus and ovaries are removed and male genitalia is created. Not available on the NHS is costly hair removal.

A quarter of sex change operations are conducted at Charing Cross Hospital in Central London.

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