The doctor who damaged his own legs in order to get them amputated was mentioned earlier.

He was a fan of Marius Gustavson's EunuchMaker website.

Well coincidentally he's just been struck off.
https://www.standard.co.uk/news/health/doctor-gruesome-fetish-struck-off-b1284307.html

Yes, Lisa definitely wanted them chopped off.

• Cord block first? "Nah, chop them off."

• Lisa realises he cannot really refuse the cord block. They do it. Lisa pretends for a bit, then says "Chop them off".

• Might not work for your pain? "Don't care, chop them off."

Surgeons start to get wise to this... The big question is what are the GLP hiding in Para 12.

Para 20 (2):

The Claimant has been on the list [redacted] (in order to access hormone treatment, which she currently receives privately)

Definitely DIYing.

But then it also says this, in Para 10:

She is a transwoman currently on testosterone blockers, so the benefit would be that she can likely reduce or stop these post-surgery. I will leave this to her Endocrinologist to monitor and decide.

So maybe the referrer knew he was DIYing, but the surgeon didn't? Am confused.

Could it be the claimant is DIYing his oestrogen?

Paragraph 6 would seem to say that. (And nowhere else does it mention that he is being prescribed anything, or is under the care of any other medical service.)

So maybe he hadn't told them, before the heavily redacted exchange of para 12? And then that changed everything.

6. The Claimant has been taking gender affirming hormones [redaction of about five words]. The Claimant has been referred to NHS Gender Services, however, there is a lengthy waiting list and therefore any further gender affirming treatment is not presently available to her

Yes, the comparator would have to be a man, how on earth would it ever be a woman? If it ever should be, it’s physically impossible here.

The crucial details in Paragraph 12 that detail why the surgery was cancelled are completely redacted. Could it be the claimant is DIYing his oestrogen?

A point occurs to me about the nature of the claim. If a doctor treated the claimant negligently, either because of ignorance or because of discrimination on transgender grounds, the claimant would be best advised to approach a no win no fee medical negligence lawyer.

The fact that this is framed as a discrimination claim suggests that the doctors did act in accordance with established practice by properly competent doctors in their specialist field, and it is accepted practice that is being claimed to be discriminatory.

I think this makes it hard to be sure how the case will go.

Sound like FoxKillah has attached himself to another unreliable witness...

Yes, this may be part of the reason for referral to GIC - Lisa being advised to discontinue testosterone blockers as they are a possible cause of the pain.
Lisa not wanting to do this.

I can imagine this would cause concern to the surgeon, in terms of less invasive options (discontinuing the testosterone blocker) not having been tried.

They've always got to think about - if the patient later complained, would they be able to justify their decision.

i.e. if after the surgery, Lisa (or patient X) complained - "the surgeon removed my testicles - both of them - it hasn't helped the pain - couldn't they have tried something else?"

Then the surgeon has to be very confident that they made the right decision in removing the testicles, and be able to argue in court why they did this when a potentially reversible cause was present.

Yes, there's often a risk of ongoing phantom pain, plus possible pain from scarring/adhesions.

It's not as straightforward as "remove painful body part = remove pain".

The whole thing is bollocks really

😆

Taking testosterone blockers (androgen deprivation therapy) can cause testicular pain or discomfort. This is usually related to the rapid drop in testosterone levels and the resulting shrinkage of the testicles.
*Protate Cancer UK

Maybe Lisa should stop the hormone blockers if the pain is that bad.

So would this be classed as discrimination. Lisa can't have the surgery in the same way that a man not requiring female sex hormones would.

Is the NHS expected to push Lisa to the top of the gender services queue because of the pain?

The whole thing is bollocks really as the NHS states it rarely would carry out this surgery for purely pain symptoms.

Why doesn't Lisa go to her private dr in that case to start the hormone therapy?
The 'Claim' document says Lisa is already taking 'gender affirming hormones', presumably from private doc.
There is so much going on here that is unclear; I guess more info will emerge when NHS gives its side of the claim.

Thanks, I've completely missed this. It's hard to follow as some important parts jave been blanked but this part is interesting

The Claimant has now been referred to the gender clinic instead. The
gender clinic has a current waiting list of 6 years 9 months for a first
appointment. The Claimant has been on the list (in
order to access hormone treatment, which she currently receives
privately), so she has approximately 17 months’ wait before her first
appointment. After this, the gender clinic protocol is that she will need to
have a second appointment (for which the average wait is 4 months), be
referred to endocrinology for hormone treatment, take hormones for 1 year,
and then be referred to urology for surgery. It is likely, therefore, that the
Claimant will have at least a 3 year wait before being considered for a
urology referral .

So in order for Urology to consider performing the surgery, Lisa would need to have been taking hormone treatment for 1 year. I assume this is different to the testosterone blockers Lisa takes privately. Why doesn't Lisa go to her private dr in that case to start the hormone therapy? No wonder the surgery was cancelled.

PP posted this earlier:
https://goodlawproject.org/wp-content/uploads/2026/05/REDACTED-Particulars-of-Claim-for-campaign-1.pdf

Oh I didn't know that, thanks for the info.

He was already on testosterone suppression and 'gender affirming' hormones, apparently.

would he in the same clinical circumstances be offered this treatment in the way that this patient was not, with the sole reason for the difference being the gender identity?

It doesn’t have to be the sole reason for the difference. Unlawful discrimination occurs (or can be) when the protected characteristic forms any part of the reason for less favourable treatment. There’s a lot of comment in discrimination judgments on this.

I hope that this is the case as it would show the system and processes are working.

They can and do work well, but with chronic lack of investment and ideological capture, there are undoubtedly dubious practices out there. It isn’t beyond the realms of possibility that some hospitals are paying fast and loose. If it were the case that a hospital in Brighton or Bristol were providing orchiectomies via a pain/ urology route it would be shocking but not surprising.

I’m not a legal expert, so I may have things wrong.

The points I am raising arise from my experiences with grievance hearings and internal investigations. Complaints about bad practice have rested on clinical decision making whilst complaints about discrimination haven’t. Discrimination complaints focus on whether the treatment has been different as a result of the protected characteristic.

The GLP are highlighting that the patient was discharged from urology. Is it standard practice to discharge patients when a nerve block treatment is reported as not working? Is it typical to offer more follow ups or investigations? If so, the Trust will have to defend why they didn’t follow this route in addition to making the GIC referral.

As others have highlighted. This could be something or nothing, depending on the care the patient received. The GLP are making bold claims, hospital records will substantiate or disprove them.

Thats what I was thinking. If the urologist had at first agreed to this extreme surgery for whatever reason, an endocrinologist would have been consulted re the need for Life long hormone replacement. You can't just chop both balls off and say have a nice life. That would be rather negligent of a surgeon. The usual protocol would be testosterone replacement but obviously this is the last thing Lisa would want. Maybe he asked for Estrogen hormone replacement and at that point the trust said in that case this patient's treatment falls under gender affirming care.

I think a naive, easily persuadable, people pleaser doctor who went along with what Lisa wanted, but got pulled back into line by the rest of the dept.

It’d be harder for urology in one dept to go rogue with removal of testes when others don’t, given that (if bilateral) there would need to be endocrine involvement as well, meaning that two departments would need to be rogue. As well as the rotating urology and endocrine registrars who would be WTF is going on here.

The claim is about discrimination rather than evidenced based practice.

You keep saying this, but evidence based practice is the defence against discrimination. If there is no evidence base for the removal of generally healthy testicles to cure pain then the decision to not remove them is based on evidence based practice, not because Lisa is trans.

The best Lisa can hope for is an apology from whoever raised his hopes of it going ahead when there is no evidence based practice to do so.

Other plausible explanations include they became acutely aware Lisa was trying to pull a fast one.