GLP - We’re suing a hospital for trans discrimination

Oh, I didn't see that GLP had published an independently verified copy of a letter confirming this or the hospital has confirmed details regarding a patient's medical information to the Press. Is it possible to link to this?

The only information that's been released publicly about this case is the GLP press release, which says nothing about Lisa's stage of transition, hormone profile or wishes to preserve or not preserve health aspects of the testes. So either you have inside knowledge or you've just made all of this up.

In which case it was very foolish of the hospital to tell the patient they'd cancelled because they don't do gender affirming care rather than explaining the actual reason.

Bearing in mind the fact that it's something open to being spun, it could also as easily be that the patient failed a preop (things like BMI, blood results, undisclosed additional medication affecting risk of DVT or pulmonary embolism..) or it had to be cancelled due to actual emergencies or surgeon/theatre availability.

Their track record of bringing discrimination cases on behalf of individuals is actually pretty good, they successfully forced a new inquest in the death of Aiden Longmuir earlier this year - or does a case from three months ago not count as "current" enough form for you?

They declined to operate after having scheduled the operation. If it was simply the case that the patient's symptoms didn't warrant surgical intervention, the surgery never would have been scheduled in the first place. Surgery isn't scheduled out of thin air, you have to have at least one, often multiple, surgical consults first, so a surgeon must have met this patient, listened to their symptoms, and agreed that surgery was indicated and that they were happy to perform it. Then suddenly they changed their mind, claiming it was "gender affirming care" which they don't do, even though it clearly wasn't considered to be "gender affirming care" when it was scheduled or they never would have scheduled it because they don't do gender affirming care. So what's happened here is either a necessary medical procedure has been cancelled because the surgeon discovered their patient was trans, or somehow a massive multi-level mistake was made resulting in unnecessary surgery getting as far through the system as to actually be scheduled, which in itself is a situation which lets down the patient and requires some investigating and explaining. Either way, something has gone badly wrong here.

Obviously, I have no idea, but it would be very interesting to know if Lisa's testicular pain started when he started taking oestrogen and/or blockers and/or started tucking.

Been looking for study evidence for any of these causing testicular pain, but can't find any (quelle surprise). Some anecdata here https://www.reddit.com/r/MtF/comments/etnqpo/is_testicular_pain_normal_on_hrt/

It would be useful for doctors/surgeons/gender clinics to actually have some curiosity about the treatments they provide. And then show some balls and publish what they find.

Of course we'll have to wait and see, but I'm going to go out on a limb and say that based on their current run of form, the likelihood of the GLP winning a court case seems fairly low.

Torsion is emergency surgery and would only result in orchidectomy of the twisted one if it had been deprived of blood supply for long enough for tissue death.

How common is it, for instance, that both testes have "chronic pain"? 🤔

But the doctors do have that info.

And are declining to operate.

Presumably Lisa has years’ of evidence of chronic pain, as described.
If the surgery was refused purely on the basis of being trans, then that would be an issue but it sounds like a borderline case- he wasn’t given the surgery before he was trans. He was offered the surgery after he transitioned. He was unhappy about treatment that preserved his hormone profile.

Then they decide Lisa’s treatment would be more appropriate from a gender clinic, which as Lisa doesn’t want to preserve any health aspects of the testes, makes sense. I guess?

It will be interesting to see how it goes, when the evidence is gathered and the case gets to court. Unless the NHS settles for an easy life.

I doubt very much it's a torsion because surely that would be a surgical emergency needing immediate attention.

I'm sorry to hear about your friend, I hope she gets surgery soon. I've had ovarian cancer too and also had to wait for surgery so I fully sympathise. I don't think anyone, including "Lisa", would argue that cancers and other life-threatening conditions shouldn't be given priority on the wait list, but this doesn't have to do with wait times, it has to do with being refused treatment altogether, which is a different issue.

No way is this fair. I've heard in incredible detail about women's surgery at the office. Some people have no filter and it seems pretty split across the sexes.

About Lisa's testicles there isn't really any way of knowing, I guess the medical detail will come out at trial. He could have torsion, there's no detail that I've seen about it.

Only a bloke would come back to the office and go on and on about this in such detail. No one wanted to know.

Yes, I worked with a guy that had this done as he had testicular tortion which was agonising, sudden onset pain and he was somewhat annoyed at the surgeon wanting to have a conversation before he operated about which size of replacement saline sac he wanted inside his testicle pouch as he didn't care either while it hurt or while he was off his face on drugs. But he had to attempt to stand up and have his testicles measured first.

Not true again.

I said it wasnt true that surgery was routinely carried out for chronic pain which is what you said. That is what is not true!

I didn't say it was "extremely common". Several posters said it never happens at all, they are provably wrong. I also repeat my point we have no idea if this patient has a history of cancer, non-cancerous tumours, cysts, injury, torsion etc and we can’t assume they don’t just because a short anonymised press release didn’t share every single detail of their personal medical history.

It's also the case that this person had a date for surgery booked in, this means there was a surgeon who was perfectly prepared to carry out the procedure based on the symptoms the patient presented with apparently until they realised the patient was trans. If this was simply not a surgery it was possible to have and/or not indicated by the symptoms, it never would have gotten as far as being scheduled.

Also, presumably as it's keyhole surgery they wouldn't be removing the whole lot, they would take out the inner organ only which I would guess is not what the patient wanted.

Careful, you'll start a fad! Think how much you'll save on haircuts, shampoo and hats!!

Yes, and it’s very rare that this would be the treatment offered for chronic pain alone. Just because it’s possible doesn’t mean it’s extremely common like you said it is. It really isn’t.

https://www.mkuh.nhs.uk/patient-information-leaflet/orchidectomy

"Why do I need an Orchidectomy?

It should have been explained by your doctor but it can be performed due to various reasons:

• To remove a diseased testicle
• To remove a testicle because it is causing persistent pain.
• To remove a tumour in the testicle"

https://www.baus.org.uk/_userfiles/pages/files/patients/leaflets/Chronic%20scrotal%20pain.pdf

"What can be done about chronic scrotal pain?...

• Men may choose to have surgical removal of the affected testicle (simple orchidectomy)"

https://onestophospital.co.uk/treatments/keyhole-orchidectomy/

"There are several medical and therapeutic reasons for undergoing a keyhole orchidectomy. It is commonly used as a treatment for testicular cancer... It may also be recommended for severe testicular trauma or chronic testicular pain"

I’m sure they would have mentioned if he had a condition where it would be reasonable to remove his testes no? Instead all they’ve said is that he has chronic pain.

Well if Lisa is suffering with testicular or prostate cancer, torsion, blunt force trauma, and surgery is the standard course of treatment, then I and most rational people would agree that withholding the option of surgery is medical negligence. But from this article Lisa is attempting to sue the NHS for discrimination.