Bit of a long post ahead: short version = this is dangerous.
This is a doctor I would have concerns about visiting with other conditions, or if I was presenting with gender dysphoria myself.
I would also be concerned with his understanding of shared decision-making.
An overarching concern:
Harrop: It’s quite easy to spot transphobic colleagues in the medical profession: they consistently fail to acknowledge or accept that trans-affirmative healthcare is a life saving treatment, & that trans peopleare willing to take on even potentially life threatening risks to access it.
Any relatively small risks, and even the risk of death itself, often pale into insignificance compared with the inevitable anguish that trans person is forced to endure if they are denied trans-affirmative healthcare
"Trans-affirmative healthcare" still doesn't have a robust evidence-base to support this approach. So to call it a 'life-saving treatment' right now is highly risky.
To conflate 'small risks' with 'even the risk of death itself' is concerning. Those 'transphobic colleagues' are essential sounding-boards for those people with dysphoria to be able to seek second opinions from.
Let's apply the same reference points to another body dysphoric condition:
Annorexia: (translated to Harrop language) It's quite easy to spot anna-phobic colleagues in the profession: they consistently fail to acknowledge or accept that anna-affirmative healthcare is a life saving treatment, & that annorexic people are willing to take on even potentially life threatening risks to access it.
In my own experience, upon telling a annorexic person that they face an elevated risk of fertility loss, heart failure, weakened immune system [or even death], I can assure you the vast majority would respond with a clear, resounding statement: “it’s more than worth it"
Suicidal patient: telling a suicidal person that they face an elevated risk of death if they decide on a non-treatment pathway doesn't result in celebratory tweets to shout about it. They may decide, following serious discussion, that this is a pathway they choose for themselves, but let's not celebrate with it's more than worth it tweet for their suicide-affirming decision.
Not quite the same, but a cancer patient with a terminal diagnosis: decides to opt for best supportive care, because their quality of life may be significantly lowered if they decide to join a clinical trial that may extend their life, but with serious side effects. 'Risk of death is worth it' Again, it may be their right, and measured, decision, but not something we'd expect a doctor to post a celebratory tweet about?
It doesn't work, does it. You have a moral, medical and ethical responsibility to work with the person with dysphoria, rather than just barrel into a treatment regime just because your poliical agenda favours rainbows, unicorns and trans?
This is a man who strikes me as having lost his perspective on clinical care for the sake of a political agenda.
And that's dangerous.