My post on the person suing NHS was taken down

[Tesla73]

So I am posting it again with no comment

www.birminghammail.co.uk/black-country/transgender-woman-rowley-regis-sue-21817673

From the NHS website:
Gender dysphoria is not a mental illness, but some people may develop mental health problems because of gender dysphoria.
www.nhs.uk/conditions/gender-dysphoria/

It's obviously not a physical illness, but if it's not a mental illness either, why does it need medical treatment?

Surely all the treatment which is required is treatment for the mental health problems which result from the gender dysphoria. Not cosmetic surgery.

@Fieldofgreycorn you do realise that most gender affirming treatments like puberty blockers, cross sex hormones and so called sex reassignment surgery destroy the child's ability to ever having a fully functioning sexual relationship ie if you start pbs before you can orgasum and then go on to cross sex hormones that they will never be able to. Add to that in boys the penis won't have enough tissue to create a neo vagina and with girls they end up needing historectomies due to vaginal attrify and other complications of taking testosterone often in their 20s! Also falioplasties (sp) are not functioning penises
This is not a course of treatment that allows them to have sex, sexual intimacy or a functioning sexual relationship it infact strips these children of any chance of them all whilst also sterilising them

Why would people describe surgery that helps someone be able to have sex and sexual relationships and be intimate with another person as “cosmetic’ or ‘aesthetic’?

If someone's sexual organs are healthy, why do they need surgery on them? Are you saying that you believe that people can be 'born in the wrong body'?

I don’t think it’s as simple as ‘born in the wrong body’ but if someone is so unable to function because they have the body of what feels like the wrong sex, then I would say that was a medical condition. Otherwise why would you need medical treatment?

@Fieldofgreycorn

I don’t think it’s as simple as ‘born in the wrong body’ but if someone is so unable to function because they have the body of what feels like the wrong sex, then I would say that was a medical condition. Otherwise why would you need medical treatment?

That was really my point. Gender dysphoria is not, according to the NHS, a mental health condition. So why does it need medical treatment?

But if it is a mental health condition, and you seem to agree that it is, how is it different from someone who can't function because they think they are too ugly, or their nose is too big, or they're too short or too tall or that one of their limbs doesn't belong to them?

Many people are unhappy with their bodies for all sorts of reasons, sometimes to the point of being unable to function. In most cases this is not treated by surgery on the offending part of the body.

Interesting article on this:
www.theatlantic.com/magazine/archive/2000/12/a-new-way-to-be-mad/304671/

We don't preform lipo suction on those with anorexia...I know this as between 14 and 28 it was a constant request of mine as was gastric band surgery but I was always denied.
To me my body didn't fit me. It wasn't me.
It was my enemy.
To look at myself everyday caused me immense pain. I hated my body and suicide was always a close option.
No cosmetic surgery was offered.
I was rightly told I needed mental health support.

Should I sue?

@Fieldofgreycorn

I don’t think it’s as simple as ‘born in the wrong body’ but if someone is so unable to function because they have the body of what feels like the wrong sex, then I would say that was a medical condition. Otherwise why would you need medical treatment?

If they feel they have a body of the wrong sex, the logical treatment is not to change the body to create a simulacra of an opposite-sex body, the logical treatment is to change the feeling.

That's the treatment we apply for every other body dysmorphia disorder.

Of course, all patients with body dysmorphia disorders can forego psychiatric care and opt for surgery instead. But not on the NHS.

Why should this particular body dysmorphia disorder be different? Because it is backed up by a belief system that posits we have disembodied, but sexed metaphysical entities that can inhabit opposite-sex bodies?

No? Then why?

Suffering? I have a family member who suffered greatly from a cosmetic issue and still couldn't get her problem fixed on the NHS. She paid to go private and it all went terribly wrong. It took years to fix the damage caused by surgery, which cost a lot of money. Should the NHS pay to fix damage from private surgeries?

The clue is in the title National 'Health' Service! The person is not unhealthy.

@OldCrone thank you for sharing that Atlantic article. It is a fascinating and very illuminating read.

If no one in the NHS wants to work in this field then suing won't make any difference.

The capacity is limited by those willing to engage in what appears to be not healthcare, it's body modification.

@Fieldofgreycorn

I don’t think it’s as simple as ‘born in the wrong body’ but if someone is so unable to function because they have the body of what feels like the wrong sex, then I would say that was a medical condition. Otherwise why would you need medical treatment?

Why wouldn't you try to fix the feeling that the genitals are wrong before trying radical surgery - which is not guaranteed to cure the dysphoria?

Given that both dd and waited 23 months longer each than the recommended time for an appointment...

and that it took 30 years for me to get a diagnosis for one of my conditions... (yes 3 decades)

I honestly don’t know how or why medical interventions such as hormones for trans people are now thought to be better rushed through?

This did not use to be the case. It was considered psychologically important to take a long period of time to live outwardly as a man or woman, before taking the next step of medical interventions.

Personally I feel that any medical procedure done in order to solely improve mental health, by that I don’t mean treatment for bipolar, but things like breast enhancements, body changing, are in a bit of a minefield. There is a lot of evidence that seeking medical procedures in order to feel better can actually damage your mental health. Caution is needed. There is also a big question mark over how much of these should be funded by the NHS. Given that it is supposed to be evidence based, that any procedures have clear physical or mental positive outcomes, and not driven by idealogy. It all needs looking at in an objective, medical and harm/risk robust decision making framework.

@midgedude

mental health issues are detectable in the brain

We may use self reported evidence but we also know there are detectable brain changes , chemical imbalances etc

How many people do you know with depression who have had a brain scan to look at the changes in the brain?

@Fieldofgreycorn

I don’t think it’s as simple as ‘born in the wrong body’ but if someone is so unable to function because they have the body of what feels like the wrong sex, then I would say that was a medical condition. Otherwise why would you need medical treatment?

You are aware that surgery cannot create fully functioning vaginas and penises, right?

@OldCrone

I’m asking for what we are entitled to, what everybody else already has and has had for many years.

What healthcare are people who identify as transgender being denied which is provided for everyone else?

Being transgender is not a medical condition. The NHS doesn't have to provide treatment for this since there is no medical condition to treat.

This.

@Eucalyptustrees

If no one in the NHS wants to work in this field then suing won't make any difference.

The capacity is limited by those willing to engage in what appears to be not healthcare, it's body modification.

This is the crux of it for me.

We look at the people who have modified their bodies to resemble cats, lizards and Barbie/Ken dolls and we wonder what has gone wrong. We wonder why the mental health provisions are so poor.

We don't suggest that they really are cats, lizards and Barbie/Ken dolls. We don't change laws and create policies to reify their beliefs and we don't expect other people to put out a saucer of milk or feed them live mice and sack them if they refuse.

I find it impossible to get my head round surgically altering healthy bodies, creating life long patients and long term health implications as a result rather than taking a non invasive approach such as addressing mental health.

But then I remember that many of these people are just pawns in a movement that is more about undermining safeguarding and dismantling women's rights and it all becomes clear again.

I am not going to enter into a debate with people on this forum generally or in this thread specifically, nor am I going to address all of the myriad points raised prior to this post, however, I cannot let the amount of deliberate misinformation being propagated pass without any comment.

1. I absolutely empathise with everyone that is either personally waiting for, or who has a family member, friend, acquaintance, etc who is waiting for care through the NHS.
2. I personally consider discussions about whether some conditions that fall within the deemed scope of NHS provision are more deserving than others to be cruel and inappropriate. If the condition has been deemed to be appropriate for care by the NHS, so be it.
3. The NHS provides healthcare services to people for a variety of conditions that are not considered to be critical or immediately life threatening or mental health issues. Take for example care during pregnancy. The NHS also provides a range of services to address quality of life and other issues such as smoking, obesity, etc.
4. There are 7 adult Gender Identity Clinics covering the whole of England. Some of these clinics have a satellite in another town and there are now also around 4 or so small pilot projects trialling a different service delivery model.
5. In January 2020 (i.e. before Covid) there were approx 13,500 patients on the waiting lists of these 7 clinics with typical waiting times of 2+ years to a first appointment. Note, this is a first appointment, it is not a waiting time to receive a diagnosis, therapy or surgery.

6.While waiting, many if not most transgender patients will not receive any trans-health related care from their GP.

1. More recent statistics indicate that around August 2021, waiting times to a first appointment had increased to between 44 and 62 months. I believe that there has also been a marked increase in the number of patients on the waiting lists but I do not have the data on this to hand.
2. The clinical pathway involves an initial consultation and then there is a second consultation, typically around 18 months later. This second consultation may result in a diagnosis of gender dysphoria. If the patient is diagnosed with gender dysphoria, they will then be referred for treatment/services such as hormone therapy. It may take more than two consultations before a diagnosis and without a diagnosis of gender dysphoria, there is no NHS treatment.
3. The NHS does not provide 'cosmetic' surgeries such as breast augmentation or facial feminisation.

I agree that waiting times, are too long. To feel distress and mental anguish and be told that you could be waiting in excess of 5 years to even have a first consultation is appalling whatever your reason for attending.

But I do think that the process should be more rigorous in terms of addressing other causes of the distress before treating it physically and irreversibly. That therewith be other cases should not be taboo.

That there might be other causes should not be taboo.

platinum of course discussion of whether certain treatments should be available on the NHS are appropriate. The NHS is not a bottomless pit of money and there are always ongoing discussions about what treatments should be available on it. That was why NICE was set up!

What on earth do you think pregnancy care is for if not because it can be immediately life threatening? Not so long ago child birth in the UK was the leading cause of death of women and even now maternal mortality in the UK stands at 17.4 deaths per 100k live births with women over 40 7.7 times more likely to die than women under 25. In Africa maternal mortality is around 1 in 100. In addition perinatal mental health problems affect up to 20% of women. And that is before we start to consider the child...

I can't believe quite how ignorant someone must be to consider pregnancy care so trivial.

Platinum78 I've no idea what thread you've been reading, but no one here has denied that the NHS provides not only care for immediately life-threatening injuries and conditions and life-saving treatments for other issues but also treatments that merely improve the lives of patients.

So your point 3 is a bit pointless here. Well, other than displaying rather astonishing ignorance about antenatal care. Pregnancy complications are common, health issues are common, pregnancy loss is unfortunately common and without antenatal care all of these problems would occur even more frequently.

And tough on point 2. Ongoing discussion and it ain't stopping anytime soon, however distasteful you find it. Necessary because funds are limited. NHS resources are finite and must be allocated according to most pressing need first.

Your point 9 is false. The NHS provides cosmetic procedures under some circumstances. Each health board makes their own decisions as to what they will or will not cover and under which circumstances. Hence I know patients who had those kinds of procedures on the NHS.

We don't need your info on points 4 to 8, we're quite aware. What we've been saying is that long waiting lists are the norm for many other conditions. Did you somehow miss that?

What we're saying is that the claim that patients who identify as trans are treated worse than all others is false. Go and talk to a few parents waiting years for their kids to get a proper diagnosis (just met an old friend in the park, who told me they'd finally got that appointment to get their kid tested and diagnosed. Only took them 6 years. Which means they missed out on help during vital developmental stages.) We waited two years for something where the waiting list target says six weeks for our kid. I was in agony for nine months while waiting for a bed to free up for surgery. And after my op I cleaned the toilet myself and fed my bed neighbour because there wasn't enough staff to go around. I mean this is not unusual for a healthcare system that is underfunded and understaffed.

The one thing I wouldn't dream of doing is suing the NHS and making it worse by forcing them to divert resources to lawyers. But maybe that's just me.

I know patients who had mental health issues because certain parts of their body were not as they felt they should be
Breastfeeding ruined my breasts. They’re two massively different sizes. I find it very upsetting, have cried and told DH I’m going to kill myself because I can’t live with this deformity. The NHS won’t do anything because it’s cosmetic. So are we now saying that if I’m upset enough about it then it counts as a MH issue and they have to fix it? Because I find it very wrong that trans people can have their breasts surgically altered on the NHS but I can’t.

hamtonn

@Platinum78 of course you are debating - that is the whole point of a thread, to put opinions out there and listen to others, not dictate to others.

I’ve worked in the NHS for many years and there are constant discussions about treatment and care, what ‘conditions’ are eligible or not. It’s very important and it evolves constantly. Especially in the case of people wanting cosmetic or medical treatment for things which are not medically necessary for their physical health or for a mental health condition such as bipolar.

Women who have had breast cancer, for example, are sometimes offered breast reconstruction. People with burns, or disfigurement are usually given options for surgery also, as it is generally accepted that this impacts on quality of life. The finances are not finite so there is also a cost / benefit analysis. This is true even of life saving drugs.

With body changes that are not necessary for medical health, this is a tricky area. As I’ve said before, if you’d bothered to read my post (which I hope so as I have given you the respect of reading yours) - there is evidence of potential harms. These cannot be from pressure groups, lobbying or surveys. Medical treatment must be based on good research on benefits / harms. That is how different ‘conditions’ are weighed up, and this will also impact on waiting times. A condition which needs urgent care should always be prioritised.

All of these must be weighed up. I’m afraid I found your post to have weighed this up already in your own mind, based on assumptions. It reads like you have determined that a trans persons need for medical intervention is rather urgent, is medically necessary within a certain time frame and has clear evidence of benefit / no harm. I don’t think that is the case at present, and the health condition harms / benefits compared to other conditions harms / benefits are absolutely to be taken into account.