GLP - We’re suing a hospital for trans discrimination

[toyl9876]

https://goodlawproject.org/were-suing-a-hospital-for-trans-discrimination/

“In May 2025, Lisa* was booked in for surgery to have her testes removed due to chronic pain. But a week before the operation was going to take place, the hospital called to say the surgery was cancelled.

The hospital claimed they couldn’t operate because the surgery was classed as gender-affirming care. But surgery for pain has nothing to do with gender-affirming care, and refusing to treat someone just because of their gender identity is discrimination.”

If there is a president of not offering the procedure for pain then I can see that there will be no case for discrimination based on refusal.

I think the GLP are highlighting that discharging him reflects unequal treatment because the discharge was on the basis of referring to GIC.

The questions arising here is whether clinical reasoning to discharge was sufficiently thorough. Woukd he have been discharged if a GIC referral hadn’t been made. What would they do with a non trans patient for who a GIC referral wasn’t appropriate.

My guess is that they do discharge and make referrals to psychiatry, psychology and other teams when they conclude pain is not caused by urological issues.

A quick literature search also reveals that in th very very rare instances that orchidectomy is performed for pain it often doesn’t cure the pain.

Because chronic pain is complex and removing the offending organ is only very rarely the answer.

Lisa is arguing that it’s transphobic that he wasn’t allowed to have an operation that no one (bar a dead testicles or cancer) gets anymore. I will speculate that it’s “complex” because he was unusually insistent about wanting it.

Defence to a claim in court overrides patient confidentiality. I think it falls under the “legitimate interest” part of GDPR.

Yes, when it gets to court.

But not right now. So GLP can publish all sorts of claims to get some cash coming in but the defending team can’t just yet.

If there is a president of not offering the procedure for pain then I can see that there will be no case for discrimination based on refusal

I posted a review article upthread listing the treatment modalities of chronic testicular pain, of which surgical options (microsurgery to the spermatic cord) were in the “only if necessary”
category, after MDT approach and pain relief.

Orchidectomy was listed as a “last resort” that wasn’t always successful. Trans Reddit highlighted the NHS guidelines saying that orchidectomy was only performed for dead testicles and for cancer.

So no, it’s not an operation offered for pain now. especially as a decent proportion of men still seem to have the pain after the organ has been removed.

One can only speculate as to why Lisa was so insistent this be done, but if it were done, it would be out of keeping with current best practice.

Oh thats right. Sometimes the “responsible” party keeps quiet and has a great hand to play, and sometimes they don’t. Look at NHS Fife in Peggy.

I guess, following the Tavi debacle and having spent over 20 years working in NHS trusts, I know that there are rogue departments and teams that operate unconventionally.

My spidey sense are activated by the clinician who did refer the patient for an orchiectomy for pain. We don’t know if this was an outlier or if others treated by this this team have been referred for the same reasons and have had the surgery. The claim is about discrimination rather than evidenced based practice.

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.

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.

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’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.

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.

That is a possibility; the realisation they were opening the door to SRS via the backdoor.

The comparator will be a man who does not identify as a woman; 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? And if this is the case, then what are the additional complications of the situation due to the gender identity that led to 'no' being seen as a reasonable answer?

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.

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

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

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

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.

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.

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.

The whole thing is bollocks really

😆

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".

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.

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

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.