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.”

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.

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.

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?

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.

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.

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.

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?

Well, quite.

I agree with you - it is rare to schedule something as unusual as an orchidectomy and then cancel. Hence my musings above for which I apologise for the terrible wording. I was not looking for studies to back up my theory - but decent meta-analyses on the physical side-effects of cross-sex hormones which are lacking. Leaving redditors and everyone else wondering.

Pure speculation, but could it be that the patient had not disclosed their oestrogen/blocker use until the pre-op, when the surgeons became aware of a possibly reversible cause for testicular pain, or at least that the indication for the surgery became more complicated? I can see the urologists getting cold feet at this stage - providing NHS orchidectomy to a person taking private hormones, and whilst the pain and gender dysphoria may potentially point at the same treatment, the counselling and conversations are completely different. Also the funding streams.

Like I said, speculation. But I think plausible.

@HouseLurcherthe GLP have successfully obtained a rerun of the inquest but @letsallchantwas referring to the number of cases won or partially won. Its by no means a certainty that they will win based on their track record. There is someone on here who keeps a running record.

I dont know if all suicides are subject to an inquest (but in any case, any suicide is a such tragedy for their family and community).

Edit. This is a sidebar. I dont mean to derail the thread. I did not know about Aiden Longmuir’ case.

Whatever you think of the GLP, it's highly unlikely they'd risk being found in contempt of court by releasing a press release containing verifiably false information.

It's also a bit of a reach tbh if the only grounds you can think of to insist the case is unfounded is to just ignore the information we do know about it, and smacks of someone determined to approach the scenario with the worst faith possible for some reason, can't imagine what.

As you say, pure speculation.

But again to get to the point where surgery has been scheduled and is due to happen in a week's time - obviously I've never found myself in Lisa's position, but I have been diagnosed with ovarian cancer and treated by having my ovaries removed, I can't even remember all the stages from initial visit to the GP with weird symptoms up to having surgery scheduled and ready to go, but I had so many appointments, visits, consults, scans, blood tests, and that's for a scenario where no one can possibly quibble that the surgery was unnecessary. It seems highly unlikely no one ever investigated other possible reasons or solutions for Lisa's problem before she reached the point of surgery, and if they didn't, again that in itself is quite a huge error in care.

Everything I said was in that link a PP posted. There’s no way I’d either know it or be able to make it up. It’s totally outwith my experience.

The only link about the case that's been posted is this one, which doesn't say any of the things you've said https://goodlawproject.org/were-suing-a-hospital-for-trans-discrimination/

And the link with everything I mentioned is here, @HouseLurcher

https://goodlawproject.org/tortured-by-transphobia-the-woman-left-in-pain-by-the-nhs/

There are two links in the first post. I added it above for you.

Ok thank you. That still doesn't actually say what you claimed - Lisa was objecting to the surgeon talking about preserving fertility when she'd already had a vasectomy which is obviously a mistake on the surgeon's part. It also doesn't say she was ultimately refused surgery because she wanted a technique they didn't offer.

It does however provide an answer to some of @DrTemporary 's wonderings - seems Lisa's pain problem pre-dates gender affirming care so can't have been caused by hormones/blockers.

OK, now this is bringing up one very important, but ignored issue around gender affirming surgery. One issue that I think is very under-reported.

This surgery; any surgery needs to be commissioned. This ensures that the hospital and the staff, etc, are reimbursed for doing the surgery. If it isn't commissioned, but they're just doing it anyway, there are two effects:

1. They're doing it for free. The hospital is losing money, as they cannot claim for the operation against their contract, because it does not cover gender affirming surgery.

2. If these are being done by gynae surgeons, then women who need gynae surgery are getting pushed further down the list for surgery, as free gender affirming surgery is being done instead. Similarly, if it is being done by andrology surgeons, men who need that type of surgery are being pushed down the list.

This is why it is being classed as 'testicular pain', so that the hospital can charge it against their commissioned (contracted) surgery. Someone, somewhere in this case has said 'no', as this is presumably classed as fraud.

One thing that we should start asking more about this surgery in the NHS, a one word question:

Commissioned?

Because if it is NOT commissioned, then it is free, gratis, and the hospitals are being made poorer, with longer waiting lists as a result.

Many thanks to GLP for bringing light onto how this fraud is being perpetuated.

I wonder if things started to unravel when the surgical team started having detailed conversations with the patient. A bilateral orchidectomy for pain presumably ordinarily involves replacing the testes within the scrotum with prostheses, and prescribing follow up HRT (ie testosterone).

When the patient told the surgeon what he really wanted, the latter may have thought it was outside his competence, and a gender specialist would have the best chance of achieving results that would satisfy the patient in the long run.

Also, this gave him a motive to lie about the pain, which can't be completely ignored, although it would be tricky to test.

Very possible. Lisa may have additionally requested life long hrt but in the form of estrogen rather than testosterone. For a urologist this would.be against the standard protocol for treating a male patient hence the suggestion to seek gender affirming care.

Probably a lot more of the story to know, but if this would have been offered to all male patients at this stage of treatment and assessment of need, and it was refused solely on trans status with no other complicating factors, then they have a slam dunk case.

I would doubt though this is the uncomplicated case.

Lisa spoke about both-
“And a doctor said my treatment was aiming to maintain hormone function and fertility, even though he knew I was a trans woman and I’d had a vasectomy.”

The doctor who is used to treatment which preserves hormone function and fertility is less used to treatment that doesn’t consider those things. I said it may make sense at that point to send Lisa to a gender clinic which would have more experience.

Perhaps you need to read more carefully before telling me- more than once- I’m making it up. And perhaps apologise.

But there is no evidence of any fraud being perpetuated, unless you assume the intention of the surgeon was to provide Lisa with gender affirming care but to conceal this by lying about testicular pain being the reason for surgery, which is quite the accusation with no evidence to support it.

You're possibly right that the cancellation of surgery was caused by someone panicking about funding and someone higher up assuming that trans patient + testicular surgery = gender affirming care, but again this is an issue that should have been settled before surgery was ever scheduled, so still does not reflect well on the hospital, and the onus in court would still be on them to prove the surgery was either not medically indicated (in which case they were wrong to schedule it) or that it wasn't cancelled because the patient was trans.

Just to be clear, when gender affirming care is performed on the NHS, it is a commissioned service. Only certain providers are commissioned to provide it so if this hospital isn't a commissioned provider, they can of course refuse to perform it. I don't think there is any evidence uncommissioned hospitals are routinely providing free gender affirming care to anyone, let alone in this case. Unless you can provide any?

But it at no point says Lisa insisted on surgery via a technique that wasn't offered and this was the reason for refusal, which is what you claimed.

A date for surgery would not have been set until after the surgical team had had as many detailed conversations with the patient as was necessary for everyone to be happy to go ahead and consent forms to be signed. I know I keep repeating this point but that's because it's true, and if you're going to invent some non-discriminatory reason why surgery might have been cancelled you have to account for the fact this surgery got to the point of having a confirmed date in the calendar which was only a week away at the point of cancellation. NHS surgeons - or private ones for that matter - don't book surgeries then consult with the patient, they consult with the patient then book surgery.

A bilateral orchidectomy for pain presumably ordinarily involves replacing the testes within the scrotum with prostheses, and prescribing follow up HRT (ie testosterone).

According to google, all NHS orchidectomy patients are given the choice whether to have protheses or not, so there's no reason to decline Lisa for choosing not. And prescribing HRT of any kind would not be the surgeon's job, if needed that would be referred back to the patient's GP (and again even for non-trans patients would be up to them - some might choose not to have HRT, and there's zero reason why a patient's choice around HRT would change the actual surgical procedure).

Also, not to keep banging my head against the wall about this, but if Lisa had been declined because she wanted a type of surgery the surgeon couldn't provide this is a discussion that would have been happening at the pre-surgical consult stage meaning the mismatch in expectations would have become apparent before surgery was ever scheduled. Believe me, they make you sign consent forms out your wazoo before they book you in for surgery, and part of that process is making extremely sure you understand exactly what you've signed up for. There is no date going in that calendar unless both patient and surgeon have agreed on what is going to happen.