Tuesday, 8 January 2013

Dodgy docs and fail hashtags

    I can't say the last few days have been good for the cause of transgender medicine here in the UK. You see, the papers have picked up a story that's been rumbling along quietly for a while now, that of the General Medical Council investigating Dr. Richard Curtis, prominent trans man as well as the go-to doctor for private treatment of our condition. As I understand it there's the usual crowd of regretters claiming that they never wanted to transition really, and blaming their doctor.
    The news coverage has been predictably depressing. Short on news but long on sensationalism and outright transphobia, it's as though the Leveson Inquiry never happened. The trans community, seeing the whole debacle as something of a witch hunt against one of their own and reminiscent of the circumstances surrounding the departure of Dr. Russell Reid a decade ago, have reacted with anger. There's a hashtag on Twitter, #TransDocFail, which is full of the staggering ineptitudes and failures of duty of care felt daily by transgender people in the medical system here in the UK. It's depressing stuff, but it needs to be said as a response to the rather obvious misinformation on the subject.
    The trouble is, I'm not entirely comfortable with the battle lines here. I think there are serious shortcomings with the way transgender people receive medical help here in the UK and I've been happy to write about them here ad infinitum over the last few years, but my personal experience of the GIC system has been mostly pretty good. I've been unimpressed a couple of times by psychiatrists modifying their responses to me because of my background and occupation, but the fact is my course through the system has been exactly as advertised. And on the other side, I'm not entirely at ease with the haste with which some people I know have passed through the private system. The screwed-up ones in my experience tend overwhelmingly to have transitioned very quickly through the private route, and I can't help thinking less than eighteen months from hairy panty wearer to post-op is just a little irresponsible on the part of an attending doctor.
    So rather than black-and-white I see grey on both sides. Overwhelmingly though I see the most fault in the relative scarcity of professionals involved in our field and their concentration in a fairly small number of places. I can't help thinking that the best way to fix the #TransDocFail would be not to go after individual doctors or clinics but to broaden the availability of treatment over many more centres.
    Transgender medicine is not rocket science, surely it can't be that difficult to make it better!


  1. Like so many things I suspect that it will take time, and some positive education for any significant change to happen, I am glad that you can see the shades of grey, just as long as it isn't 50 of them.

  2. Reading these I can't help thinking that my mainly positive experience has been a product of a mountain of personal privilege.

  3. I totally agree that a better system of care is needed in the treatment of the transgendered, especially those who are transitiong transsexuals. In the first case a more robust system of psychological assessment is required but even then some will pass through the filter only to regret it later. I was under Dr Russell Reid just prior to his departure having been accused of pushing through his patients too quickly. I myself was given the 'ticket' after only six months but that was more to do with my insistence that his eagerness to fast track me, in fact he wasn't going to allow me through so quickly suggesting at least a year to make a proper assessment. He could see however my determination and allowed me through. Fortunately I was one who did not regret my actions and many more I feel were the same. There will always be some who regret their decision but in comparison to those who don't the percentage must be extremely small. As for the media, well what can one say? They are only after sensationalism for that sells newspapers and makes money.

    Shirley Anne x

  4. This is largely a matter of self-diagnosis, and the patient should therefore take a major slice of the responsibility. The professionals rely on what they are told. A patient who misleads or exaggerates in a convincing way must accept the consequences.

    Of course total sincerity on the patient's part is no guarantee that they are not suffering from a delusion, or a powerful wish to transform themselves, that comes from a psychological state quite different from gender dysphoria. In that case, one would expect the clinitian to detect what else is influencing the patient's self-view, and to brake the proceedings in order to assess what is really going on. A failure to detect an obvious alternative mental state would surely be culpable.


  5. I agree with your last paragraph, that there should be more places or centers one could go to seek help. Here on our side of the waters, people have lots of options for dr's or centers to seek the help they need for information.