Trans Teenager Launches Legal Action Against NHS for Delays to Treatment

Trans people say they often face a “soul-destroying” wait for initial consultations and treatments that should be provided through the NHS.
November 23, 2020, 2:37pm
A doctor showing a patient a syringe used to inject testosterone (1)
A doctor showing a patient a syringe used to inject testosterone. Photo: The Gender Spectrum Collection.

A trans teenager has launched a legal case against the NHS over delays to medical treatment for his gender dysphoria. 

The legal case, put forward with the Good Law Project, is based on NHS England’s legal requirement for young people to receive treatment for gender dysphoria in under 18 weeks. But extensive waiting lists for trans people means that on average, patients referred to the Gender Identity Development Services (GIDS) often wait years for treatment. 

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The NHS outsources GIDS to two clinics in London, the Tavistock clinic and Portland Foundation Trust. The latter’s website acknowledges a delay in providing treatment to trans young people: “We are aware that the time young people have to wait for a first appointment here at GIDS is long. We are doing all we can to address this,” the message says. “We know that for the year starting 1 April 2019 and finishing on 31 March 2020, the average (median) waiting time, from GIDS receiving the referral to a first appointment, was 558 days or around 18 months”.

The claim does not refer to what types of treatment young trans people are given, but extensive waiting times for initial appointments are likened to denying patients treatment.  

In September, the NHS announced an independent review into gender identity services for children and young people, which will focus on “how care can be improved” for patients with gender dysphoria. 

A legal letter sent by the Good Law project and the 14-year-old trans teenager says if the NHS does not commit to “urgent action,” then further legal action will be taken. 

Caspar Grey, a trans tattoo artist based in London, waited years to be referred to the NHS for treatment, eventually resorting to private medical treatment costing over £7,000. He describes waiting for treatment on the NHS as “soul-destroying.”

“It’s very difficult to describe the weight of gender dysphoria to someone who hasn’t experienced it,” he said. “It is such a deeply upsetting state to be in, where you are constantly being perceived and treated like someone you’re not. To be visibly trans in society puts an individual at much higher risk of discrimination, harassment and violence, particularly for trans women and even more so, trans women of colour.”

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Erik Pascarelli, a trans hairstylist in London, also experienced long waiting times while seeking treatment on the NHS. “I came out over ten years ago and have still only ever managed to get surgery and prescriptions privately,” he said. “What cis people don’t seem to understand is that it’s not just that we’re waiting for hormones or for surgery, we’re waiting for anything, any single scrap of information. It’s a complete loss of control in your life.”

Jolyon Maugham, director of the Good Law Project, said: "Whatever your views about the right treatment regime for young people with gender dysphoria it can't be right that they face lengthy waiting lists – on some reports up to four years – for a first appointment.”

“Children are losing the opportunity to be seen within a window in which they can secure effective treatment and so are, in practice, being denied access to that treatment.”

An NHS England spokesperson said, "There has been more than a 500 percent rise in the number of children and young people being referred to the Tavistock's gender identity service since 2013 as more people come forward for support and treatment.”

 "The NHS has already asked Dr Hilary Cass to carry out an independent review including how and when children and young people are referred to specialist services,” they added, “so legal action against the NHS will only cost taxpayers' money and not help the actions already underway."