“Sorry, your file has you down as male. It must be a mistake,” the GP receptionist says to Zachary, a 27-year-old transgender man living in South Wales. For Zachary, this response has become a common occurrence when contacting his general practice about anything stereotypically associated with the ‘female’ reproductive system.
“Trans men (who are registered with their GPs as male) aren’t automatically invited to have pap smears because they’re classed as men, so I have to book mine myself, which is really awkward because obviously when they pull up my file, they see ‘man’ and I have to explain I’m trans,” Zachary tells me. For him, this is just one of the many roadblocks he faces when trying to access basic healthcare.
In an era where strides are being made towards greater inclusivity, the restrictions imposed on transgender healthcare should concern us all.
Earlier in the year, the NHS published new guidelines stating they would be implementing restrictions for future access to puberty blockers for transgender youth in England and Wales. The guidelines have been met with heavy criticism, with some accusing them of being influenced by outdated theories from right-wing groups, who mainly rely on dog-whistle politics surrounding transgender people.
The guidelines restrict access to puberty blockers to those with “early-onset gender dysphoria” – a highly contentious term that isn’t properly defined.
Rejecting a young trans person from receiving blockers or gender-affirming hormones could have a significant impact on their mental health. These guideline changes were made despite the 2015-16 Transgender Equality Report, published by the Women and Equalities Committee, stating that “there was a significant risk of self-harm or suicide where hormone treatment is not yet given; they drew attention to evidence that the attempted suicide rate among young trans people is 48 per cent.”
Most importantly, the guidelines specifically contradict policies put in place to ensure that children in the UK have autonomy over their own bodies and are ‘Gillick competent’ – a law that refers to whether or not a young person under 16 has the emotional capacity to make relevant decisions in relation to their health. The agenda to prohibit marginalised communities from having autonomy over their own bodies goes far beyond children with gender dysmorphia.
With the overturning of Roe v. Wade by the Supreme Court in 2022, thousands of women across the US are being denied their right to an abortion. Although it may seem like trans healthcare and women’s healthcare are two entirely separate issues, the limitations that both these marginalised communities are faced with tend to overlap more than we think.
Tori Ford, founder of Medical Herstory – an international not-for-profit that aims to eliminate sexism and stigma from healthcare – explains how the limitations on transgender healthcare access potentially affect broader healthcare systems and access for marginalised groups. “Limitations on trans healthcare have knock-on effects for everyone,” she explains.
“These regulations undermine the fact that individuals are the experts on their bodies. Bodily autonomy, reproductive choice, and gender expression are human rights that must be protected, and when these rights are threatened, it sets us all back.”