TL;DR - A new legal case has been given approval to go forward after the NHS failed to make changes and prevent it. It will look at NHS England's trans healthcare provisions. It will determine the lawfulness of transgender discrimination, delays and access to puberty blockers.
92% of trans patients do not begin treatment within 18 weeks of referral. That's illegal.
It's why NHS England is now facing legal action in a new multifaceted case that has been approved to go ahead. It could have a huge impact on a broad swathe of NHS gender identity services.
NHS England's lack of services is 'discrimination against trans people'
Under the NHS Constitution, adult patients should begin treatment within 18 weeks of referral. That's true for people seeking help for gender dysphoria too.
But many people now wait over four years for treatment. It's a key pillar of new legal action, in the form of a judicial review into trans healthcare. However, the case goes further than just waiting times.
It also argues that NHS England has failed to provide access to puberty blockers to children, before starting puberty.
And on a broader point, several of the points in the case argue a broader theme: a culture of discrimination against transgender people in NHS healthcare.
“I would describe being on the waiting list as torture, and there were times when I felt that I may not even be alive long enough to receive my first appointment."
- Eva Echo one of the claimants in this case
The case comes from four trans people and the charity Gendered Intelligence, supported by the Good Law Project. Their case will see a judge review the lawfulness of the NHS's decisions and actions around trans healthcare. It has been given the approval to go forward.
“For too long, trans people have faced life-altering - and sometimes life-threatening - waits for specialist NHS healthcare," says Jo Maugham, director of Good Law Project.
"We believe that these waiting times, and other failures in trans healthcare services, are discriminatory and unlawful. This court case will be a vital moment in the fight for healthcare justice for trans and non-binary people. Healthcare should be for everyone.”
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Good healthcare is something we all deserve
The case will look at the broader picture of how trans people are being denied health care and mental health support. It has a focus on all trans people, but the action on children's healthcare stands out.
Though it feels sometimes there isn't much we can agree on, we all want children to be safe and happy.
But as Mental Health Awareness week draws to a close, we know all young people, but especially trans young people, are suffering from a mental health crisis. It's been made worse by the pandemic, but began long before it. That's the background of this case.
“We know from first-hand experience - and from working closely with and for the trans community - that the waiting lists for gender healthcare services are proving disastrous to people's health and wellbeing," says Cara English, Head of Public Engagement at Gendered Intelligence.
"These illegal waits long predate the pandemic and are only getting worse as time goes on. We need action, not words."
"The clinic holds my life in its hands. Waiting lists are long, even once you’re in the system. Over six years after my first appointment I’ve still got nothing more than basic hormones."
- QueerAF contributor Kestral Gaian
Why is this action going forward?
Rather than being listened to, young trans people and their supportive families are routinely ignored, misunderstood and misrepresented. This is increasingly happening in the press, in rhetoric by government ministers - and within NHS services.
That’s why this case is so important for the trans people bringing it forward.
However, they've already faced abuse on social media for ‘trying to hurt an already struggling NHS’. Comments largely followed by gender-critical rhetoric.
So it’s important to note, that this isn't the first step in this case.
When it was first announced in 2020, the Good Law Project reached out to the NHS. They asked it to make a clear, concrete and meaningful commitment to improvement. That could have prevented this legal action. - Forbes
That didn't happen. And now it's going ahead Gendered Intelligence, the young trans people's charity, hopes the judicial review will help kickstart a move towards the "proper, timely healthcare for trans and non-binary people that’s needed."
A date hasn't been set, but it's expected to be in court in Autumn 2022.
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