All my patients are the same on the inside.
Look past their outer layers and you will, more or less, find the same bones, body parts and cells.
That being the case, it should naturally follow that everyone has the same right to
the treatment they need, in a manner that is appropriate, irrespective of how they look on the outside or what their particular medical problem happens to be.
We are taught, as doctors, to provide access to unbiased healthcare. To treat smokers the same way as non-smokers, Christians the same way as Catholics. Tall people, short people, fat people, thin people, married or single, commercial sex workers - putting our personal feelings aside in order to provide the best level of care for each individual.
So why do some minority groups still feel that when they visit their GP, care is the very last thing they experience?
Time and again this is the story I hear from my transgender patients.
A recent report from the Women and Equalities Commission revealed that for members of the transgender community, the significant discrimination they face in day-to-day life does not always stop when they step into the consultation room.
According to the report, there was overwhelming evidence of serious deficiencies in the quality and capacity of NHS gender identity services, particularly in waiting times for first appointments - which in the case of some of the adult clinics is between two and three years. It was even suggested that some of this discrimination is born out of the fact that some GPs do not agree with the choices that trans patients have made.
But being transgender is not a choice that these patients actively make.
People who have gender identity disorder find that their body on the outside doesn't completely match the one their brain expects to see. Medically, we call it 'Gender Variance', and when it causes psychological distress, we call it 'Gender Dysphoria'. But since setting up GenderGP I have come to realise that much of this dysphoria is actually contributed to by the medical profession and the fact that they may not provide the standards of care we have come to expect.
The NHS has excellent values. You can expect to be seen by the hospital specialist within 18 weeks of your GP referring you on the NHS. You can expect to be treated with respect and dignity, and to be listened to with empathy and consideration by the doctors who are there to help you. You can expect to receive the treatment that is available to you on the NHS, if it is found to be suitable for your condition. You would hope to come away from your doctor's appointment feeling better, with renewed hope and a mutually negotiated management plan for your condition. You would hope that your wishes and ability to consent were taken into consideration when tailoring your treatment. You would expect to have the same access to NHS approved medication and operations as the next person. This may not be the case if you have issues with your gender.
Transgender people have a huge amount of support from their community, but they are still being ostracised by those in society who do not understand. Some of my patients have been told by their own doctor that 'they will grow out of it', that 'their treatment is cosmetic', that 'they shouldn't drain the resources of the NHS'. Patients have been turned away by their GP because he - or she - 'doesn't know enough about it'.
Is a timely appointment, with a kind and caring professional, to receive sound and unbiased medical advice for a condition which has recognised treatment options approved by the NHS, really too much to ask? I don't think it is.
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