Over the past few years, it would be fair to say that I have heard my fair share of Transgender healthcare related horror stories; both those that are whispered on the wind and passed around as tales of warning to those who might dare attempt transition, and those deeply personal first hand accounts which I have felt honoured to be trusted with. These stories pertain to all areas of healthcare; from refused blood-tests due to poorly completed gender markers, to people being asked to leave by GPs; from avoidance (and essentially covert refusal) of treatment by certain GICs, to other peoples’ impossible struggle to get onto the pathway in the first place.
What disturbs me about this, however, is not the nature of the tales but rather the sheer quantity. It dawned on me recently that over the course of the average week it is rare that I don’t hear a first hand account of – what the government might try to describe as – “poor experiences of the NHS” by individuals who are trans. These may be minor in nature – for example, a trans woman having to explain multiple times that she didn’t have a uterus – or significantly more major – for example. transphobic abuse by hospital staff. In either case this appalling and as a healthcare professional myself I can honestly say this should not be happening.
Relatively recently, a medical student was published in the student lancet calling for LGBT issues to be added to medical school curricula in order to raise awareness amongst future doctors and thus reduce discrimination. Since this could be quite easily incorporated into medical school teaching [Just to clarify, doctors are taught a lot of social science already (which includes similar topics such as ethnicity), not simply hard science] it is an example of a suggestion which could be easily realised and could potentially make a huge difference. It is small suggestions of this nature which we – by which I not only mean the trans community, but also the medical community – should really be pushing for. I am not saying that this alone would be enough to change the current picture of discrimination, but if combined with getting other similar small stones rolling then it definitely has the potential to turn into a landslide.
If we were to pursue this idea, it would be both unfair and unrealistic – not to mention go against my own experiences – to say that all transphobia which occurs in healthcare is orchestrated by doctors (for those of you less familiar with this, for specific examples and to get a feel for just how broad the source of discrimination is you do not need to go further than Press For Change’s 2007 Engendered Penalties Document which has numerous examples). As such, pressure would also need to be put on other healthcare professions – such as nursing – at an institutional level to likewise incorporate this into teaching, and hopefully improve nursing for the next generation of transgender individuals. By targeting the individual components of our healthcare system in this manner, we could potentially remove the ignorance surrounding transgender issues and tackle a source of our discrimination.
Education is a valuable and often underrated tool in instigating change. In many ways, the issue with education – and the reason it is often overlooked – is that it takes a long time between implementation and for the results to be seen; often far exceeding patience. As such, when it is used it needs to be combined with short term strategies which aim to address the issue of the problem as it currently stands – in this case, this could be done through raising awareness and pushing for training for current staff – and to challenge issues on an individual level as they arise in order to make sure that transphobia in healthcare never gains [or regains] an air of acceptability. I feel these 2 strands will combine to give a small and short-term change, which the education of training healthcare professionals will be able to use as a platform to build upon to generate sustained change.
It may not be the fastest process, and even with the addition of short term awareness raising strategies it mays still take a generation before we see change, but if you were asked to sacrifice happiness today for the guarantee of a brighter future for everyone, wouldn’t you?