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  • Writer's pictureKit Ross

"There are a myriad of reasons why Bristol should have a GIC" [Bristol24/7, March 2021]

This was originally published on Bristol24/7 on 1/3/2021.

I can recall, in precise detail, the exact moment where I realised just how difficult accessing gender-affirming healthcare would be for me. Hunched over my laptop, aged 21, in the very early days of my own coming out and transition as a non-binary person, grinning from ear to ear as I purchased my first chest binder, and deciding to ride this wave of gender euphoria and research the process of getting a referral to an NHS Gender Identity Clinic.

What I found was soul-destroying. Reams of Reddit posts detailing wait times getting longer and longer, people self-medicating with hormones purchased online, a total lack of clarity regarding pathways for people who want surgery but not hormones, and the heartbreaking realisation that, in all likelihood, I wouldn’t have access to any medical gender care before I turned 30.

I’m not the first trans person to experience this crushing realisation. I certainly won’t be the last.

The UK is currently facing something of a trans healthcare crisis. For the roughly 600,000 trans people in the UK, the process of accessing gender affirming healthcare through the NHS is long and complicated. With only eight specialist Gender Identity Clinics (GICs) to serve England’s entire trans population, waiting times for a first appointment are currently sit at a minimum of two years- and this is an optimistic estimate. Here in the South West, it’s even worse, with only one clinic- Exeter’s The Laurels clinic- serving the entire south. Given the sheer area this clinic covers, it’s no surprise that The Laurels has the some of the longest waiting times of any GIC in England.

When you finally receive an appointment, after years of waiting, there’s the travel. The closest Gender Identity Clinic in Bristol is either London or Exeter- and if you’re under eighteen, you don’t get the choice, you have to go to London. The Exeter clinic is a little under a two hour drive from Bristol. London is further. And if you don’t drive, the exorbitant cost of train fares is a huge strain for many. Most of England’s specialist gender care is based in the North and Midlands, and any and all talk of pilot schemes to increase access to gender affirming care has focused on the north. While our trans siblings in these areas still face the same years-long wait times we do in the South West, there is certainly a greater variety of choice.

Put all this together, and it’s clear that the country urgently needs a

Locations of GICs in England

new GIC, and the South more than anywhere- and Bristol would be the ideal place.

There are a myriad of reasons why Bristol should have a GIC. On a practical level, Bristol has some of the best rail links outside the capital, and it’s easily accessible by road from Wiltshire and Somerset. There’s several hospitals in the city, including a large teaching hospital, and we’re close to the RUH in Bath, another immense hospital, so access to specialist surgeons for gender confirmation surgery is plentiful. Indeed, the presence of UoB’s medical school would offer opportunities for medics in training to undertake placements, ensuring that the next generation of healthcare professionals is well-versed in trans issues. On a cultural level, Bristol has a diverse queer culture, one where increased support for trans people would not only be accepted, but welcomed and prized.

Sadly, this is all wishful thinking. I could put forward any number of well reasoned, logical arguments for why Bristol- or frankly, anywhere in the South West- needs a Gender Identity Clinic, but it won’t happen. Our current government has made it quite clear that they don’t respect the rights of trans people- whether that’s turning back on promises made to reform the Gender Recognition Act, restricting access to life-saving puberty blocking drugs for trans youth, secretly meeting with a transphobic pressure group or proposing legislation that prevents trans people from using public bathrooms that match their gender identity. Private services like GenderGP are doing their best to fill the gap, but for many of us, all we can do is hang tight, cram ourselves into our binders, and wait.

by Kit Million Ross, March 2021

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