2 weeks Ago By Munroe Bergdorf
Having begun my own medical transition 15 years ago , I know first-hand the importance of hormone replacement therapy. I have seen and felt the potential that it has to save, change and sustain a life. Quite honestly, like the vast majority of trans people who medically transition, I would not be alive without it.
While, yes, medically transitioning is a choice, it is often a choice between life or a life of escalating despair; life or a life of self-destruction; life or no longer living at all...
Gender affirming care isn’t the controversial, understudied or farfetched luxury it’s painted as by those invested in a relentlessly anti-trans agenda. For those who are waiting to medically transition, it is a lifeline – one that’s in desperate need of protection. Across the UK, transgender people are being contacted by NHS doctors, notifying them that their access to hormone replacement therapy (HRT) is to be immediately withdrawn.
HRT is a key element of gender affirming care that helps to alleviate feelings of gender dysphoria, to align a person’s gender identity with their physical appearance. Whilst the exact numbers of those who have had their care withdrawn or refused is still unknown due to an absence of official data, increasing numbers of trans people are taking to social media to express their concern, while NHS gender service workers are also reporting that the level of withdrawn care has increased over the last 12 months. Danielle St James, chief executive and trustee of Not A Phase , a trans-led nationwide charity with a commitment to uplifting the lives of trans+ adults, tells me: “The sudden removal of access to hormones is having a devastating impact on trans+ adults, particularly those who were already facing barriers to healthcare.
At Not A Phase, we’re hearing from people who are scared, desperate and struggling to understand how they will continue their transitions. For many, HRT is not just medication. It allows them to live in alignment with who they are, improving their mental health and overall wellbeing.
Losing access overnight is not just distressing – it’s dangerous.” In 2023 it was reported that some transgender people in England had waited up to seven years even for an initial NHS assessment. (After spending 1,023 days waiting for a first appointment, 20-year-old Alice Litman took her own life in May 2022.
Following her death, Alice’s family said: “Alice described the years-long wait and the inadequacy of her care as leaving her feeling hopeless and helpless without an end in sight...
We all deserve to live in dignity with access to the healthcare we need. We are asking NHS England to prevent further deaths by urgently addressing the crisis in trans healthcare.”) Meanwhile, apprehension towards assisting medical transitions has undoubtedly been compounded following the highly critiqued Cass Review of April 2024, which resulted in a ban on the prescription of puberty blockers for transgender teens (even though they are still considered safe to use for cisgender teens).
Add to this an overwhelmingly hostile anti-trans media bias, which frames gender affirming care as “unsafe” or “experimental”, with a disproportionate fixation on the subject of medical regret and detransition. In reality, gender affirming care is a diligently studied field that has existed since the early 20 th century, in which regret rates for medical transition remain inarguably low. In a 2022 study carried out by The Lancet, it was found that 98 per cent of transgender youth who had access to transgender healthcare continued their treatment into adulthood.
These findings were reinforced by a 2023 study carried out by the Transgender Health Program, in which it was found that 99.7 per cent of transgender individuals were satisfied with their surgery, with a regret rate of 0.3 per cent – six patients out of a sample of 1,989.
The study concluded that “a care environment that welcomes and normalises authentic expression of gender identity, affirms surgical goals without judgment, and destigmatises the role of mental health in the surgical process are foundational to mitigating the occurrence of any form of regret”. While we should absolutely have compassion for the small number of those who do detransition, just as we should with anyone who regrets any medical decision, it’s important to acknowledge that a medical regret rate of less than one per cent should not be weaponised in this way. We wouldn’t restrict the ability for people to procreate because eight per cent of British parents regret having children, just as we would not ban knee surgery because six to 30 per cent of people express dissatisfaction with their knee replacements.
Yet we are witnessing our government and National Health Service encouraging and enforcing sweeping medical restrictions on gender affirming care. The politicisation of healthcare should never be accepted by anyone. If – due to an absence of policy – NHS doctors are allowed to refuse specific treatment to a specific minority group based on their personal beliefs or a lack of education, it creates a breeding ground for institutional discrimination and a dangerous, unacceptable precedent.
What next? Access to abortion and birth control? Or HIV prevention? A targeted withdrawal of medication should alarm us all. And so, the UK’s transgender community is now having to contend with yet another government making it harder to exist as a trans person, instead of addressing or fixing the mounting issues trans people face in their day to day lives. Systemic transphobia is being presented as the solution, while transgender people are reduced to the status of a “problematic ideology”.
And it doesn’t stop at British healthcare policy – or indeed in Britain. We are living in an era of multinational governments clamping down on the existence of transness within public life itself, with our supposedly closest political ally, America, introducing some of the most shockingly restrictive anti-trans policies in history. A memo issued by Secretary of State Marco Rubio, which could result in all international transgender people being banned from visiting the country, is just the latest in a recent run of epic discrimination.
Stemming from a Donald Trump day one executive order, US citizens who had submitted passport applications or renewals have started getting them back listing the gender marker they were assigned at birth, despite them having selected their correct gender on their paperwork. Euphoria actress Hunter Schafer posted a now-viral video on TikTok, sharing that she had received a new passport listing her as male. On the US State Department’s website, it now says that they “only issue passports with an M or F sex marker that match the customer’s biological sex at birth”.
Concurrently, a Texas bill introduced in Austin seeks to make identifying as transgender a felony, pushing for it to be classed as “identity fraud”, while in March Iowa became the first US state to repeal civil rights protections for transgender and non-binary people. Following another Trump executive order, the US army announced that transgender service members will be removed from the military and new recruits are barred from enlisting. These are damning developments.
Even when a proposal doesn’t have legal grounding, a media narrative takes root. From North America to Europe and beyond, reality is being warped. It doesn’t matter if UK trans people can already legally use public bathrooms in accordance with their gender identity: if the media makes it an issue, it becomes one.
And it affects everybody. In a culture where transness is demonised and unprotected, anyone who may not visually conform to traditional gender norms can face public invasions of their privacy, dignity and bodily autonomy. This can include cisgender people who are suspected of being trans, putting women who possess strong features, perceived to be “masculine” by some, at risk of harassment and violence.
We need only look at the mindboggling internet trend of “transvestigation”, in which largely Black cisgender women, including public figures such as Michelle Obama and Serena Williams, are subjected to obsessive, racist conspiracy theories, as a way of justifying their subjection to the same condemnation and hounding experienced by actual trans women. This is an issue making its way offline, with increasing numbers of women sharing videos on TikTok of them being asked to leave public bathrooms after being suspected of being men or trans women. It bears repeating that there is no one way to look like a woman.
There are also no statistics to suggest that trans women using female public bathrooms puts cisgender women and girls at risk. The fact remains that the vast majority of attacks carried out on women and girls, both cisgender and transgender, are carried out by men who are already in their lives. What we all need to remember is that transgender identity is nothing new.
It’s not an ideology or a trend, we have always existed in different ways, on every continent, in every culture, throughout time. Just as with sexuality, someone’s gender identity is defined by their feelings, not their actions. It is who we are, not what we do.
So, no matter what governmental roadblocks are implemented, no matter what healthcare, language or books are banned, no matter what misinformation is disseminated, trans people have never stopped and will never stop existing. If history has shown us anything, the greater the oppression, the greater the resistance..
