Gender clinic: Anger over transgender service delay
20 May 2019
Transgender patients have been left in "limbo" after the opening of Wales' first gender identity clinic was delayed, campaigners have said. They currently have to be referred to a London clinic for care and support. The new service in Cardiff did not open in April as planned, prompting the transgender rights group Wales Equality Alliance (WEA) to write an open letter expressing their anger. The Welsh Government said an opening date would be announced shortly. In the letter, which has also been sent to Health Minister Vaughan Gething, the WEA raised concerns about the impact delays were having on waiting lists and the impact this had on the mental health of people wanting treatment. "Patients can wait up to three years after initial GP presentation before being seen by a gender clinician. During this time, their mental health and well-being can deteriorate significantly with some cases resulting in suicide," the letter said. "This situation reveals a complete lack of regard for prioritising waiting times, and Welsh trans patients are once again in limbo." The clinic for Wales was announced by the Welsh Government in 2017. Once it is opened, it will help transgender patients to have their non-surgical gender identity-related healthcare overseen closer to home, which will include hormone prescriptions and speech therapy. Jenny Charles, WEA's campaign manager, said the delay and lack of new opening date was "very worrying". "Things are bad enough as they are. People have died on waiting lists after taking their own life," she said. "The Welsh Government must act now on our demands to rectify the situation before serious harm is done to the community." Crash Wigley, Stonewall Cymru's policy and campaigns officer, said a service in Wales would help transgender patients access care much closer to home. "The problem with the current system is that it forces people to travel to London for treatment, as well as having to go through a complicated referral system where they needlessly have to attend many appointments with mental health services before they are put on a waiting list," she added. Patients who are over the age of 18, who wish to access gender identity services, currently follow a "gatekeeper" system. They initially have to meet with their GP and request a referral to local mental health services where they will be assessed. The assessment is then reviewed by a local gatekeeper - a trained healthcare professional - and a decision is made about a referral to the gender identity clinic in London. According to the Welsh Health Specialised Services Committee, there was a 130% increase in referrals from Wales to the adult gender identity clinic in London between 2016 and 2018. Stacy Winson is a transgender woman from Caernarfon in Gwynedd, who had to wait two years from her first appointment with her GP until she was seen at the Gender Identity Clinic in London, She said travelling to London was not practical. "Because I live in north Wales, it takes about three and a half hours to get to London and it costs me over PS100 every time I need to go to the clinic," she said. "I don't have a lot of money and they won't reimburse you unless you're on benefits, which is hard because I'm not on any kind of benefits at all." She said her own journey to access care was fraught with difficulties, adding: "When I went to my GP and said that I wanted to be a woman and that I wanted to transition, he just turned around and said he didn't know what to do with me." She said the entire process became complicated - including being sent to a psychologist who refused to acknowledge that she was transgender - and it took a serious toll on her mental health, "I just felt like everything was over, I found it so hard to accept," Stacy added. "I just considered ending it all and thought about taking my own life." Cardiff and Vale University Health Board said it was in the process of recruiting staff for the Welsh service. "Our Welsh Gender Team have been liaising with gender identity clinics across the country, including London, so that we can learn from their knowledge and experience to ensure we provide the best service for our Welsh patients," a spokesperson said. "We are sorry that the service has taken longer than anticipated to establish, however as this is the first time a gender service has been implemented in Wales it is important that we ensure it is sustainable and that we get it right first time for our patients, but also for the trans community to have confidence in the service." A spokesman for the Welsh Government said: "Arrangements for the Wales Gender Team are being finalised and an opening date will be announced shortly. It is important that the health board secures the right balance of clinical expertise to meet the needs of patients. "The Wales Gender Team is one element of the three tiers of support that will be available as part of the new integrated gender services being introduced." If you need information or support about gender identity, click here. If you are feeling emotionally distressed and would like details of organisations which offer advice and support, click here
Patients who are over the age of 18, who wish to access gender identity services, currently follow a "gatekeeper" system. They initially have to meet with their GP and request a referral to local mental health services where they will be assessed. The assessment is then reviewed by a local gatekeeper - a trained healthcare professional - and a decision is made about a referral to the gender identity clinic in London. According to the Welsh Health Specialised Services Committee, there was a 130% increase in referrals from Wales to the adult gender identity clinic in London between 2016 and 2018.
2151_0
How does the system currently work?
Stacy Winson is a transgender woman from Caernarfon in Gwynedd, who had to wait two years from her first appointment with her GP until she was seen at the Gender Identity Clinic in London, She said travelling to London was not practical. "Because I live in north Wales, it takes about three and a half hours to get to London and it costs me over PS100 every time I need to go to the clinic," she said. "I don't have a lot of money and they won't reimburse you unless you're on benefits, which is hard because I'm not on any kind of benefits at all." She said her own journey to access care was fraught with difficulties, adding: "When I went to my GP and said that I wanted to be a woman and that I wanted to transition, he just turned around and said he didn't know what to do with me." She said the entire process became complicated - including being sent to a psychologist who refused to acknowledge that she was transgender - and it took a serious toll on her mental health, "I just felt like everything was over, I found it so hard to accept," Stacy added. "I just considered ending it all and thought about taking my own life."
2151_1
Why does a Welsh clinic matter?