A spotlight on healthcare inequalities in the UK
Too many people in the UK face healthcare inequalities, and all too often it’s overlooked. Healthcare equality for trans people can only truly be achieved when all forms of healthcare inequality are eradicated.
These feature articles were written by trans people based in the UK about their experiences navigating healthcare and transition as people who experience multiple forms of oppression at once.
We were able to pay all the writers included in this series with thanks to funding by The LGBT+ Futures: Equity Fund in partnership with the The National Lottery Community Fund.
Being trans in 2023 means knowing deep in your bones that looking out to the world to confirm that you’re safe and that your needs will be met is simply not an option.
I heard stories of other trans people’s gender diagnosis appointments, and how a diagnosis of autism can work against the trans person as they may not be deemed to have sufficient mental capacity to understand themselves, or lack sufficient life experience to ‘know for sure’. I panicked.
The first time I approached a doctor about a medical transition, I was eighteen years old, and instead of listening to what I was saying, this cis, White, male GP instead questioned the validity of my gender dysphoria, prodding into whether I was ‘really sure’.
Throughout my twelve weeks as an inpatient being treated for cancer, I found myself scared to be open about who I was or ask to be named and gendered correctly. The reason I did not disclose my gender identity or that I’m transgender was that I was scared of backlash, prejudice and that I would not get the care that I needed.
Seeking medical care has never been straight forward. I have found myself lying about my identity. Ticking ‘woman’ or ‘female’ on forms when I’m non-binary. Ticking ‘white British’, ticking ‘straight’, and not revealing aspects about myself that should in theory help to inform the medical care and support I receive, but in reality have hindered that care.
I have had quite a few instances that look like this scenario, and this is the reality for many Transgender black people and people of colour (BPOC) who are at increased risk of being overlooked or dismissed when it comes to expressing symptoms like pain.
There are many instances where pain can present itself in non-physical ways, and it’s up to the healthcare provider to use their discretion to treat patients. It can be a scary thing to experience being at someone else’s mercy to this extent, especially as BPOC who are transgender that face additional challenges in accessing healthcare due to both our race and gender identity.
I can’t help but look back at the start of my journey and wonder how much the sea of racial stereotypes I’ve encountered has affected me. Have I internalised the good with the bad? Hiding in my artificial comfort zone for just that little bit too long?
I’ve only been on testosterone for three months, so I’m still in the earliest stages; I joke that I must have a similar hormone profile to my best friend’s thirteen year-old brother. I have no regrets about my decision. What is rarely talked about, however is that hormonal transition is a rocky road, one in which good feelings are by no means guaranteed.
Instead of my lack of energy being seen as evidence of mental illness, it was, to them, evidence that I wasn’t serious about being trans. Surely if I was trans, I would try harder to look like a man, even if I was incredibly ill?
While I know that plenty of cis-het couples face infertility, I don’t think their hands are ever forced in the same way it is for trans people. I could afford transition or store my sperm, not both. And what’s the point of gamete storage if I’m not transitioning? There are options, of course. But even assessing my current fertility involves navigating the incredibly cisnormative world of fertility clinics which – in my experience so far – don’t even seem to recognise the existence of trans people. This is complicated further by the fact that I’m in a lesbian relationship.
I recently started a medical role working in the NHS. As a black, queer, non-binary person with autism, I’ve found it a strange yet eye-opening experience. Learning how our healthcare system works has changed the way I attend doctors and hospital appointments. It also highlighted the flaws in our healthcare system.
I had been waiting for 2 years for this appointment only to find out all the trains to London had been cancelled that day. I rang the GIC and told them the situation and they said if I didn’t come I would be taken off the waiting list completely, and have to start the process again. My mum managed to take the day off work at short notice and drive me to London, but if she wasn’t able to do that then I’m not sure I would be here today and comfortable in my body.