What it's really like to access gender affirming healthcare as a young trans woman

Missing Voices is a new series from Huck centring and platforming the voices of those ignored or left out of some of the biggest debates in politics.

It is not unreasonable to say that trans rights are under intense political and societal scrutiny.

From the media frenzy surrounding the Scottish Government’s reform of the Gender Recognition Act (GRA); to ridiculously long waiting times for youth and adult gender services (exacerbated by the government’s response to the Cass Report); what I see as the transphobic opposition to Scotland’s new hate crime laws; and England’s draft school guidance which resurrects the spectre of Section 28 by advising teachers to forcible out children questioning their gender identity to parents.

Unsurprisingly, many trans people and their families are rightfully concerned about what the future holds. This concern is amplified by the consistent framing of trans people’s lives as a valid ‘debate’ or ‘discussion’, irrespective of many of us dreaming to be regarded as the ordinary people we are.

I’m a 26-year-old trans woman who lives in Glasgow. I’ve been out since 2020 but remember questioning my gender from a very young age. Since coming out and beginning my medical transition, I have begun work on a PhD in Transgender Cinema, with a particular focus on films which deconstruct and subvert common trans narratives. These films offer a perspective on trans lives and experiences which are distinctly trans and do not conform to mainstream sensibilities.

Despite coming out three years ago, and quickly referring myself to a waiting list to be seen at a gender identity clinic (Glasgow’s Sandyford Clinic), I have been unable to access gender affirming care on the NHS, as the waiting list has remained stuck in 2018 for the last four years. To say this has been frustrating and disheartening would be an understatement, and my experience is certainly not unique, with many friends of mine also languishing on static waiting lists.

The lack of any provision of care while on GIC waiting lists has been extremely distressing and it has often left me feeling abandoned by the very system which should be supporting me. With no end in sight to the now six year long waiting list, it is hard to remain hopeful that I’ll ever be able to access gender affirming care through the NHS, forcing myself and others in the community to turn to other means.

I am in the fortunate and privileged position of being able to afford private healthcare and have been accessing HRT through YourGP in Edinburgh for almost a year now. While this has been a massively positive move for me, it is simply not financially feasible for all trans people to access healthcare in this way. Trans people should not be denied vital, gender affirming care due to financial barriers or inexorably long waiting list times. Sadly, however, this is the reality facing many trans people in the UK.

Despite being able to access HRT privately, I have still come up against frustrating and exhausting barriers in my transition, first and foremost amongst this – the very process of being diagnosed with gender dysphoria in the first place. Trans people in the UK are currently required to receive a formal medical diagnosis of gender dypshoria in order to be prescribed HRT. This meant that I was required to “prove” my transness to others in order to convince them that I would benefit from hormones.

The only way to do this is through attending multiple appointments at a Gender Identity Clinic as GPs are unable to prescribe hormones for trans people. I was first required to describe what was referred to as my “gender history” to a doctor, essentially having to explain why I am trans. This was then followed by a psychologist assessment in which I had to give over the same information. After this came a three month “reflection period” before I was prescribed hormones.

This in particular seemed laughable considering the considerable time and financial expense involved in getting seen at the gender clinic in the first place. There is a narrative in the media that trans people, especially trans young people, are being “rushed” into making decisions about medically transitioning. This couldn’t be further from the reality: it is a long, mentally draining and often expensive process.

Since starting HRT I have noticed a massive change in how I’ve seen myself. I’ve felt far more settled and at home in my body. It was the right thing for me, and I knew this long before I came close to entering a gender clinic’s doors.

I would like to see a streamlining of the transition process, involving a decentralising of Gender Identity Clinics and a demystifying of the transition process, enabling GPs to prescribe HRT under an informed consent model. This would allow trans individuals to make informed decisions about their bodies without the need to be pathologized in a drawn out and needless process. I would also like to see further efforts to destigmatize transitioning, particularly when considering trans young people who may be questioning their gender. It often feels as if transition is treated as a “bad result” for young people, when it can in fact be a joyful moment of self-actualisation.

Mermaids is a charity doing vital work in supporting trans youth and campaigning for their rights across the UK. Their work is key in giving young people and their families time and space to explore their gender identities, something we desperately need to see more of. Trans people, and especially trans youth, need our support now more than ever. Our Trans Youth Manifesto outlines exactly what our young people need from the next government (out on the 11th June) This election, demand better.

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