When I was in major class, I was a child, but I just knew the words to describe what I was feeling at the age of 15. I eventually came out when I was 18 and since then, I have been happy. Coming out, transitioning, and living my life as my true self has been one of the best items I could have ever done. I’m not only. Repeated surveys have shown that transgender people are happier after transition, even when they are confronted with abuse, discrimination, and social debate.
I hoped that the long-awaited Cass Review, which will be commissioned by NHS England in 2020 to examine gender identity solutions for under-18s, would greatly improve the trans children and young people’s understanding that they should be given the support and attention they need to change. Otherwise, the report, published on Wednesday, has left more doubt – especially around the use of puberty filters.
It was surprising to learn that Wednesday’s record urged extreme caution when prescribing puberty blockers, which delay the progression, and questioned the research conducted in relation to them, as NHS England announced last month, based on Cass’s earlier research. But, I worry that this scenario leaves young folks in purgatory.
I don’t like to dwell on the past or feel regret my mistakes; instead, I’m happy right now and have a life and a future where I can thrive. There will always be a small part of me that will beg the question, “Why didn’t I come out sooner?” and seek medical care before I went through male puberty. Knowing that I was a woman, the inevitable alteration in my body caused me much pain and still does today.
Instead of putting me through a puberty that wasn’t appropriate, puberty blockers could have given me the opportunity to discover who I really was and what I really wanted from life. It would have allowed me to put the clock on hold and consider who I was in my relationship to my parents, physicians, and other people in my life.
In my situation, we are aware that we would have come to the conclusion that yes, I am trans, and that a medical transition through hormone therapy was the best course of action for me. However, in the event that I wasn’t trans and that this wasn’t my path, I would have ideally been supported off the puberty blockers and carried on with my life. Although I would have been a very late comer, my harmony of danger would always have been in favor of taking the blockers when faced with the choice of a delayed adolescence versus the risk of completely going through the bad puberty.
This wasn’t the path I was going down. Instead, I jumped on the waiting list for mature female services when I was 18 and made my first appointment almost six years later.
The review makes recommendations that, depending on how they are put to use, may increase the barriers to the physician transition for 18 to 25 year olds. Specifically, it has been criticized for rejecting a large portion of the research into the efficacy of puberty blockers and hormone therapy.
Trans people have been urging healthcare providers to enhance transition-related care for many years, but recent events have shown that the trend has recently been in the same direction.
Some of the review’s advice should be welcomed, including those that decentralize the company, ensure highest standards of care for all people, and increase workplace capacity across the services, but these positive aspects may be harmed by the potential harm that other recommendations might cause.
People – especially young people – must be supported throughout any physician move process to ensure that it is the right one, but this support can and must be provided without raising the bar so high that so many trans people would find it impossible for them because it would significantly improve their lives.
Rishi Sunak recently said that supporting children through their transitions is “not a negative act” as opposed to putting them through the incorrect puberty or denying them health or social support that would enable them to succeed both in their junior and later age. For so many trans young people, this report will be concerning, and it’s critical that it doesn’t further gatekeep the essential healthcare we so desperately need.
The National Union of Individuals Scotland is led by Ellie Gomersall.
