Ivan: 0:04

Hello and welcome once more to the Bench Report, where we discuss recent debates from the benches of the UK Parliament, a new topic every episode. You're listening to Amy and Ivan.

Amy: 0:14

So today we're looking at a debate focused on health care for transgender people. And it was interesting because the stated aim was to move past the uh political sound bites and really concentrate on real life experiences with the NHS.

Ivan: 0:28

And what came out almost immediately were these two critical interconnected failures. First, pervasive discrimination, and second, just chronically inadequate access to gender-affirming care.

Amy: 0:39

Let's unpack that discrimination first. There were some incredibly specific examples brought up. One was a trans woman at her GP's office who was misgendered, told she couldn't use the women's toilets, and then was told she scared other patients. She had to leave the waiting room entirely. It's an unbelievable story.

Ivan: 0:55

And that kind of hostile environment has um a very clear public health consequence. Almost one in four transgender people just avoid the doctor completely for fear of this kind of mistreatment.

Amy: 1:06

Which means they delay crucial care, like cancer screenings. Precisely. And the debate also cited a survey where 60% of trans people reported being refused care simply because they're trans. That includes GPs refusing to continue hormone prescriptions from NHS clinics.

Ivan: 1:22

And it's felt in other areas too. The material mentioned that nearly one in three trans and non-binary birthing parents felt they weren't treated with dignity during maternity care.

Amy: 1:32

So if that's the prejudice on the ground, the waiting time showed just how deep the institutional failure goes.

Ivan: 1:37

This is what many of the debate called a national scandal. And we should remind everyone the NHS constitutional standard is that patients are supposed to be seen within 18 weeks.

Amy: 1:46

But the reality is it's nowhere near that. As of March 2025, there were over 48,000 trans adults on waiting lists. The averages presented were frankly alarming.

Ivan: 1:57

In England, it's 12 years.

Amy: 1:59

41 years in Northern Ireland, and then in Scotland, a staggering 58 years.

Ivan: 2:03

58. One person's weight was apparently three times the average British life expectancy. I mean, what happens to a person during those decades of waiting?

Amy: 2:11

The debate provided a tragic answer. Untreated gender dysphoria is linked directly to self-harm, to increased drug use, alcohol, cannabis, cocaine. We even heard that coroners have cited the lack of care as a factor in people's deaths.

Ivan: 2:25

And that takes us to the policy failures. These shared care agreements, for instance. That's where a GP refuses to continue prescribing medication that a specialist has recommended.

Amy: 2:36

That's it. And the rate of GPs rejecting those agreements has jumped from 5% to 21% in just the last year.

Ivan: 2:42

We also need to touch on youth care. Following the ban on puberty blockers, there's a new pathways trial. But it seems there was controversy over its size.

Amy: 2:50

There was. It's capped at only 226 young people, which contradicts an earlier assurance that it would be um uncapped.

Ivan: 2:57

And the issue with that gap is time, isn't it?

Amy: 2:59

It is. Puberty blockers aren't permanent, but puberty itself is. With these long waits, by the time a young person can access any care, significant physical development has already happened. The air, damage is done.

Ivan: 3:11

So looking forward, the debate did note a couple of ongoing government efforts. The David Levy review of adult gender services is expected soon.

Amy: 3:19

And the Dr. Brady LGBT plus health review should have findings early next year. But when you pull this all together, I think the final takeaway is this. Based on the current rate of appointments, a trans person in the UK can expect to wait an average of 25 years for a first appointment. So the question is: if we would never accept a 25-year delay for any other health condition, what specific steps must policymakers take right now to meet that 18 week standard for this population?

Ivan: 3:47

As always, find us on social media at bench report UK. Get in touch with any topic important to you. Remember, politics is everyone's business. Take care.