\n
But no official data exists to clearly indicate the number of trans+ people who have had ongoing prescriptions withdrawn, neither across the NHS as a whole nor at most individual gender clinics. Prescription refusals, which occur when a person tries to start the treatment, are sometimes documented but not at a national level.<\/p>\n
TBIJ sought to collect its own data and Emily was among more than 60 trans+ people who replied to our survey on the subject.<\/p>\n
While the survey cannot be considered representative of the trans+ community as a whole, responses included others who say they have experienced withdrawals of care. Emily, who is 25, was not the only respondent who had been taking HRT for years when their prescription was stopped by a GP.<\/p>\n
Staff at multiple NHS gender services also said that the issue of care withdrawal has become more frequent in the past year.<\/p>\n
Gender-affirming healthcare<\/h2>\n
While HRT is best known for its use in treating symptoms of the menopause, it is also a form of gender-affirming healthcare for trans+ people, as it can help them feel more aligned with their gender. It\u2019s a lifelong treatment. Studies have found it to be safe and that its many benefits to the health and wellbeing of transgender people usually outweigh the risks. As another person who replied to our survey put it, \u201cthis prescription is life-saving for me.\u201d<\/p>\n
The reasons given for why such treatment is withdrawn or refused vary. Some people have been told their GP doesn\u2019t feel qualified to provide the care, whereas other GPs have declined the work on the grounds they don\u2019t have the resources to provide it. Some GPs are refusing to prescribe HRT due to a contractual dispute.<\/p>\n
\n
\n
\n
Others, in their responses to a survey by Transactual, a trans-led research group, said their GPs had cited a lack of policy or personal beliefs as reasons why they had withdrawn or refused their HRT prescriptions.<\/p>\n
The issue appears to reflect a wider rollback of access to gender-affirming healthcare in the wake of April\u2019s publication of the controversial Cass Review into health services for trans young people. This review claimed that the evidence base of using puberty blockers and gender-affirming hormones for young people was \u201cweak\u201d. Some of the same medicines are used in adult care.<\/p>\n
The review did not recommend a ban on puberty blockers but resulted in one for young people experiencing gender dysphoria (they are still permitted for children experiencing early puberty). The ban was extended by the new Labour government in August. Adult gender services are now also under review.<\/p>\n
The World Professional Association for Transgender Health said the refusal or withdrawal of HRT for trans patients raised \u201cethical and clinical\u201d concerns.<\/p>\n
\u201cHormones should not be stopped for political reasons or in the absence of a recognised medical issue,\u201d a spokesperson told TBIJ. \u201cIf GPs are withdrawing prescriptions despite recommendations, this could result in negative impacts on patients’ mental and physical wellbeing.\u201d<\/p>\n
\u2018I\u2019m in limbo\u2019<\/strong><\/h2>\nIn 2021, Emily received a diagnosis of gender dysphoria \u2013 the distress or unease felt by a person when there is a mismatch between their gender identity and the sex they were assigned at birth.<\/p>\n
To avoid a lengthy wait for an NHS gender clinic, she had opted for a private gender service. Analysis by the BBC\u2019s Newsnight programme in March found that the backlog of people waiting for first appointments would take 10 years to clear.<\/p>\n
\u201cIt\u2019s important to say that even for trans people who do have access to healthcare they don\u2019t necessarily get the care they want or would prefer, but you kind of just have to go along with it,” said Emily.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
![](\"https:\/\/www.gaytimes.com\/wp-content\/uploads\/2023\/10\/TRANS-RIGHTS-ARE-HUMAN-RIGHTS-2.jpg\")
<\/p>
\n
\n
\n
The HRT which would later be prescribed by her GP made life feel more livable. Her doctor had been prescribing and monitoring it \u2013 until this summer, when this suddenly changed without consultation.<\/p>\n
No one spoke to her face-to-face about the decision. Instead she was informed by text message. \u201cI\u2019m in limbo,\u201d she said. \u201cMy mental health has been in such a precarious position because of the struggle to get healthcare.\u201d<\/p>\n
Emily doesn\u2019t believe all staff at her practice were on board with the decision. \u201cI feel sympathy for the members of staff who are having to go along with [withdrawing prescriptions] \u2026 it\u2019s obviously a systemic problem.\u201d<\/p>\n
Elijah, 33, also used a private service to avoid waiting for an NHS clinic. He waited six months for an appointment and paid a fee before receiving a gender dysphoria diagnosis.<\/p>\n
The testosterone he was prescribed after this diagnosis had made him feel confident, grounded and happier. His GP had been so supportive that he hadn\u2019t imagined losing access to it. But, after moving house and registering with a different practice, his new doctor decided to discontinue the prescription he had been receiving for two years.<\/p>\n
\u201cI found it so paralysing that she had made that decision for me,\u201d said Elijah. \u201cI had no say, despite having proof that everything had been fine for the last two years.<\/p>\n<\/div>\n<\/div>\n<\/div>\n
\n
![](\"https:\/\/www.gaytimes.com\/wp-content\/uploads\/2024\/03\/TRANS-HEALTHCARE.jpg\"){kind=spacer}
<\/p>