A 14-year-old transgender boy is starting legal proceedings against NHS England over delays to gender reassignment treatment.
The teenager has waited over a year for referral to the only NHS gender clinic for children and adolescents.
The Good Law Project, which is acting for the teenager, says the NHS has a legal obligation to provide specialist care to all patients within 18 weeks, or provide an alternative.
NHS England says a review is under way.
It announced the independent review into gender identity services for young people in September. An NHS England spokesperson said this would include “how and when children and young people were referred to specialist services”.
There have been previous reports of trans young people experiencing “hugely distressing” waits for treatment at the gender-identity development service (GIDS) run by the Tavistock and Portman NHS Trust.
But others believe the clinic is too quick to offer gender transition treatment to teenagers.
The teenager at the centre of this latest case, who wants to be known as Reece, told the BBC he “ideally” would not have to bring legal action.
But he says he had no choice because “nobody else is sticking up for trans young people”.
Reece first came out as a trans boy in primary school. His family, friends and teachers were all supportive of him transitioning.
Since moving to secondary school, everyone has always known him as a boy, only referring to his new name and he/him pronouns.
However, Reece says he was able to access help with his transition only through expensive private healthcare. He spoke to his GP about a referral to GIDS in October 2019, but he is yet to hear anything from an NHS specialist.
He says he is aware of others awaiting gender reassignment treatment.
“I know more than 30 trans people, from school and LGBT groups. Everybody’s been waiting for months, or even years, but nobody’s been able to get in yet.
“It’s scary because it shows the service isn’t available to the people who need it.”
‘Deeply concerned’
The Tavistock is currently booking appointments for people who have been waiting for an initial session since September 2017.
However, a Freedom of Information (FOI) request made by the BBC has revealed that, since 2017, over 10,000 more young people have been referred to the already over-subscribed service.
This problem pre-dates the coronavirus pandemic.
Waiting times, the number of referrals, and the treatment given, are all being investigated by an independent review.
Bev Jackson, from the LGB Alliance, a self-funded lobby group, said: “We don’t think children should be allowed to self-diagnose any medical condition.
“The numbers of referrals are so huge that I believe this is a social problem caused by miseducation. It is impossible for the NHS to deal with all of these young people who are coming forward.
“We need to take a step back and ask why are so many young people presenting at the clinic for a gender treatment?”
One psychotherapist, who wanted to remain anonymous, said she believed the long waiting times could be “a positive”.
“Having to wait a few years for initial treatment may benefit some young people who question their gender, as they will become more mature and more knowledgeable about their identity.”
However, Reece disagrees, saying this view “really frustrates” him.
“The solution to working out if a person is trans or not, is not to leave them on their own in a bad situation. If a person isn’t actually trans, they won’t realise that without professional support. That’s why the different stages exist.”
‘Right to treatment’
Jolyon Maugham, director of the Good Law Project, who is representing the teenager, said: “NHS England has a statutory duty to ensure that patients referred by their GP to a gender identity development service are seen within 18 weeks.”
“This is not happening, and as a result, we believe the law shows they should be providing alternative care to anyone on the waiting list. That could include private and overseas healthcare.
“Whilst the young people are waiting, puberty passes and transitioning becomes a lot harder – some people are effectively denied treatment.
“The NHS needs to make a cultural decision that trans people are real, and they have the same rights to treatment as everybody else.”
An NHS England spokesperson said: “There has been more than a 500% rise in the number of children and young people being referred to the Tavistock’s gender identity service since 2013 as more people come forward for support and treatment.
“The NHS has already asked Dr Hilary Cass to carry out an independent review including how and when children and young people are referred to specialist services, so legal action against the NHS will only cost taxpayers’ money and not help the actions already under way.”
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