- Nov 16, 2003
- Dunedin, New Zealand
Once again there seems to be a conflation of two separate issues. On the one hand there are gender affirming surgeries (top, bottom, face, tracheal shave, etc.), which are constrained by an actual lack of supply. Bottom surgery is a complicated procedure in a niche field of practice and there is a small number surgeons globally who actually do reliably good work, so wait times are consequently and understandably (if regrettably) long.
On the other hand there is the GIC system in the UK which is an entirely manufactured problem invented by a people who see us as an infestation to be managed rather than people who deserve dignified care. We know this because most countries who have implemented self-id do not experience this problem.¹ So then the problem isn’t due to budgetary constraints or convoluted interlocking bureaucratic systems or medical exigencies - indeed the GICs add to budgetary constraints by necessitating an entire parallel bureaucracy of gatekeepers to limit service for a comparatively minuscule population; and WPATH has maintained for a half a decade now that self-identification is sufficient for a gender dysphoria diagnosis. Parliament could vote tomorrow to end the GICs and move to a self-id system, and while many problems would remain - both with the NHS and with trans care - the problem of wait times for HRT would resolve almost overnight.
¹In Chicago I made the mistake of trying to go through an endo at a time when specialists were on massive backlog due to COVID, so I had a 3 month wait for my visit, but once the visit day arrived,the time from entering the clinic to drugs-in-hand was about 90 minutes.
Here they're making an effort with safety rooms at school and things like bathrooms.
Successive governments just tinker and kick can down the road on big issues.
Which leads to cratering support levels. Socially liberal more or less but good luck getting much done outside crisis management.