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Lot of moaning here but surely the NHS is designed for real medical issues not for those who have decided they want to change sex. If they are that desperate they can pay privately.
Lot of moaning here but surely the NHS is designed for real medical issues not for those who have decided they want to change sex. If they are that desperate they can pay privately.
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AOG: "How can you possibly equate a terminal illness situation with a none life threatening situation, such as gender re-assignment? "
The problem with this point is that, again, it seems to belittle anything that could be seen as a mental health issue -- and, in their way, they certainly are life-threatening. Not physically, but anyone who is driven towards depression and doesn't receive the attention needed can be at risk of death just as much as someone who, say, has suffered a horrific physical injury. It may be less visible but it is no less valid.
As to the rest of your post, I suspect that if there has been such an increase in referrals then it's to be expected as a result of the progress that has been made so far -- in being more accepting of transgender people, and on the whole less judgemental. There remains some way to go, but if people feel under less pressure to hide their transgenderism then it's not surprising to see a corresponding increase in referrals at clinics.
Pixie, re the desert island question: dunno. Very possibly not, I suppose, because arguably the entire point about trans* issues is that gender, as opposed to biological sex, is very much a social construct. Absent such contact with society I can well imagine therefore that it might never be an issue. But transpeople aren't stuck on desert islands and they do grow up in society and so it does become a problem. In the future, perhaps the traditional understanding of gender will change so drastically that it again stops being an issue, because people can just be themselves free from prejudice or judgement. We can but dream.
The problem with this point is that, again, it seems to belittle anything that could be seen as a mental health issue -- and, in their way, they certainly are life-threatening. Not physically, but anyone who is driven towards depression and doesn't receive the attention needed can be at risk of death just as much as someone who, say, has suffered a horrific physical injury. It may be less visible but it is no less valid.
As to the rest of your post, I suspect that if there has been such an increase in referrals then it's to be expected as a result of the progress that has been made so far -- in being more accepting of transgender people, and on the whole less judgemental. There remains some way to go, but if people feel under less pressure to hide their transgenderism then it's not surprising to see a corresponding increase in referrals at clinics.
Pixie, re the desert island question: dunno. Very possibly not, I suppose, because arguably the entire point about trans* issues is that gender, as opposed to biological sex, is very much a social construct. Absent such contact with society I can well imagine therefore that it might never be an issue. But transpeople aren't stuck on desert islands and they do grow up in society and so it does become a problem. In the future, perhaps the traditional understanding of gender will change so drastically that it again stops being an issue, because people can just be themselves free from prejudice or judgement. We can but dream.
andy-hughes
/// if it is purely for vanity reasons. ///
I heard a transgender person on the radio state that there are two different operations to choose from, one that (to put it mildly) makes one look like a woman and the other makes one fully functional.
So would you agree that the first one is simply for cosmetic purposes only?
/// if it is purely for vanity reasons. ///
I heard a transgender person on the radio state that there are two different operations to choose from, one that (to put it mildly) makes one look like a woman and the other makes one fully functional.
So would you agree that the first one is simply for cosmetic purposes only?
The NHS funds all sorts of things that I disapprove of - and doesn't fund some other things that I think should be part of its core services.
But I accept that other people think differently and that scarce resources need to be apportioned somehow.
It's a difficult task (that I was actually involved in a while ago) - often heartbreaking, often frustrating, occasionally anger inducing - but never either easy or taken lightly by those involved.
Although emotive, gender reassignment is not inherently different to many other treatments/operations that the NHS funds - why it should be singled out for this particular tirade I can't think ... or perhaps I can.
But I accept that other people think differently and that scarce resources need to be apportioned somehow.
It's a difficult task (that I was actually involved in a while ago) - often heartbreaking, often frustrating, occasionally anger inducing - but never either easy or taken lightly by those involved.
Although emotive, gender reassignment is not inherently different to many other treatments/operations that the NHS funds - why it should be singled out for this particular tirade I can't think ... or perhaps I can.
AOG - //andy-hughes
/// if it is purely for vanity reasons. ///
I heard a transgender person on the radio state that there are two different operations to choose from, one that (to put it mildly) makes one look like a woman and the other makes one fully functional.
So would you agree that the first one is simply for cosmetic purposes only? //
No - because I don;t know anything like enough about the issue to make an informed decision.
What I do know - and aspects of this thread, including the OP, prove it - is that it is very easy to sneer and look down on the notion that tansgender surgery is required be narcissistic freaks who don't deserve the time of day for their wierdness and self-obsessed perversions.
I don't take that view point - I think a degree more compoassion and understanding of issues beyond immediate experience would make the world a better place all round.
/// if it is purely for vanity reasons. ///
I heard a transgender person on the radio state that there are two different operations to choose from, one that (to put it mildly) makes one look like a woman and the other makes one fully functional.
So would you agree that the first one is simply for cosmetic purposes only? //
No - because I don;t know anything like enough about the issue to make an informed decision.
What I do know - and aspects of this thread, including the OP, prove it - is that it is very easy to sneer and look down on the notion that tansgender surgery is required be narcissistic freaks who don't deserve the time of day for their wierdness and self-obsessed perversions.
I don't take that view point - I think a degree more compoassion and understanding of issues beyond immediate experience would make the world a better place all round.
There are two levels of decision making in the NHS, gness.
National policy (from NICE) will determine most issues, but there will always (I hope) be some scope for local decisions on exceptional/difficult cases that don't fit the national criteria for some reason.
Gender reassignment used to be under a national decision making framework, but if people fell outside that then we had some scope for local decisions (as we had about other exceptional cases). Any local decision could be appealed and a different panel would consider the appeal.
I can rattle on for many hours about the issues that used to be considered in our decisions - it was an exhaustive, arduous and occasionally heart-rending process - might need more than one pint.
Dx
National policy (from NICE) will determine most issues, but there will always (I hope) be some scope for local decisions on exceptional/difficult cases that don't fit the national criteria for some reason.
Gender reassignment used to be under a national decision making framework, but if people fell outside that then we had some scope for local decisions (as we had about other exceptional cases). Any local decision could be appealed and a different panel would consider the appeal.
I can rattle on for many hours about the issues that used to be considered in our decisions - it was an exhaustive, arduous and occasionally heart-rending process - might need more than one pint.
Dx
Thanks, Dave......I'll stand you a few pints then...just one for me and half a shandy for Pixie...... ;-)
I will be really interested to hear....over the pint.....if possible...some situations you've had to make a decision on......and I'll bet we disagree on some......but it's good to get the experiences of someone involved.....thank you....x
Have you ever gone home and regretted a decision?
I will be really interested to hear....over the pint.....if possible...some situations you've had to make a decision on......and I'll bet we disagree on some......but it's good to get the experiences of someone involved.....thank you....x
Have you ever gone home and regretted a decision?
Hi Pixie - often a balancing act between scarce resources and the needs of an individual patient.
The crucial thing was always "what is the general evidence for the efficacy of the treatment" - this got very difficult even with (for instance) new drugs for an existing condition - evidence is often contradictory and/or not statistically valid enough. So imagine the problems with mental health procedures and treatments - not easy at all.
Once we had some evidence for the treatment we then had to look at "what will it achieve for this person" - often getting second opinions from other medics than those closely involved with the patient.
Then (and only then) we looked at "is it value for money" - which is not done by saying "what else could that money buy" - but by looking at the improvement the patient could expect related to the cost of the treatment.
A difficult job - but a worthwhile one.
The crucial thing was always "what is the general evidence for the efficacy of the treatment" - this got very difficult even with (for instance) new drugs for an existing condition - evidence is often contradictory and/or not statistically valid enough. So imagine the problems with mental health procedures and treatments - not easy at all.
Once we had some evidence for the treatment we then had to look at "what will it achieve for this person" - often getting second opinions from other medics than those closely involved with the patient.
Then (and only then) we looked at "is it value for money" - which is not done by saying "what else could that money buy" - but by looking at the improvement the patient could expect related to the cost of the treatment.
A difficult job - but a worthwhile one.
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