Should The Nhs Even Be Doing Tg Operations?...

[ToraToraTora]

http://news.sky.com/story/1622257/nhs-failing-transgender-people-report-says
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.

[andy-hughes]

Orderlimit - //Should The Nhs Even Be Doing Tg Operations?

A simple no from me. //

But as this post has shown, expecially the illuminating posts from sunny-dave - 'simple' is exactly what this is not.

[Peter Pedant]

// XY=Man, XX=woman, ...... no amount of gluing/chopping can change that. // //

erm not quite - Justice Ormerod considered this as far back as 1969 in the famous April Ashley case ( whose real name was Corbett ) and even HE reaslised that just having a 'y' chromosome was not quite enough [ he was a judge and a doctor by the way ]

http://www.vanuatu.usp.ac.fj/courses/LA306_Family_Law/Cases/Corbett_v_Corbett.html

[gness]

As we never know what's ahead of us I wonder how those looking at this narrowly and without compassion would feel if....in years to come... the happiness and well being of a child or grandchild was only achievable after gender reassignment......

Or would they just cruelly dismiss them in the terms that have been used here?

[DTCwordfan]

Never easy to prioritise when one has so many diverse treatments to cover, others that could also fall in the same category, weight-loss for example, aspects of cosmetic surgery, etc. Never mind the patients and their age and sociometrics..... Having studied some aspects of public policy making, I for one would not want the job as, by definition, it will always be a judgemental decision.

As to the question here, one word of caution and that would be one has to be very careful about definitions of transgender and transsexual - throw in crossdressing too and, in practice, there is a continuum and not separate categories. However, I agree with the comment that the mental and other consequences of not assisting transsexuals, (and especially when they are young as that is more cost effective), well then the other costs on the NHS may well be higher. The NHS require an awful lot of commitment and psychiatric assessment before any operation is undertaken....at least two years full time living and a minimum of two independent psychiatrists reports over the period too, so the decision is not a lightweight one.

In practice, a lot head overseas, not because of the wait or cost, but the best surgeons tend to be offshore and the candidate will save to take advantage of this.

[sunny-dave]

Have I ever regretted a decision?

Yes - a couple where I just couldn't convince the rest of the panel to agree with me to fund what I thought was a valid case. We always tried for consensus, but I later wished I'd stood my ground and forced a deadlock at least.

There was also one where we gave in to some nasty arm-twisting from further up the NHS hierarchy to fund something which I knew was wrong (but a political hot potato).

It was a drug of dubious efficacy (and nasty side-effects) but with an effective public campaign for its use. The person still died and the quality of life of their last few months was much worse than it needed to be. It would have cost me my job to refuse funding (and they'd have still found a way to do it) - but I wished I'd been more vociferous in my disapproval.

[DTCwordfan]

On Dave's point of complexity and cost-benefit and efficiency, there was a good example this morning on Breakfast TV, that being over new Downs testing coming in and how far should the NHS take this - still pricey but far cheaper than an amniocetosis and just as accurate, to be offered to women with a 1:150 chance of Down's - but the question of why not to every pregnant woman.......?

[gness]

Thank you, Dave......I will certainly buy you a pint or two to hear more....

Off to shower and bling up for dinner out now but thanks also for your contributions to this thread......xx

[Gavmacp]

There is a lot of madness in the NHS where funding is concerned. Friend's remit is to prevent admissions to hospital and this is closely scrutinized. She has proven that her service saves the NHS hundreds of thousands yet she is expected to find cuts!

[DTCwordfan]

Further to Peter's response, XX, XY and not quite....

True - hate to say it boys, you are born with male and female genes inside you.....it's called your parents. There is a complete spectrum from the Alpha Male all the way through to Women's women.....and 'Brain Sex and Men are from Mars and Women are from Venus' explain the biochemistry and psychology of this spectrum - read either and you might be more understanding of the trans or transgender situations or even bisexual or gay personalities.../

[pixie374]

That's absolutely right, dt. The question is whether hormones and surgery are the best response.

[DTCwordfan]

Depends on the individual case and the potential consequences...... someone down here was taken over at 70 and to me that is a waste of money - at 18 having been on hormone programmes since puberty and she can live a full and rewarding life.....

[ummmm]

You think they don't have to wait for years?

[pixie374]

It's nothing to do with bandwagon. It's obviously genuine feelings and very carefully assessed. I'm just not sure we have it right, yet.

[Gavmacp]

I'm waiting for the "they should just pull themselves together", response.

[viv41]

No, the NHS should NOT fund these ops not at the expense of cancer patients and other patients with REAL illnesses. Either go private or abroad, if its cheaper. The NHS is stretched enough as it is. And no, I don't know any transgender people, but I do know people with cancer and other serious health problems.

[Mamyalynne]

There's nothing new about these issues - they have been written of and known since ancient times.

If people were allowed to live without having to conform to officialdom 'tick box' - M/F then maybe fewer would have to undergo treatment etc.. to obtain a 'certificate' to satisfy the red tape department.

[jim360]

What is heartening is that despite the predictable lack of understanding from many posters, it seems that there are about as many people able to adopt various much more reasonable positions, from "I totally get this" to the really wonderful "I don't really get why people feel this way but I am not going to let that stand in the way of their receiving [what is currently perceived as] necessary treatment". Attitudes are changing, and in the right direction.

[grasscarp]

The sad facts are that after surgery 20% regret changing genders, over 40% attempt suicide, and a large number remain traumatized.

[jim360]

[citation needed]