A trans health expert has disagreed with a leading doctor from the Royal College of General Practitioners (RCGP) on whether gender reassignment is a specialized area of medical care.
In February, Dr Jonathan Leach, the Honorary Secretary of the RCGP said ‘trans patients should be treated in general practice on the basis of need and without bias’.
‘In the vast majority of cases, trans patients will present to the GP with the same conditions that cisgender patients do,’ Leach said in his statement.
But Leach further said that GPs should not bear the responsibility of helping trans patients with gender affirming care.
‘But new presentations of gender reassignment are exceptional in general practice – it is a specialist area of medicine, and treatment should be initiated in specialist care,’ Leach said in late February.
‘We understand that access to specialist gender reassignment services in the NHS is inadequate, and that this is incredibly frustrating for trans patients and their families.
‘But GPs should not have to bear the brunt of poor access to specialist services by being put in a position where they are being asked to prescribe treatment that they are not trained to prescribe or monitor safely without expert support.’
Dr Helen Webberley is an expert in trans medical care and established a private practice in 2015. Despite having treated thousands of patients and many parents crediting her for saving their trans children’s lives, she was fined in Wales failing to register her online advice services.
She however remains a preeminent authority on trans health and disagreed with Leach’s statement.
‘But is this approach, which effectively groups all trans patients together as requiring “specialist” care, irrespective of their individual situation, the best way of dealing with a spectrum of individuals whose needs are often very different?’ Webberley said.
‘Surely, a model which effectively triages each patient would lead to a better understanding of where specialist care is needed and where patients could be managed in Primary Care, by their GP.’
Webberley acknowledged this approach was ‘radical’. But there was ‘no alternative healthcare provision for gender variant patients who are simply directed to the back of a very long queue’.
She said it was unfair to burden the UK’s 14 gender identity clinics with care that a GP could be trained to provide.
‘Dr Leach is worried for the GPs in the UK. He says “GPs should not have to bear the brunt of poor access to specialist services by being put in a position where they are being asked to prescribe treatment that they are not trained to prescribe or monitor safely without expert support”,’ Webberley said.
‘It is worth remembering that the list of drugs prescribed for these patients is small, and consists of drugs that are used in every-day General Practice when treating menopause, andropause, endometriosis and prostate cancer.’
However the RCGP has decided to introduce a new e-learning course for GPs on gender variance.
‘The College is currently funding and developing a new e-learning course for GPs on gender variance, which should be launched later this year,’ Leach said.
‘We have also received funding from the Government Equalities Office to develop resources to support GPs and other healthcare professionals to deliver the best quality care for our LGBT+ patients.’
Webberley felt reassured by the announcement.
‘However, this news comes under the cloud that the e-learning resource that was developed by the Gender Identity Research and Education Society (GIRES) was recently removed from the RCGP website,’ she said.
GIRES discovered the RCGP had made changes to the resource without its permission. In response to those changes Leach said the resources ‘risked creating unrealistic expectations for patients regarding the role of the GP in initiating treatment’.
‘Is it unrealistic on the part of the patient to be able to access basic clinical care?’ Webberley asked.
Gay Star News reached out to the RCGP for further comment about the issue. It responded saying ‘we’re unable to expand on our statement at present as we’re formulating an official College position on gender variance, which will hopefully be published later this year’.