This week I’ll be going up to London to do some research on Michael Dillon, an Irishman who because the world’s first female-to-male transsexual while living in Bristol. Dillon not only holds a record for his own gender change, but also trained as a doctor and later assisted with the UK’s first male-to-female gender surgery. In many ways he kickstarted the whole transsexual phenomenon. It is ironic, therefore, that this week also sees the beginning of what may well be the end of medical treatment for trans people in the UK.
I refer you first to this article that appeared on the Guardian website last night. It may seem fairly innocuous, but to trans people the mere sight of the byline “David Batty” is enough to signal that this will be a deeply distorted piece of reporting.
The article details a long list of supposed malpractice charges brought by the General Medical Council (GMC) against a gender specialist, Dr. Richard Curtis, working in London. None of these charges are proven, and obviously I have no knowledge of their substance. However, I am one of Dr. Curtis’s patients, I’m very happy with how he has treated me, and yet the substance of Batty’s article leads me to suspect that one of the people Curtis is accused of mistreating is me. Let me explain.
We should start by noting that the practice of medicine is by no means easy. Doctors can, and do, make mistakes. Just as an example, a year or so ago my mother was mistakenly prescribed pills ten times stronger than she needed. Had she taken then, she would have suffered kidney failure and might have died. Thankfully someone noticed in time and phoned her up to warn her not to take them. It was later discovered that the diagnosis for which the pills were prescribed was faulty, and even the correct strength pills were actually making her sick. No one was disciplined over this. It was accepted that getting the correct diagnosis can be very difficult.
A week or so ago my friend Christine Burns, who is an Equality and Diversity Programme Manager at a Strategic Health Authority, was tweeting about a report that showed that black and minority ethnic (BME) doctors were much more likely to be disciplined and struck off for mistakes than their white counterparts. No one ever makes a complaint saying, “this person is a bad doctor because she’s black”. That would be illegal. And yet when you look at the statistics it is very clear that a BME doctor who makes a mistake is likely to be disciplined, whereas a white doctor who makes a similar mistake will probably be let off. It is one of many ways that racial prejudice is alive and well in Britain, despite laws supposedly protecting people.
Now here’s another statistic for you. It isn’t a very good one, because the sample size is only four, but of all the gender specialists I have seen in my life, 75% of them have been accused of malpractice. Also, 100% of those so accused had their cases prejudged by being dragged through major newspapers in a way that would probably result in contempt of court proceedings had an actual court been involved. (I’m not sure what happened to the fourth — the clinic where she worked appears to have been closed, probably due to the California budget crisis.) I submit that this is not an accident. Rather it is because there is a group of “crusading” journalists, including David Batty and Julie Bindel, who make it their business to seek out unhappy post-op trans people and exploit them to try to get the doctors who treated them struck off.
There’s more to it than that, though. Back when I transitioned, the National Health Service had a really poor reputation when it came to treating trans people. Basically you went to them only if you could not afford to go private. And you knew that if you did go to them you would be put through a cruel obstacle course of tests intended to prove whether you were worthy of treatment; part of those tests being conforming to absurd stereotypes of gendered behavior that were firmly rooted in the 1940s.
The people responsible for that have since retired. New, younger doctors have taken over, and are trying to move the NHS to be more in line with international guidelines on responsible treatment of trans people. Part of this is a requirement to treat your patients as human beings rather than as dangerous lunatics. However, I understand from trans activists that one of these old men has taken it upon himself to harass anyone following modern treatment guidelines, and sometimes instigates malpractice suits against them. Hence the nature of most of the complaints against Dr. Curtis.
In this case, however, there is an additional complication. As the Telegraph shamefully reveals (in direct contradiction of ethical guidelines for reporting stories about trans people), Dr. Curtis is himself trans. In any sensible environment, this would be applauded as he will obviously have a unique insight into the problems faced by his patients. However, in the warped mind of the old men at the GMC, who believe that all trans people are, by definition, insane, such a person should not be allowed to practice medicine at all, let alone minister to his fellow lunatics.
By the way, while Batty did refrain from outing Dr. Curtis, he will have been well aware that once he broke the story other papers who care even less about press ethics would do the outing for him. This is not a case of the Guardian doing the right thing. It is a case of the Guardian being cowardly and encouraging other people to do their dirty work for them.
Zoe O’Connell takes issue with the substance of Batty’s article here, and shows how most of the charges look to have been manufactured to prevent Curtis from following modern best practice. I’ll just concentrate on one issue — how this applies to me.
I became a patient of Dr. Curtis several years ago. My existing doctor had taken voluntary retirement having got tired of being hounded in the press by a journalist called David Batty. I needed to see a gender specialist in order to get hormone prescriptions. As I have explained here before, although international guidelines state clearly that post-op trans people are cured of their gender dysphoria, and require regular doses of hormones to stay healthy, a succession of GPs have refused to accept that and have either refused to supply a prescription at all, or would only do so if an independent gender specialist certified me sane.
So I went to see Doctor Curtis, presented my medical records from the UK, Australia and California, and he agreed to prescribe hormones for me, on my first visit. Batty’s article implies that this was malpractice on his part. He goes on to state that the GMC now insists that:
“He [Dr. Curtis] must not prescribe hormonal treatment for patients with gender dysphoria, or refer any patients for gender dysphoria surgery, unless those patients have undergone a recent mental health or psychological assessment carried out by an appropriately trained mental health care professional.”
Batty may be mis-stating the condition somewhat, but if he isn’t that means that Dr. Curtis will no longer be able to write prescriptions for me unless I regularly undergo psychiatric testing, presumably at my own expense. And this is to get a prescription which the international guidelines say is essential for my continued health.
I could apply to an NHS gender clinic, but the waiting lists at all such places are several years long. I don’t have enough supplies to get through such a period. And of course I’d then class as a new patient and be required to spend a year or two surviving without hormones to prove that I was worthy of them.
The obvious solution is to find another private doctor. I understand from friends on twitter that there is one, though how long that person will be free of malpractice suits is another matter. You see, there is a bigger game in play here.
Under the old National Health regulations, funding of gender clinics, and referral of patients to them, was a matter for individual Primary Care Trusts, which were regional bodies. Gender medicine was one of a number of areas that fell victim to what the UK calls the “postcode lottery” — that is, depending on where in the country you lived, you might or might not be able to get treatment. Tabloid newspapers often fulminated against those PCTs that funding gender treatment, and praised those that did not, even though a point blank refusal to fund under any circumstances was actually illegal.
The reforms brought in by the current government will do away with this. Instead the decisions on what types of treatment can be funded will take place at a national level. You can be sure that Bindel, Batty and their allies will be working hard to ensure that NHS funding for all gender medicine is stopped at this convenient central spot.
The only loophole in that strategy is that the government is also very keen on private medicine. If the NHS can’t afford to fund something, well private doctors can take up the slack. However, if anyone who dares to go into practice in gender medicine is quickly shut down by spurious malpractice suits, well then the disgusting tr*nnies will have nowhere to turn, will they?
The end result will be more people like me (indeed, probably including me) risking their lives by buying essential medical supplies on the black market over the Internet. There will also be more suicides. And with every death I expect that Batty, Bindel and their allies at the Guardian will do a little dance of joy.
Update: Post edited to give Christine her correct job title. Also please see this post which goes into the wider issue of discrimination against minorities in the Health Service and other “professional” occupations.