The NHS is undergoing as major shake-up right now, and as a result is looking closely at various areas of its operations. On the assumption that gender treatments will still be available in future, they have a consultation out concerning their current standards of care. It is part of a wider look at mental health services, and you can find it here.

Looking at the papers they have on that site shows that, when people who know about the treatment of trans people get involved, the NHS can do pretty well. I still wish they would not class gender dysphoria as a “mental illness”, but I can’t see them changing that until the World Health Organization changes their classification.

The first paper, the one on clinical commissioning, contains a review of the literature on the effectiveness of gender therapy. As you might expect, it is more cautious that the EHRC document I blogged about recently, but it does repeat the findings of the NHS Audit study from 2008 which found that 98% of patients (from 647 responses) were happy with the outcome, despite 49% feeling that services at gender identity clinics could be improved.

Interestingly it also quotes a study from 1998 which estimates that male-to-female surgery saves the NHS up to £950 per patient per year, because those people would no longer need treatment for their distress. That means that the surgery pays for itself in around 10 years (based on the cost of mine in 1999).

I note that paper one also says that patients should only proceed with the Real Life Experience without a hormone prescription if it is practicable to do so, whereas as David Batty is suggesting that prescribing hormones before the RLE is malpractice.

The second paper clearly states that it is the duty of GPs to provide support for the life-long well-being of patients after they have been discharged by gender specialists. The only reason I can find for not discharging patients beyond 12 months after surgery is if they are not “medically stable”. If I’m not medically stable after 14 years, I wish one of these GPs would tell me what the problem was.