When I wrote the post about Richard Curtis I couldn’t find any links to the issues that Christine Burns has raised. However, she has kindly sent me some links via Twitter, which I’ll now share with you.

First up there’s a Department of Health paper (PDF) on the need for “revalidation” of doctors, particularly in the light of recent equalities legislation. The problem is that, once a doctor is certified to practice, she can carry on doing so for life. There is no requirement to keep up with best practice, or to familiarize yourself with issues that might never have been addressed when you were trained.

The section on trans people is quite illuminating. The headline statistic is that 84% of GPs and hospital staff are opposed to the funding of gender reassignment on the NHS. It is not surprising, therefore, that post-op trans people are treated in a hostile manner when they present themselves for treatment for ordinary health issues. Now of course the NHS is massively overstretched, so I appreciate concern about the use of funds. But given the suicide rate amongst trans people, the relative cheapness of the treatment (surgery costs are a tiny fraction of the levels typically quoted by newspapers, and the NHS would make a profit on my hormone prescription if I could find a GP willing to prescribe them), and the very high success rate, I suspect you’d find that gender reassignment was one of the more cost-effective live-saving treatments around.

In addition I can report, from personal experience, that there is often a double standard applied here. While NHS employees do not want trans people treated by the state, if you do opt for private medicine they don’t thank you. What they do is accuse you of having self-medicated, and assume that any further health problems you have, of whatever sort, are a result of that self-medication, and therefore also not worthy of treatment by the NHS. Being a post-op trans person is like being someone who smokes 50 cigarettes a day and is massively overweight as far as some NHS staff are concerned.

This, however, is only the tip of the iceberg. The report I linked to goes into detail on all nine strands of the Equality Act, and there are problems with all of them. Furthermore Christine sent me a link to this report (PDF) produced by the University of Bradford on the disproportionate use of disciplinary action against black and minority ethnic workers in the health service. The headline stat there is that a BME member of staff is twice as likely to be disciplined as a white person. Because these days managers and HR departments are adept at phrasing their attacks on minority staff in ways that avoid allegations of discrimination, they get away with this. (And indeed I’ve suffered it myself. In the last job I had, I quit because it became obvious that the HR team was fabricating a disciplinary complaint against me so as to avoid being subject to California’s trans equality legislation.)

The good news is that the problem is being recognized, and Christine also sent me a link to this conference being held at the University of Manchester in March to discuss the problem, not just in the health service, but throughout all so-called “professional” occupations.