Wrongful Life

That article on LGBT.co.uk, mentioned another controversy in the UK, about a doctor, Richard Curtis, who is being sued by a patient for wrongfully allowing her to transition.  The suit alleges that the doctor was committing malpractice by prescribing hormones and offering a referral for a mastectomy to this patient given his interactions with her.  The response to this suit included a twitter feed, #TransDocFail, in which trans patients had the chance to excoriate doctors and other healthcare providers for being transphobic.  Cis readers were duly shocked at the anecdotes, which involved anything from misgendering to insults to a flat refusal to use the patient’s legal name ever.  One post-op patient was refused documentation from her GP that she had undergone surgery.  

I didn’t see any references to tweets about this particular problem, though: the feed was set up for patients to share transphobia stories, not for patients who felt their doctors had wrongly allowed them to transition.  There’s nothing wrong with that, politically or strategically, but it’s interesting.  It’s also interesting that the shift in theme doesn’t seem to be reactive–that is, collecting complaints about doctors who exclude trans people from treatment or offer it only on humiliating, frustrating terms was not a response to this story about a regretter who is suing her doctor.  It wasn’t an effort to turn attention to a far more common, more serious form of medical mistreatment of trans people.  

Even though there is a current debate in the trans community about what to do about Everyone’s Worst Nightmare (Resolved: Haven’t We Been Through This?).  This patient isn’t only the embodiment of cis fears about trans as a destabilizing influence.  This patient embodies care-provider fears about the risks of proxy: what if they sue?  Between the vindictive litigation and the false gender positive, this patient stands in the gender anxiety that underlies both clinical and lay attitudes towards trans people: what if they’re all dangerously insane?  

I’m being flip here; I don’t mean to be.  I’m not commenting on the justice of the suit or the justice of worries about this lawsuit in the context of NHS provision of treatment/access.  

But it’s interesting.  Between the complaints that the media loves to run with stories about trans regretters and the fact that the media loves to run with stories about trans regretters, it’s interesting that this story has become about the abuses of the medical profession and especially its tendency to make transition needlessly difficult for trans people.  

That isn’t a story that gets much play.  Most people don’t know that much about the process; most people haven’t thought very much about what its consequences are; most people believe that trans people should have to submit to some proofs and checks before being allowed to transition.  I don’t think more than a tiny minority of cis people would question the idea that trans people should be allowed to transition–or the implicit converse, that some may therefore be rejected and that all will thus be delayed.  Informed consent would probably match with terms like willy-nilly and taxpayers.  Or maybe lawsuit.  

It’s even more rare that these barriers are framed as a moral issue–when they are discussed, it’s usually in articles that purport to show readers what it’s like to be a transsexual person, and presented as simple fact alongside the procedural details of surgery and the parents’ list of childhood portents.  To be transsexual is to have a doctor.  Even though stories like those populating the hashtag are really common, and even though many transsexual people are rejected, I don’t know if I’ve seen much reference to the fact that delays are common, that access is cut off.  

This doctor is being sued for being too helpful, too permissive:

The allegations include commencing hormone treatment in complex cases without referring the patient for a second opinion or before they had undergone counselling, administering hormone treatment at patients’ first appointments, and referring patients for surgery before they had lived in their desired gender role for a year, as international guidelines recommend. One patient allegedly underwent surgery within 12 months of their first appointment. He is also accused of administering hormones to patients aged under 18 without an adequate assessment, and wrongly stating that a patient seeking gender reassignment had changed their name.

And then there’s this woman:

One of the most serious cases concerns a female patient who regrets switching to a male role. She underwent hormone treatment and had her breasts removed. The woman is one of the complainants in the current GMC investigation.

It’s interesting that the other allegations are not specified this way: it’s not clear whether those people regretted transitioning.  If your doctor offers you the correct treatment without making sure it’s correct, can you say that you have been harmed?  

The article also references the WPATH SOC (formerly known as the HBSOC):

Patients seeking breast or genital surgery should have “persistent, well-documented gender dysphoria”, be over the age of consent, and have the mental capacity to consent to the treatment. They should live full-time in their desired gender role for at least a year before surgery, to see how they cope with work, family, friends and relationships. But the guidelines are not legally binding but flexible directions which can be modified to suit a patient’s needs.

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