麻豆传媒

DOCTORS are failing their transgender patients. In the UK, an estimated 1 in 5 general practitioners are , said James Barrett of the British Association of Gender Identity Specialists last week. 鈥淪ome are remarkably frank, and say: 鈥業鈥檓 not doing this as it is against my deeply held religious principles鈥�.鈥�

The problem isn鈥檛 confined to the UK. Surveys carried out in the US describe in doctor鈥檚 offices or hospitals.

What鈥檚 more, we know that trans people have a far higher rate of suicide 鈥� a 2010 study in the US found that 41 per cent had attempted it; the national average is 1.6 per cent. But we also know that social support, access to hormones or surgery, and reducing transphobia lower the likelihood of a suicide attempt.

Doctors are bound to have the same range of prejudices, personal beliefs and religious views as the rest of us, but they have chosen a profession that . So what鈥檚 standing in their way?

鈥淭rans people often say that they have to teach doctors about trans care鈥�

Barrett says in his experience some doctors will say they don鈥檛 know enough about how to prescribe the relevant treatments (BMJ, ). This isn鈥檛 just an excuse.聽For example, in the US in 2013, . Those that did gave an average of 45 minutes to the subject.聽Trans people often point out that .

This lack of education can lead doctors to refer trans patients to mental health clinics, instead of gender identity clinics. As a first port of call, this is wrong 鈥� while many people will need counselling, feeling that your gender does not match the one assigned to you at birth does not mean you have a mental disorder.

Part of the problem is how it is defined by the medical community. The World Health Organization鈥檚 (ICD) still categorises 鈥済ender identity disorders鈥� within the 鈥渕ental and behavioural disorders鈥� bracket. It also refers to 鈥渢ranssexualism鈥�, which it defines as the desire to live and be accepted as a member of the opposite sex 鈥� when in fact many people choose not to identify as either male or female.

鈥淭he definition has so many problems I don鈥檛 know where to start,鈥� says Timo Nieder, who runs a gender identity clinic at the University Medical Center Hamburg in Germany. Nieder is pushing to change the category鈥檚 name聽to gender incongruence, and remove it entirely from the ICD鈥檚 section on mental health disorders, changes that are scheduled to happen next year.

There are other signs that things are moving in the right direction. In March, the UK鈥檚 General Medical Council urging doctors to support their trans patients. There are also whispers of plans for the National Health Service to provide fertility-sparing treatments, such as egg or sperm freezing, for all those who start hormone treatment 鈥� as they do for cancer patients.

In the meantime, the front-line medical community needs to address the way it is failing to support a group of potentially vulnerable people, and recognise its duty of care.

This article appeared in print under the headline 鈥淒octors must get up to speed on trans issues鈥�