Attempting to manufacture yet more anti-trans panic, The Telegraph ran a story regarding ‘bridging hormones’, which is short for a doctor prescribing you medication for harm reduction purposes. According to The Telegraph this basic harm reduction strategy is bad, because transgender.
The story by The Telegraph is headlined “Offer ‘bridging’ hormones to people on gender clinic waiting lists, Scottish doctors told” and written by Daniel Sanderson, Scottish Correspondent. The subheading then reveals that this is advice on bridging hormones that they’ve been given, not an order to start filling out prescriptions.
An important distinction as this would mean literally nothing has changed. Advice to offer bridging hormones to transgender people has existed within the NHS since at least October 2013. As can be evidenced in “Good practice guidelines for the assessment and treatment of adults with gender dysphoria” by the Royal College of Psychiatrists.
The document sets out to define, explain, inform and educate doctors on what is considered to be good practice for treating transgender adults. This includes explaining medications, dosages and what to look for in monitoring a transgender patient.
The document mentions bridging prescriptions on three occasions. First to say that it is recommended by WPATH (World Professional Association for Transgender Health) in 2011. Preceded by “Hormones and hormone-blockers are readily available via the internet. The medical practitioner or specialist must consider the risks of harm to the patient by not prescribing hormones in these circumstances.”
The second example is; “However, the GP or other medical practitioner involved in the patient’s care may prescribe ‘bridging’ endocrine treatments as part of a holding and harm reduction strategy while the patient awaits specialised endocrinology or other gender identity treatment and/or confirmation of hormone prescription elsewhere or from patient records.“
And the final example is; “Some patients may obtain hormones from the internet or other agencies. The clinician should discourage patients from using such sources but may offer monitoring and advice on the effects of such agents. The clinician should assist patients in obtaining hormones from properly authorised sources. A harm-reduction approach should be taken. Accordingly, hormones should not be stopped. A bridging prescription may be appropriate, and blood tests and health checks are undertaken to screen for contraindications.”
Interesting then that The Telegraph piece only mentions the word “harm” once and its to quote a representative from a group who have written complaints to Scottish Government which say “cis is offensive to women”. This after Karen Adam and Gillian Mackay used the term in a debate. The group are suggesting that transitional medicine is harmful itself, whether as bridging hormones or not, though they do not provide any factual evidence to support this claim.
Instead she relies on saying that there are no long term studies about the harms she believes exist. Though equally there’s no long term studies on the risks associated with being a frothingly nonsensical transphobe either. I don’t see any of those putting the brakes on that any time soon.
The piece does attempt to backup its anti-trans moral panic by citing some unknown doctors worrying about bloodclots and infertility. However both of these are indeed mentioned in the good practice guidelines we looked at earlier. There is an extensive section on storing gametes, information about blood clots which affect older transgender women in particular circumstances, and a whole section on this thing called “informed consent”.
That’s when you explain things to a patient, make sure they understand the things and then the patient says “I would still like to go ahead with this treatment”.
The Telegraph do reveal that The Royal College of General Practitioners Scotland have said in a submission to a Holyrood inquiry that they are not given detailed training to support transgender patients. In my personal experience this is true and is cited as a reason by GPs to avoid giving you bridging hormones.
But I’ll tell you what I tell my doctor; get the training. As The Telegraph reveals; the number of people seeking care and now languishing on waitlists, some to the point of suicide, has skyrocketed. Estimates suggest that 1% of people are transgender and therefore a GP practice with 100 patients or more is likely to have at least one transgender person needing help.
If you feel unqualified to support that person the solution isn’t to send them off to a GIC waitlist or anywhere else; the solution is to get yourself informed. That’s what documents like the good practice guidelines are there to get the ball rolling on.
Gender Identity Specialists; for as much as they are a part of the system that gatekeeps transitional healthcare from transgender people, genuinely seem like they want to help for the most part. They will, if contacted by a local GP, do what they can to support a transgender patient alongside a primary care practitioner. Including information on bridging hormones.
The only thing getting in the way of transgender patients and the care we are entitled to is a complete lack of motivation from anyone in the NHS to make the first move; lest they be demonised by anti-trans groups for doing so. Though I suppose if primary care doctors do this it wouldn’t be bridging hormones at all, it would just be hormones. Nice.
The piece from The Telegraph is obviously designed from the ground up to manufacture the fear and outrage over transgender people’s healthcare that makes doctors hesitant to support us. That’s all its there for. It serves no other purpose and frankly shows a lack of research into the subject. I would be ashamed to have my name attached to it, personally.