In March 2023 the UK doctors’ regulatory body, the General Medical Council (GMC), put out on its website information about adult ‘Trans healthcare’ with a sub-heading, ‘Every patient has the right to high-quality and inclusive healthcare.’ Patients do not, I think, want low-quality, non-inclusive healthcare, so this hardly needs saying.

Under another sub-heading, ‘How to make your practice more [sic] inclusive’, the site features a patronising video narrated by an unnamed person who is obviously a man – he has a square jaw, broad shoulders, and a deep voice – pretending to be a woman. Sporting green-tinted hair, earrings, and lipstick he starts by saying: ‘All patients should be listened to, treated with respect, and given good person-centered care.’ Do doctors really need to be reminded in this way of these obvious principles of how to behave towards patients?

(I do wish they would write proper English. Something is either inclusive or it is not; you cannot have degrees of inclusivity.)

Trans ideology trumps common sense
It looks as if the GMC has swallowed the transgender ideology hook, line, and sinker. For a start, what does ‘trans’ (short for ‘transgender’) mean? I submit there is no such entity. They seem to concur, since they say, ‘As set out by the Royal College of Psychiatrists, being transgender or gender diverse is not a mental health disorder.’ What is it then? Is it normal or a variation of normal, as homosexuality appears to be? And if this is the case, why does it need treatment?

Sex ‘assigned’ at birth
The GMC also defers to the Royal College of Psychiatrists’ 2018 Position Statement on the matter, called ‘Supporting transgender and gender-diverse people.’ However, I find it hard to take seriously a medical organisation which states that ‘transgender and gender-diverse people are individuals whose gender identity and/or gender role do not confirm to the sex assigned to them at birth.’

I am getting tired of repeating that sex is not assigned at birth. Sex is determined at conception and recognised (or observed) at birth as male or female, and registered accordingly.

Trapped in the ‘wrong’ body
Transgenderism is a concept that refers to individuals who have a sense, feeling, or delusion that they are trapped in the ‘wrong’ body. It is, therefore, a psychological problem and if it is causing significant distress may need psychological treatment. It is controversial to offer so-called affirmative care, which means abnormal hormonal administration (see below) and even mutilating surgery.

The GMC also mentions ‘gender dysphoria’. I submit, likewise, there is no such entity. There is only dysphoria (unhappiness, dissatisfaction, or distress) which may have myriad causes. For example, if someone is unhappy about a big beaky nose do we say they have rhino dysphoria? (From the Greek, rhinos, pertaining to the nose.) No, we say they are unhappy because they think their nose is too big.

Prompt referral
Now we come to what doctors should do for transgender patients:

If your patient presents with or requests treatment for gender dysphoria or gender incongruence [implying the existence of an abnormality] explore the options available including prompt referral to a specialist gender service.

If the options include referral to a gender service, what other options do they have in mind?

And what is a specialist gender service? Is it a service that specialises in gender matters, or is a specialised type of gender service? In either case, referral to one such implies a decision to treat accordingly, and this is where the situation gets complicated. It is the patient who makes the diagnosis – there are no objective criteria for transgenderism – and he or she will then likely be started on a pathway that will lead in the vast majority to the offer of hormone administration and even mutilating surgery!

Abnormal hormone treatment
I should point out that prescribing hormones in this situation is abnormal. It means treating unhappy though physically healthy people in a way that will cause an endocrine disorder. Giving oestrogen to a man or testosterone to a woman will not change a man into a woman or a woman into a man, respectively. This is not treatment in the usual sense. It deliberately induces an abnormal physical state with the dubious aim of helping the person so affected to feel better in his or her mind. Such cross-sex hormone administration will usually be continued for the rest of the person’s life and will inevitably carry a risk of side effects.

Is this really something doctors should be doing?

Text © Gabriel Symonds