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'This is my First Trans Visibility Day Where I'm Truly Visible'

A blog by Jack Evans, Liverpool Hope University Students’ Union Transgender Plus Officer, in his second year of a Philosophy, Ethics & Religion degree:  


"Crippling NHS waiting lists mean that I, as a transgender undergraduate, have been forced to use my student loan to pay privately for life-changing hormone treatment. 

And as the world celebrates  International Trans Day of Visibility, I want to shine a light on the shocking lack of funding in the NHS for trans people - and also how the pandemic has added to the misery, extending waiting lists and ruining the chances of being able to save up enough money to pay for surgery. 

This is going to be my first ever International Trans Visibility Day where I’ve been truly visible. This time last year I still couldn’t talk about things openly with my family, despite” the fact that I came out to them four years ago, aged 16. 

And what has brought about this complete change in my outlook on life? The fact that I’ve begun taking the male hormone testosterone. 

jack trans pic

After being told I faced a three year wait for such treatment on the NHS, I knew I couldn’t last that long. It simply would have been disastrous for my mental health. 

Instead I’ve used my student maintenance loan to pay a private clinic for various consultations and the testosterone prescription. In a way, I feel lucky that I was able to go down this route, but I also deeply resent it. A cisgender person who wants to visit a doctor does not have to wait several years for an appointment. 

And not only do I have to pay for hormone treatment, I’ll also continue to pay for routine appointments, too. But I, like many other trans people, are willing to do it because the hormones are so important to us. 

Let’s rewind a little bit. 

I was born female, went to an all girls school, and I wasn’t aware of any dysphoria issues until I was in my early teens. I came out in the summer between leaving school and starting sixth form college. My friends were supportive, and gave me the confidence to tell my parents. 

And I’d done enough research to know that I’d ultimately need testosterone to suppress female sex characteristics. 

But here’s the problem - to get access to free hormones on the NHS you need a referral from a GP to a gender dysphoria clinic (GDC). 

There are just eight GDCs in the UK to service an estimated trans population of between 200,000 to 500,000 people, while around 13,500 people are currently on an NHS waiting list. 

Waiting times between a referral from a GP and an appointment at a GDC have also worsened dramatically during the coronavirus outbreak - as I discovered - as the NHS stopped some services deemed ‘non-essential’.

I put myself on the adult waiting list for a GDC referral in the first half of 2020 when my mental health was not in a good place at all. It got to the point where I’d just sit in my room all the time and I’d never do anything. Without the hormones, I couldn’t be myself

I didn’t even want to go to university because I just couldn’t see a future for myself. 

But in the end I decided to go privately. I emailed a clinic in July, had two appointments, got a diagnosis of gender dysphoria and had the hormones by November. It was so much quicker than the NHS.  

Yet it’s also extremely expensive. I paid £300 for my first appointment to be diagnosed with gender dysphoria, the second appointment to see an endocrinologist who prescribed the hormones was £250, and the price of the first prescription cost around £70. I still need to find £150 for every routine appointment. 

And it’ll be like this for the next couple of years until I’m able to access NHS care. 

There’s no getting away from the fact that it’s a huge amount of money for a student from a working class family like mine. But what alternative is there?

As soon as I knew I had my appointments confirmed, I became a completely different person almost overnight. At university I’d never have had the confidence to speak in class. I think some people used to think I was a mute. Now, they can’t shut me up! I’m 100 times more confident and feel as if I’ve got my life back.

But there are other ways the global pandemic has had a knock on effect for the trans community, besides the longer NHS waiting lists. 

I hope to have chest surgery in the future. I know the same NHS waiting lists will mean I’ll have to pay for it privately, leaving me with a bill of around £8,000. 

Yet it’s impossible for me to save that sort of money when the pandemic means it’s so tough for me to find a job. 

Thankfully, my mental health is in a good place. With taking hormones, everyone talks about the physical changes - your voice might drop or you might get a beard. But it’s also about the mental changes, too. I still have anxiety, but it’s much more manageable now that I know I’m on the way to being how I want to be.”

** To find out how Hope supports and helps transgender students, head here


Published on 31/03/2021