I have been really disappointed in what happened with the present government on many things but in particular over their efforts to reform the Gender Recognition Act. The fact that they were making the right noises that they were going to do away with a diagnosis of gender dysphoria caused huge disappointment and disillusionment and accusations of a lack of leadershipwhen the so called reforms were announced and which did very little except reduce the fee for obtaining a Gender Recognition Certificate.
I was surprised to read yesterday an article in Pink News entitled “Why Tories and Liz Truss dropped vital Gender Recognition Act reforms” in which it states a wholesale Gender Recognition Reform Act had been on the cards and had the support of the Prime Minister to do so, as had been widely trailed.
The article says that evidence has been submitted to a judicial review in the Northern Ireland High Court which is looking at the need as to whether medical evidence is needed for Gender Recognition. The evidence submitted by the Government Equalities Board shows the “behind the scenes wrangling” over the GRA reform and that all of the proposed reforms were shelved due to the input of Dr Michael Brady, the National Advisor for LGBT Health. Reading the article I am really disappointed that the original plans to reform the act were abandoned on the advice of one clinician.
The government proposal as late as March 2020 had been to do away with a diagnosis of gender dysphoria. As there is a waiting list of five to six years for a NHS Gender clinic appointment obtaining such a diagnosis is nigh on impossible and has resulted in considerable mental health problems for transgender people. In proposing this the government had listened to the proposal from the 2018 consultation on the Gender Recognition Act and the guidance from the WHO had removed a diagnosis of gender identity out of its disorder chapter and used a description of gender incongruence under its sexual health chapter. The reason for doing this was to reduce stigma and the Human Rights Watch had indicated that governments should “move swiftly” to reform laws that require this now “officially outdated diagnosis”. It seems the government were willing to do that.
Then along comes Dr Brady. His view apparently was that “whether the diagnosis was categorised ( under mental health or sexual health) didn’t matter, it remained a diagnosis but was not perpetuating a mental health stigma”. Dr Brady recommended continuing with using the term gender dysphoria as it was used in the medical community and suggested any reform should be clinician led. In the evidence submitted to the judicial review in Northern Ireland it was revealed that removing the requirement for a gender dysphoria diagnosis was “impractical’.
According to the Pink News article even despite this Liz Truss and the Government wanted to change the terminology to gender incongruence and remove the need for a diagnosis of gender dysphoria as late as 22ndJune. However by the 2nd July this had been dropped and effectively there were no changed to the GRA save for a reduction in the fee from £140 to £5. There is still a five year wait to get a diagnosis unless you are able to afford to go private which the majority of people are unable to do.
Dr Brady’s opinion according to NHS England is that “in line with the majority of respondents to the governments consultation on Gender Recognition Act, the process for requiring a gender recognition certificate should be as seamless ad barrier free as possible.”
It beggars belief. How can one clinician go against the tide of opinion and change the direction of proposed reforms in this way.
In writing this post I fully acknowledge the information from the Pink News article referred to above.
It's never too late.... 