Hundreds of trans people in UK are being denied hormone replacement therapy by GPs, report finds

More than 200 trans people in the UK have been refused hormone replacement therapy (HRT) by their GPs in the past year, an investigation by LGBTQ+ publications has revealed.

According to a summary report of data by Trans Actual, 215 people have been refused the hormones. In 26 per cent of those cases, the individuals – 56 of them – had a recommendation from an NHS gender clinic.

The figures follow an increase in personal accounts of HRT refusal published on social media by transgender people in the wake of the Cass Report and a contentious statement from the Royal College of General Practitioners (RCGP).

The results, which were shared with QueerAF and What The Trans, following those publication’s broader investigation into HRT refusals, showed the majority of the 56 people were in England (86 per cent), with nine per cent and five per cent in Scotland and Wales respectively. There was no recorded data for Northern Ireland.

Twenty-seven per cent were seeking a new prescription, 73 per cent had previously been on HRT and 38 per cent had already been discharged by a NHS gender clinic.

Forty-five per cent of respondents had been on HRT for more than five years and 20 per cent had been on the treatment for less than a year.

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The main reasons for reportedly refusing to issue the prescriptions were that GPs “didn’t feel competent to [do so]”, there was no shared policy between local care boards and GPs, and “personal beliefs”.

Speaking to QueerAF, Keyne Walker, the strategy director at Trans Actual, said: “Some GPs admitted it was due to their personal beliefs.

“Transphobic GPs, especially in England, are feeling empowered to unilaterally deprive their patients of critical medicines for reasons of their own bigotry, and every part of the NHS must take some responsibility for letting this happen.”

Hundreds of trans people have been refused HRT. (Photo credit should read Wiktor Szymanowicz/Future Publishing via Getty Images)

It is believed that many of the GPs who refused to issue prescriptions felt emboldened by an RCGP statement in April which said they do not have to provide gender-affirming care.

“We have received feedback and comments from several organisations and individual GPs following publication of our revised statement in April,” the RCGP said in further guidance issued earlier this month.

“After carefully reviewing and considering the feedback, we have added two clarification sections highlighted in our statement below, together with some minor edits to relevant sections of the statement itself to reflect our clarification points. These remain in line with our previously approved council statement.”

The statement continued: “We know that the care of transgender and gender-questioning people is complex. We acknowledge that we need to recognise the experiences of our transgender patients as a result of the changes occurring in, and limited capacity of, our health system.

“We recognise the deep sense of hurt and frustration that many of our transgender patients are feeling, and the college remains strongly committed to the improvement of services for patients with gender incongruence.

“We continue to call for significant expansion in resources and dedicated services to ensure timely access to high-quality care. We are hopeful that, with the right investment and action, the establishment of regional gender incongruence clinics across England will lead to a positive shift in waiting lists and improved care and health outcomes.”

While welcoming the clarification, TransActual demanded “accountability from the RCGP for the harm their guidance has caused and the need to go much further in their guidance to ensure that rogue GPs stop toying with the critical medicines of trans people and have a clear responsibility to comply with the prescription of HRT by gender clinics”.

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