transition, and the principle of Gillick competence is supposed to allow doctors to prescribe
medication in a contextual manner depending on the minor’s understanding, rather than
applying a blanket rule.
The document as a whole paints the picture of trans under-18s as an undesirable
outcome, for which all should be done to avoid. Minors are only to be accepted as trans if
they are seriously distressed over their current situation: unless they are on the verge of
suicide, nothing needs to be done. The report was criticised by the World Professional
Association of Transgender Health for how it ‘quotes selectively and ignores newer evidence
about the persistence of gender incongruence in children ’. 56
Problems with the current system: waiting lists, anti-diy policies Waiting lists for access to GIDS and GICs is a major issue for transgender individuals awaiting
treatment, as despite the NHS’s claimed goal of just 18 weeks between referral and first
appointment with a gender identity clinic, the average individual receiving their first
scheduled meeting as of May 2022, had been referred in January 2018, waiting 225 weeks. 57
This was the foremost finding of the Cass Report, which had commissioned former President
of the Royal College of Paediatrics and Child Health, Hilary Cass, by order of the NHS to
assess the performance of GIDS, which found that the current model was ‘neither safe nor
viable’ due to the ‘unacceptable’ long waiting lists. 58 When this is considered alongside the
statistics for trans people in the UK who have not undergone but want medical intervention,
currently 23 per cent of the transgender population, and that 62 per cent of those that have
56 WPATH, ASIAPATH, EPATH, PATHA, USPATH 57 Gender Identity Clinic, Waiting times (2022) <https://gic.nhs.uk/appointments/waiting-times/> [Accessed 12/01/2023] 58 Sarah Marsh, ‘NHS to hold review into gender identity services for children and young people’, The Guardian [online] (22 September 2020) <https://www.theguardian.com/society/2020/sep/22/nhs-to-hold-review-into- gender-identity-services-for-children-and-young-people> [Accessed 09/01/2023]
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