Transvox - Gillian meets Dr Helen Webberley

[00:00:02] Hello and welcome back to Transvox. And it's sitting in front of me today, a different face, not Jenny, but actually a Helen.

[00:00:10] First of all, hello Helen. And I'm delighted to introduce Dr Helen Webberley, who's someone I've wanted to talk to for many years.

[00:00:17] We've just had a quick intro chat that lasted seven and a half minutes, so I suspect we're going to be doing lots of chatting.

[00:00:23] But first of all, hi Helen. Hi Dr Helen, I should say. How are you?

[00:00:28] Helen is absolutely fine. Thank you so much for having me. I'm wonderful, I love talking about my favourite subject. Thank you so much for having me on.

[00:00:35] So that's 55 minutes about cake making.

[00:00:38] Absolutely. I'm rubbish at cake making.

[00:00:40] I love cake making. Anyway, no, that's not too distracted.

[00:00:44] So for the three people on the planet in our world that haven't heard of you, maybe you can just give us a quick intro as who you are.

[00:00:51] Sure. So I'm Helen Webberley. I'm a medical doctor, trained in the UK.

[00:00:56] And back in 2015, I stumbled or stepped or fell into the world of transgender healthcare.

[00:01:03] And since then, it's become my absolute life mission to improve healthcare and other elements of trans people's lives.

[00:01:12] But obviously, I'm a doctor, so I focus on healthcare. And there's a huge need for it.

[00:01:15] I never, ever realised what a huge need there was. But goodness, was I wrong.

[00:01:20] So what, what alerted you to you?

[00:01:22] There's back in 2015, 2012, whenever you first bumped into the subject, because I'm not aware that you have anyone with trans experience in your world, but maybe wrong on that.

[00:01:31] So how did you first notice the need?

[00:01:33] Yeah, I'm the kind of doctor that I hate inequality, unfairness.

[00:01:38] I worked a lot in sexual health. And when I was training, it was in the 80s and 90s, when HIV was becoming really paramount and sexually transmitted infections after that.

[00:01:48] So I worked a lot with that and saw a lot of discrimination there, obviously, against homosexual men in particular, and also drug users and women in the sex industry.

[00:01:58] And I just hate it. I hate inequality.

[00:02:00] And then I was working in a GP practice in up in a small valley in Wales.

[00:02:06] And I suppose that was my kind of, I don't expect it was, but it felt like my first transgender patient.

[00:02:11] And she was a mature lady who'd never really been able to acknowledge her identity.

[00:02:17] It was always very hidden.

[00:02:19] And she asked me to help her and I had no idea about it, no training, no experience, nothing.

[00:02:23] And so I looked into what to do. And what I was supposed to do was refer her to a clinic in London, where she had to get the train kind of wearing a dress.

[00:02:33] She'd never got the train out of Wales and never mind to go to a clinic in London.

[00:02:37] And so I said, don't worry, I'll do it. I'm a doctor. I can. I'm sure I can look this up and learn how to do it.

[00:02:42] And so as I was looking it up and learning, I just came across so much awful, terrible stuff.

[00:02:48] It was, I was just shocked. And the worst thing was that it was my own profession that was dealing out the horribleness, this discrimination, the prejudice, the terrible things I was reading was being done by my own profession.

[00:03:02] And I was just shocked to the core. And actually, at the same time, I was, I'm very interested in digital and tech technology.

[00:03:09] I just love it, always have done. And I was making my own website.

[00:03:13] And I made some pages on there dedicated to what I was learning about transgender healthcare.

[00:03:17] And that's how it took off, really. That's how my kind of work started.

[00:03:21] A simple couple of pages on a website and a keen interest to learn more about this patient group.

[00:03:27] So there you go.

[00:03:29] So how would you characterize the difference between things which were going on back then and now?

[00:03:32] Because there are similarities because things are going pendulum swings backwards and forwards.

[00:03:36] But I guess that was still the time of the real life experience, was it? Was that still going on at that stage?

[00:03:41] Yeah, sure. And that real life experience and the kind of hoops that people were being expected to go through in order to just simply be themselves or to live their life as themselves or even just to swap their hormone profile.

[00:03:56] When I started learning about it, it seemed like the most unnatural thing to do in the world to swap someone's hormone profile.

[00:04:03] But then as I learned, I'm like, you're simply like turning off testosterone and replacing it with estrogen or turning off estrogen and replacing it with testosterone.

[00:04:11] And as I looked into it, I realized actually it's one of the most simplest things to do.

[00:04:15] It's just one or two black or white estrogen or testosterone.

[00:04:18] It was really very simple.

[00:04:19] But the hoops that people were being asked to go through in terms of what have you done to live as a woman?

[00:04:25] How can you prove to the world that you are a woman?

[00:04:28] What steps have you taken?

[00:04:29] Who have you told?

[00:04:30] And then the other awful things like what do you do in the bedroom?

[00:04:34] What do you watch privately on your computer?

[00:04:36] And I was like, hang on a minute. This is what's this got to do with anything?

[00:04:40] And then the other side of it was the kind of this must have come from somewhere.

[00:04:44] You must be feeling this because you were abused as a child or raped in the park.

[00:04:48] And I'm like, oh, my goodness, this is just someone's identity.

[00:04:51] And I was just shocked at what I was reading.

[00:04:54] And the other thing I realized, it was just at that time that the Women Inequalities Commission produced their report.

[00:05:00] And they openly said that the NHS is failing transgender people.

[00:05:04] And I was like, now it's been acknowledged. Now we'll do something about it.

[00:05:08] And I thought the whole world would rally around and make things better.

[00:05:12] And actually, as Gender GP was starting, I thought we wouldn't need it for very long.

[00:05:16] We'll just be a little stopgap while the NHS catch up.

[00:05:19] But I was so wrong.

[00:05:21] It seems to just be getting worse and worse and worse.

[00:05:25] But I don't want to be negative today.

[00:05:26] I want to be positive.

[00:05:28] And there's always lots to be positive about.

[00:05:30] But that's really interesting, though.

[00:05:31] The real life experience for those of you who was quite interesting, wasn't it?

[00:05:35] And I remember going for my own diagnosis.

[00:05:38] We actually had to be diagnosed in those days, didn't we?

[00:05:41] I know you probably remember Dr. Richard Curtis.

[00:05:42] That was a lovely person I met in Harley Street or whatever.

[00:05:46] And then going on to meet one of the gender clinics who said things like, you don't look very pretty.

[00:05:51] You don't seem to be wearing a skirt.

[00:05:53] There was this.

[00:05:54] And what was very interesting is that back in the day, there was almost this idea of what a woman is.

[00:05:59] What a woman is for.

[00:06:01] And I find it's quite interesting that as many years of feminism of ledists in America back to the same place.

[00:06:08] Because actually, we're in Scotland, I think at the moment they're debating what a woman is.

[00:06:12] And in America, they're just deciding that a woman is for a certain thing.

[00:06:16] And it is odd, I see, how you see this sort of pendulum swimming backwards and forwards.

[00:06:20] And I just wonder whether this is, I have a view that there's a reason for this.

[00:06:24] But I just wondered if you could think of any reason yourself why this might be happening.

[00:06:29] That's interesting. I was reading about the Scottish Supreme Court this morning, and I was just thinking, my goodness, this just sounds like the olden days.

[00:06:35] Should we allow the woman to vote?

[00:06:38] Should we allow the woman to go to work?

[00:06:40] Should we allow the trans woman to sit on a board meeting as a woman?

[00:06:44] And I'm like, oh, my goodness.

[00:06:45] Have we not learned anything in the last however many years?

[00:06:48] And I actually feel really sad.

[00:06:51] I feel, you know, if we were talking about, for example, for example, black people have fought for so many years for equality.

[00:06:58] And then once and we're still not quite there, but we're better.

[00:07:02] And what if then black people started being unequal to brown people or people from a different color to them?

[00:07:10] And that's what's happening at the moment.

[00:07:11] Women fought for equality.

[00:07:13] And now those women themselves are fighting against equality.

[00:07:19] And I just think it's really unfair to the women that to those women in the past who really did put up a big fight for equality.

[00:07:26] And now it's being abused.

[00:07:28] I feel really sad about that.

[00:07:29] I understand part of their argument.

[00:07:32] They fought very hard for many years to have this term woman to be something, to stand for something, to mean something, to be a source.

[00:07:40] The narrative is right.

[00:07:40] The source of power, the gathering point for a whole community.

[00:07:45] And that's right.

[00:07:45] But the thing I don't agree with is the fact that trans women would be any less passionate about women's rights.

[00:07:52] Because actually, as an ex-cis man, of course, I've lost my white male privilege.

[00:07:57] I say it.

[00:07:58] I really do say it.

[00:08:00] And there's all the hierarchies in all organizations and wherever you are, you have men at the top, women somewhere else.

[00:08:05] And then you have trans people under those if you're lucky enough to get in the room.

[00:08:09] But the fact that you wouldn't see that genuine, and I know the argument is actually against people who are non-genuine, but it is interesting that as trans women, I've never met a trans woman who says women shouldn't have equal rights.

[00:08:20] We are much more on the cause of feminism than people really understand it, I think.

[00:08:27] I think if you talk to young people, and the modern generations are going to be so much better.

[00:08:33] I almost can't wait for them to be the ones in absolute power, if you like.

[00:08:38] But if you speak to the younger generations, they're like, does it not bloody matter?

[00:08:40] Does it matter?

[00:08:41] Man, woman, trans woman, non-binary person, it doesn't matter.

[00:08:46] We're just people.

[00:08:47] We're just people.

[00:08:48] And whatever our identity is, whatever our body organs are, we're just equal.

[00:08:53] And maybe we made a very big mistake many years ago by segregating gender, or even making this thing called gender, with just people.

[00:09:02] And actually, and all people have hormones.

[00:09:05] And those hormone profiles sometimes aren't quite right for how you feel and how you want to live your life and how you want your body to look in the mirror for you and to the outside world.

[00:09:15] And what's wrong with that? Nothing.

[00:09:18] So I do sometimes feel I wish we hadn't done that whole gender thing, and then we wouldn't be in such a pickle.

[00:09:24] And then I live in, I spent a lot of time in Spain.

[00:09:27] And then the Spanish language is one of those ones where they have male and female cups and plates and knives and forks.

[00:09:34] And I'm like, oh, goodness.

[00:09:35] We've got a male plate of the female car.

[00:09:38] We've got a long way to go.

[00:09:38] I know.

[00:09:39] To undo that, we've got a long way to go.

[00:09:41] But I wish we'd never started it in the first place.

[00:09:42] We didn't need to.

[00:09:44] But it's an interesting point you make though.

[00:09:46] As a psychologist, I absolutely completely understand and get the idea of identity.

[00:09:50] And you can talk to the most rabid anti-trans person, and they understand identity.

[00:09:55] What they don't understand is gender identity as linked to trans people.

[00:09:59] I think the argument's right.

[00:10:01] I just don't think we've made the argument well enough that people link the two things together.

[00:10:05] But if we're sort of characterizing this biology or sex on one side and identity on the other side,

[00:10:11] even the biology is complicated, isn't it?

[00:10:13] Because there's chromosomes, there's hormones, there's the whole intersex argument as well.

[00:10:19] I wonder if you can take us through a little bit of that, if you wouldn't mind.

[00:10:22] You've only got to have.

[00:10:23] Yes, I'm a mother and I've got two sons.

[00:10:25] And they have the same chromosome.

[00:10:28] They both come from the same two parents.

[00:10:30] And they are completely different.

[00:10:32] And I don't want to say one is more masculine than the other.

[00:10:37] But they're so totally different.

[00:10:40] What does that say about us?

[00:10:41] We classify people as XY or XX, or sometimes the X's and the Y's get a little bit mixed up

[00:10:48] and unquiet rendered, if you like.

[00:10:50] But personality, identity, the way that your brain thinks and feels, the way that you view the world,

[00:10:58] the way that you want to be viewed in the world is so independent of just simply your chromosomes.

[00:11:05] And that's what we've got to understand.

[00:11:08] And I think, Gillian, sometimes people just use it as an excuse, because they can't fight that argument that I've just explained.

[00:11:15] So they're like, no, we have to go back to XX or XY and there's nothing else than that.

[00:11:19] And I'm like, in my brain, I don't say it out loud, but in my brain, I'm like, it's not a very intelligent argument, actually.

[00:11:23] So let's just be a little bit more progressive and expansive when we think about that kind of what you're trying to excuse this as.

[00:11:30] Do you know what I mean?

[00:11:31] I do. And I think it comes into things like the boxer and the footballer and the sports people who are biologically female, but their social identity looks male.

[00:11:42] And that's the thing is that categorization is that thing about what people appear as, which is quite interesting, isn't it?

[00:11:48] And it always brings me back to some of the sort of race theory about the fact that it's getting contentious now.

[00:11:52] But we're talking about real men and real women.

[00:11:55] And the idea is that white men are the best.

[00:11:57] Black men and black women are not the best.

[00:11:59] And therefore, black women seem to be lower down the pecking order.

[00:12:02] And Asian men are seem to be the least manly of all the men.

[00:12:05] So that people, when you start talking about that, they recognize that these are all biologically male.

[00:12:10] But actually, people are inferior or superior based on their social standing.

[00:12:17] And it's and I find that quite interesting.

[00:12:19] And as a way of being able to explain the difference between biology and identity.

[00:12:23] And people get that because some of the most big, and I deal probably a lot more with bigoted men than bigoted women, to be fair.

[00:12:29] But bigoted men get that.

[00:12:31] They really do understand this, that I'm better than them.

[00:12:34] I'm a better man than you are.

[00:12:36] And you say, what is it that makes that man less good than you?

[00:12:38] Or they're more of a girl than I am.

[00:12:39] Oh, so there is the thing of the girl that's not biological.

[00:12:43] And then the wheels start to come off.

[00:12:45] And I do think that, I do think that the debate is right.

[00:12:48] I do think the terminology is right.

[00:12:50] I just don't think we've made the argument that well.

[00:12:51] And I think we've done that thing where we've assumed the argument was made well.

[00:12:55] And what we discovered is that the argument hasn't been because it's the argument is stripped away, hasn't it?

[00:12:59] And being, I wonder why that is.

[00:13:04] Yeah, I think you're right.

[00:13:05] When you start unpicking it, it doesn't work.

[00:13:07] It doesn't, you can't put everybody in that category, in that box.

[00:13:10] It doesn't fit.

[00:13:11] And then people are like, we're not breaking it now.

[00:13:12] There's no better solution.

[00:13:13] And I'm like, there probably is a better solution.

[00:13:16] And we just need to come together to find it.

[00:13:18] But actually, what we shouldn't forget is that everybody, regardless of their sex or their gender or their level of ability or where they come from or the religion that they have, those protected characteristics, which we should be on a big placard in all of our lives.

[00:13:34] And we should not forget about the beauty of diversity and the need for equality.

[00:13:42] And I think those two fundamental things, once you understand that diversity is beautiful, and we don't all want to be the same, we don't want to be that white male cisgender heterosexual person that you were just talking about.

[00:13:53] And we don't want to be that.

[00:13:55] I definitely don't want to be that.

[00:13:57] And then when we understand that people are beautifully diverse and beautifully different, and then we should and everybody is equal, and everybody should have the equal opportunity to live their life to the absolute fullest.

[00:14:10] And when they go to their grave, they should be able to look back and say, I had the best life I could possibly have had.

[00:14:16] Now, what's wrong with everybody aiming for that and aiming for that for everybody else, and then helping people to achieve that?

[00:14:24] It sounds simple, but I just wish we could get on that together.

[00:14:28] I violently agree with your second half of your statement, but can I take exceptions to the first bit?

[00:14:32] And I wonder whether, sorry, not exceptions, I just wanted a wicked debate at the first bit.

[00:14:35] I'm a bit more worried about diversity.

[00:14:38] And there's a couple of reasons for that.

[00:14:40] One, which is diversity has become a tick box exercise.

[00:14:42] And it's been one of those things where the haves have lost.

[00:14:45] And I think over the course, what's happened is people have been tick box into diversity.

[00:14:50] No one's really made the link of why diversity is important.

[00:14:53] We just talk about diversity as being, we should have this wonderful thing called diversity and everybody who's losing out because of that diversity.

[00:14:59] We forget that the reason for diversity is to create conflict and innovation and change.

[00:15:04] That's what diversity gives you in an organization.

[00:15:07] And it's never measured, which is why lots of EDI programs fail because there's no impact from them.

[00:15:12] So that's the first thing.

[00:15:13] The second thing is we've got this whole thing in psychology about in groups and out groups.

[00:15:17] As soon as you have people who are coming in from one group to another, if people haven't got the skills or ability to handle that, then actually they see out groups as threats.

[00:15:26] And so the reason for bringing untrammeled diversity through the socialite fabric was bound to create conflict without the ability to actually get that benefit that came from it.

[00:15:38] I know we might be into philosophy here rather than psychology, but I just wonder whether the roots of actually making change today is to recognize that.

[00:15:47] Is to recognize that actually it's not obvious that just because you're different you should be accepted.

[00:15:51] I don't think that's handy.

[00:15:55] I think the difficulty is that I hear these kind of discussions around a top table in a boardroom, for example, in an NHS trust or parliament government.

[00:16:06] I can hear these conversations going on.

[00:16:08] But actually what we need to do is translate it to the average person who is going about their average day in the street, at work, in the shops, in the pub, in restaurants and cafes.

[00:16:19] And those are the people that we need to, I feel, direct the level of conversation to.

[00:16:24] So although that level that you were discussing just now, I totally understand what you're saying.

[00:16:29] But I almost feel we need to go back down a little bit to just understanding that everybody is different.

[00:16:36] Everybody is beautiful and that there are minority groups, if you like.

[00:16:40] And they have been, as I said, labelled by the Equality Act and that we should be just aiming for embracing everybody as who they are.

[00:16:50] And I think that's where I'm trying to come from when the work that I do in increasing visibility, increasing education, just the ordinary person walking down the street who doesn't know anybody who lives their life in a wheelchair or doesn't know anybody who is trans or doesn't know anybody who's gay.

[00:17:05] Apart from that funny guy down the street, do you know what I mean? And it's about bringing that normality, ordinary and into the everyday lives.

[00:17:12] And that's what my work has been about, really.

[00:17:15] And we're both agreeing. It's just how we get there.

[00:17:17] My view is that you have to have leaders. You have to shape the world. You have to shape the community.

[00:17:21] You have to have people that build a framework to allow that to happen.

[00:17:24] And I think what we don't, we didn't do that.

[00:17:26] And what's happened is as soon as someone's come along and knocked a sort of, you know, the gentle, decent, lets everybody, actually, strangely enough, the sort of old white club, we're all part of the club, let's all look after each other.

[00:17:37] That's gone now. And what we ended up with, this is slightly dog eat dog sort of thing.

[00:17:42] But it is a sort of, there's two things that always make me smile when I, when we're talking to groups of people.

[00:17:47] First is that the perceptions of trans people are very different once you've met one.

[00:17:51] And I think that's exactly what you're saying. It's the same with any vulnerable or marginalized community.

[00:17:55] It's the same as disabled people. It's this, disabled people have got, they've got all these rights.

[00:17:59] Do you know they've got rights? Apparently they have to, they're allowed to go upstairs.

[00:18:03] Isn't that terrible? We have to have a building converted so we can put a lift in. Isn't that terrible?

[00:18:07] Yeah, once the CEO's as a disability, suddenly find the lifts then.

[00:18:11] And I think you're right about, it's about how you accommodate those minorities to, or vulnerable communities make it work.

[00:18:17] But for a start, we've got to stop them being vulnerable. And I think that's one of the challenges.

[00:18:21] And some of that comes out of the community, doesn't it?

[00:18:23] And I don't know whether we are A, a community, or B, cohesive enough to A, stop fighting with each other,

[00:18:29] and actually start figuring out where the real problems fit.

[00:18:33] You said two words there which are very passionate to me, which is the community and the vulnerability.

[00:18:39] And I'm going to come back to that in just a second.

[00:18:40] But the other thing that you...

[00:18:41] I'll write them down so you don't forget.

[00:18:42] Okay, good idea. Very good idea with me.

[00:18:45] The other thing that you said was just about...

[00:18:48] Some people feel they've never met a trans person.

[00:18:50] And so I have people in our extended family, so parents of boyfriends or whatever,

[00:18:56] extended people who still don't quite get it.

[00:18:58] They know that Helen works in this field, and they know that Helen's very immediate family really understands it really well.

[00:19:04] But the slightly extended family are, and they would never be disrespectful to me about that.

[00:19:08] But I know when I'm not there, there's always those discussions go on, really, you know, the kind of discussions.

[00:19:13] And so we did some work recently with Gender GP, and we asked some trans people to come along and just share their story on video,

[00:19:20] just to be themselves and tell the world about themselves, about their journey.

[00:19:25] So these people look ordinary.

[00:19:28] They're on our website.

[00:19:29] And if you're listening, thank you so much for the work we did, because it's just amazing.

[00:19:33] Brings tears to my eyes every time I watch them.

[00:19:35] So these are just ordinary people.

[00:19:37] And I said to one of my extended family members, I was like, this person was born a girl.

[00:19:43] And they were like, no.

[00:19:44] And I'm like, no.

[00:19:45] This person, for all intents and purposes, and I'll use that common language on that, you know,

[00:19:50] this person was born a girl.

[00:19:52] Vagina, womb, ovaries, girl.

[00:19:55] And they were just like, you're joking?

[00:19:56] And I'm like, I'm not joking.

[00:19:58] This is a trans person.

[00:19:59] And I think that's, when we talk about that vulnerability, when we see people, that people, when you think of trans people,

[00:20:05] sometimes people portray them as blue hair and maybe scars on their arms because they've had a terrible life.

[00:20:12] And it's that portrayal of that vulnerability, which, you know, I feel tragically sad that those people had to cut their arms.

[00:20:20] But that is not what we're aiming for with ordinary, normal trans people who've had the opportunity to live their life as them.

[00:20:28] And I think showing people, ordinary trans people, is really important.

[00:20:34] They're not scary.

[00:20:35] They're just beautiful people like everybody else.

[00:20:37] And I think if we portray this vulnerability, and if you see NHS protocols and place protocols, education protocols, protect the vulnerable.

[00:20:47] And I'm like, they're not.

[00:20:49] Maybe some of them are vulnerable.

[00:20:51] And maybe some cis people are vulnerable.

[00:20:54] And maybe some heterosexual people and homosexual people and black people and white people are vulnerable.

[00:20:58] But don't label trans people as vulnerable.

[00:21:01] But they are, there may be some that are vulnerable.

[00:21:04] But it's not because they're trans.

[00:21:06] It's because the world doesn't yet accept trans people fully.

[00:21:10] And the other...

[00:21:11] Can I jump in there?

[00:21:12] Because I think that's quite interesting.

[00:21:13] Two things.

[00:21:13] One, which is that we have this image of trans people, usually, as you say, trans women.

[00:21:18] And I think we forget that.

[00:21:21] Actually, there's a...

[00:21:22] I think the majority now is trans masc.

[00:21:24] And there isn't the fuss about that.

[00:21:26] There isn't...

[00:21:26] I know the feminists just say they're misguided.

[00:21:28] And that's just an even more hateful argument than anything else, really.

[00:21:32] But we forget that.

[00:21:33] And we also forget the non-binary community as well.

[00:21:35] And we'll come back to non-binary issues a little while if you don't mind.

[00:21:38] But I think that's really important to say.

[00:21:40] And I like what you're saying there.

[00:21:41] I always say that we're not vulnerable.

[00:21:43] We're not special.

[00:21:43] We're a minority community.

[00:21:45] And that's a different thing.

[00:21:46] And I think we have to be careful not to characterise ourselves as a vulnerable community.

[00:21:51] We are a minority community.

[00:21:52] And that's it.

[00:21:53] And some of us are loud antsy and not the slightest bit vulnerable.

[00:21:57] And as you say, some people are.

[00:21:58] But we don't want to be special.

[00:21:59] I just want to live a life, have a great relationship, go on holidays, eat cake.

[00:22:04] The usual sorts of things that we all do.

[00:22:06] Sorry, usually cherry pie these conversations revolve around with today's cake.

[00:22:10] But you must have met hundreds and hundreds of trans people.

[00:22:14] They're just like that, aren't they?

[00:22:15] They just want to live a normal life, I'm guessing.

[00:22:17] They just, well, don't we all?

[00:22:19] And that's the thing.

[00:22:20] We just all want to live our best life.

[00:22:22] And to persecute or be prejudiced or biased towards somebody because of their identity.

[00:22:30] If you do it for long enough, they hurt inside.

[00:22:34] And when you hurt inside, your mental health suffers.

[00:22:37] And your psychological health suffers.

[00:22:40] And your social ability suffers.

[00:22:43] And eventually it just goes down.

[00:22:45] And so the people that we see who have poor mental health or can't integrate into social

[00:22:51] society in the way that they've had the ability to do, it's because they've been battered for

[00:22:56] so long, ignored for so long, suppressed for so long.

[00:22:59] And we've really got to stop that happening.

[00:23:01] And then, oh, don't get, I'm not going to, I'm just going to say this quickly and move

[00:23:05] on because I hate it.

[00:23:06] It's okay.

[00:23:06] You don't qualify for treatment if you're not distressed.

[00:23:10] But then when you get distressed, you're not allowed treatment.

[00:23:14] I'm not going to say any more about it because I could go on forever and I don't want to be

[00:23:17] negative.

[00:23:18] But OMG is all I can say about that.

[00:23:20] I think the best rebuttal of that is that the CAS report was saying, thumbing along the

[00:23:25] lines, that we suspect the evidence because people are too happy having transitioned.

[00:23:29] Their fault can't be true because they're happier than having recovered from cancer.

[00:23:32] The other thing I really want to talk about is community.

[00:23:35] Yes.

[00:23:36] I had it on my list.

[00:23:39] And I don't know what I feel about it because I think it's segregating.

[00:23:44] I don't call myself as someone who comes from the cisgender community or the white

[00:23:49] community or the female community, the heterosexual community.

[00:23:53] Maybe I come from the medical community.

[00:23:55] Not really.

[00:23:56] Actually, I am a medic.

[00:23:57] I am white.

[00:23:58] I am female.

[00:23:59] I am cisgender.

[00:24:00] I am heterosexual.

[00:24:01] But I think once we give somebody a community or label them, then it's almost like segregating

[00:24:06] in itself.

[00:24:07] But the other side of that, I feel, is that people have often said to me, how come?

[00:24:13] They're like, I reckon if you go into one of those LGBT groups, then it makes you

[00:24:18] LGBT because you think it's cool or you think you want to have your hair like that.

[00:24:22] And you think, and I'm like, actually, it's because birds of a feather flop together.

[00:24:26] And people who have similar identity or similar interests, similar hobbies, will find themselves

[00:24:32] together and enjoy each other's shared experiences.

[00:24:36] And then does that make you a community?

[00:24:39] I'm a pro-community person if it's voluntary and because you're getting something out of

[00:24:45] it.

[00:24:45] I'm an anti-community person if you're stuck there because the other community, the bigger

[00:24:52] community that's not your community, isn't welcoming to you.

[00:24:55] Does that make sense?

[00:24:56] It does.

[00:24:57] You're describing the difference between community with a capital C and community with a small

[00:25:00] c in a way, aren't you?

[00:25:01] I think that's how I always think about this.

[00:25:03] But I think the communities, I think, are just groups of people that coalesce together

[00:25:06] with common threads of common interests, aren't they?

[00:25:08] But the problem for us is we're into community.

[00:25:11] We're not mobilized.

[00:25:12] We don't work together.

[00:25:13] We don't always help each other.

[00:25:14] And there's a reason for that because we're often competing with each other.

[00:25:17] We're trying to scrabble around with competing with legit fine funding.

[00:25:20] I've worked with two or three organizations now and said, look, let's come together.

[00:25:23] Let's build partnerships.

[00:25:24] Let's be bigger together.

[00:25:26] But then there's an ego thing that pops up, which often pops up.

[00:25:29] And then, of course, then you remember that trans people are people.

[00:25:32] And that's what always happens in organizations, isn't it?

[00:25:35] And I come from an organizational background.

[00:25:36] So forgive my analogy to this.

[00:25:38] But I hate this term community.

[00:25:40] It really bugs me.

[00:25:42] So I'm quite interested.

[00:25:43] I think it was where Bobby Pickard was talking about this quite recently, that we don't have

[00:25:46] a hut.

[00:25:47] We don't have a song.

[00:25:48] We don't have a uniform.

[00:25:49] We don't have a badge.

[00:25:50] And I thought it was quite a clever thing to talk about.

[00:25:53] And the fact is, actually, we do spend a lot of time infighting instead of figuring out

[00:25:57] who we should be working with.

[00:25:58] And that's because that's normal behavior.

[00:26:00] And that's a sign that it's a vibrant group of people.

[00:26:03] One of the things that I'd love you to tackle, if you wouldn't mind, this is contention,

[00:26:06] but I did enjoy reading the cast report, actually, as an academic, looking at the quality of research.

[00:26:12] And it was interesting.

[00:26:13] But I was quite fascinated with this idea that transgenderism could just be a branch of autism

[00:26:18] or neurodivergence.

[00:26:20] So I just wonder, as an actual doctor, a medical doctor, what you would say about that.

[00:26:24] Yeah.

[00:26:26] I hate the way that it's become weaponized.

[00:26:30] And if somebody has...

[00:26:31] And it's very difficult.

[00:26:33] And I'm going to give this to my best shot.

[00:26:36] So if somebody has traits of autism or being on the autistic spectrum, Asperger's, whatever

[00:26:42] neurodiversity we want to call it, then it's almost like that's used as a weapon against them

[00:26:47] to undermine their transgender identity.

[00:26:49] So the amount of times I've seen somebody turned away because they might have traits of neurodivergence,

[00:26:56] and that's just been placed way above their gender identity.

[00:26:59] And that makes me feel very sad.

[00:27:01] But then when I unpick that, and I think about it, and I think about what those traits are.

[00:27:05] So the classic traits that we see with, for example, somebody with autism, that example,

[00:27:11] and the classic traits that you will find if you Google it are inability to have normal,

[00:27:17] and I've got big inverted commas up, normal social interactions.

[00:27:21] And I'm like, yeah, but you know what?

[00:27:23] If you have a trans person and you ignore their identity or negate their identity or bully them

[00:27:29] or persecute them or don't respect their identity, don't accept them, then it won't be very long

[00:27:36] until they find it difficult to have social, have normal, in my big inverted commas, social interactions.

[00:27:43] And it's like, okay, so does this person have traits of autism?

[00:27:47] Or does this person have traits of, you've bullied me so blooming long that I find it really difficult

[00:27:52] to integrate in society because you won't let me be who I am.

[00:27:57] And then you have the opposite way round, which is you have people who are truly neurodivergent

[00:28:04] and also they may be gender diverse.

[00:28:07] And then you're trying to get them to explain to you, are you a man or are you a woman?

[00:28:12] And how would you like to, how does your identity feel to you?

[00:28:14] And they're like, I'm not very good at explaining this.

[00:28:16] And then they're like, okay, then I'm not going to believe that you're trans

[00:28:18] and I'm not going to respect your identity.

[00:28:20] And I'm like, well, you can't win, can you?

[00:28:22] How do you win that?

[00:28:23] Really complex, really difficult to understand.

[00:28:26] But what I really want to do is stop denying people the care, the support, the help that they need

[00:28:33] because they might have both.

[00:28:35] Why don't we just work the other way round and say, how can we support people

[00:28:38] who find it difficult to explain their identity as well as I can explain this to you here and now

[00:28:44] and who might have difficulty in social interactions?

[00:28:46] And maybe people who are autistic and also gender diverse.

[00:28:50] Let's just work out how to help those people rather than put these barriers up.

[00:28:54] Oh, you've got both of those.

[00:28:55] You can't have one.

[00:28:56] You can't be supportive.

[00:28:57] I'm like, oh, goodness.

[00:28:59] But that did make me think actually funny.

[00:29:01] Not just as a massive screeching change of subject in terms of getting themselves in messes.

[00:29:06] You went through quite a torrid mess, didn't you, with the GMC?

[00:29:10] I think most people have heard of your fight with the GMC.

[00:29:13] Can you just remind us of those dark days?

[00:29:16] Because it's good to know that however dark the days are, people can come out the other side.

[00:29:20] It was 6.60.

[00:29:22] I had my first complaints to the GMC from the NHS doctors who didn't like the way that I was approaching transgender healthcare.

[00:29:30] And some of the complaints were nasty.

[00:29:33] I would like to say some of those complaints were untruthful.

[00:29:36] I won't go further than that.

[00:29:38] And when the GMC receives those kind of complaints, they have to act.

[00:29:40] If you say somebody has harmed a child, you have to act.

[00:29:44] Especially in the case of transgender people.

[00:29:46] Child abuse, killing people, all that other stuff.

[00:29:49] We can ignore that.

[00:29:50] But definitely a complaint about a trans thing.

[00:29:52] Sorry, Helen.

[00:29:53] I interrupted you.

[00:29:54] That's another conversation for a minute.

[00:29:55] The irony is not lost on me, frankly.

[00:29:58] But yes, of course.

[00:29:59] And I respected the GMC for taking up the concerns because you have to.

[00:30:03] It's really important that doctors do a good job.

[00:30:05] What I felt really sad about was that they wouldn't talk to me.

[00:30:08] They wouldn't listen to me.

[00:30:09] And actually, before all this happened, I was working with them saying, we need to educate doctors better.

[00:30:14] We were just about to make some educational materials, the GMC and I.

[00:30:18] Some videos, training materials.

[00:30:19] And then as soon as all this happened, they dropped that.

[00:30:21] They were like, oh my God, get rid of her, get rid of her, get rid of her.

[00:30:23] And they wouldn't talk to me after that, which made me really sad.

[00:30:27] And I remember my first interim orders tribunal.

[00:30:30] And they said that we're going to restrict her practice for 18 months.

[00:30:34] Because this is going to be a long investigation.

[00:30:37] And I just thought, 18 months?

[00:30:39] And it felt like an eternity.

[00:30:42] And actually, it was very nearly six years of hell.

[00:30:46] It was awful.

[00:30:47] It was really awful.

[00:30:48] And the worst thing was I didn't get listened.

[00:30:51] They wouldn't hear me.

[00:30:52] They wouldn't hear me.

[00:30:53] They wouldn't hear the trans people who were supporting me.

[00:30:56] They just said, thank you.

[00:30:57] We'll put it in the file for the end.

[00:30:59] Thank you.

[00:30:59] We'll put it in the file for the end.

[00:31:00] And actually, when I had my tribunal, which lasted three months, the actual hearing lasted three months.

[00:31:06] And then the whole procedure lasted a year.

[00:31:08] I finally got listened to.

[00:31:11] And actually, I think they saw my knowledge because I'd learned ever such a lot.

[00:31:16] And not only had I learned a lot, but I'd learned from the people.

[00:31:20] I'd learned from trans people as well as from the medical literature.

[00:31:24] And I put the two together, which I think gives me my wonderful knowledge now.

[00:31:29] And they listened to me.

[00:31:30] They saw somebody who actually really cared.

[00:31:33] They saw somebody who was educated from a medical point of view.

[00:31:37] And they saw somebody who had very good intentions for her patients.

[00:31:42] Maybe she did it differently to the way that the NHS doctors did it.

[00:31:45] But they understood that I did it the same as the other doctors from America.

[00:31:50] The proper, as I would say, proper transgender health care doctors.

[00:31:54] Not the ones that the NHS were trying to compare me to.

[00:31:57] And I got heard and I got listened to.

[00:32:00] But then really sadly, right at the end, they just threw in this curved ball and said,

[00:32:03] actually, they're still, I don't know why they did it.

[00:32:05] They said they're still going to say that I did a bad job anyway on this one point,

[00:32:10] this fertility and patiency.

[00:32:12] And I just knew that the press, the media, the baddies, the haters,

[00:32:17] they would just pick up on that one thing.

[00:32:18] They wouldn't look at the whole picture.

[00:32:21] They would just pick up on that one thing.

[00:32:22] So I had to go back and fight it again in the high courts.

[00:32:26] And you never know what kind of judge you're going to get.

[00:32:29] And I've seen, I've been in front of a few judges.

[00:32:31] But that final judge, if I could, if I met him in the street,

[00:32:34] I'd hug him tomorrow, definitely.

[00:32:35] He listened, he understood, and he gave a very fair judgment.

[00:32:41] And which, so after six, now I'm talking kind of six and a half, seven years,

[00:32:46] I was vindicated.

[00:32:48] And it was really hard.

[00:32:50] It was hell.

[00:32:50] It was very expensive.

[00:32:52] It was hard on the family, hard on me.

[00:32:54] But I knew I was right.

[00:32:55] And I knew I had to win because of the people that were relying on it.

[00:33:00] And that was what was really important to me.

[00:33:03] And adults, adult trans people, but mostly, you know what?

[00:33:06] Those children, those trans children, really important to me.

[00:33:09] Yeah, quite right.

[00:33:10] And does that mean you can work in the UK now as a licensed GP?

[00:33:16] Or are you, how's the situation?

[00:33:19] The trouble is, Gillian, when you've been out for six years, medicine moves on.

[00:33:24] And so actually when, at the end of it, and I was like, okay, I could go back to work now.

[00:33:29] A, nobody wants a doctor who has been out for so long.

[00:33:33] B, nobody really wants a doctor that's got that history around their neck.

[00:33:37] And C, you do become unskilled.

[00:33:38] So I'm not unskilled in my favorite subject in the world, which is transgender healthcare.

[00:33:43] But ask me how to do blood pressure.

[00:33:45] I've completely forgotten.

[00:33:46] So actually, I've hung up my medical license, if you like, and I'm going to focus on a wider job.

[00:33:53] So rather than treating patients individually, I want to focus on education, visibility, and equality for the rest of my kind of professional life.

[00:34:03] That's my aim.

[00:34:05] And obviously, gender GP still carries on.

[00:34:07] Yes.

[00:34:08] That's had its own rocky road as well.

[00:34:10] How would you describe its progress over the last two or three years?

[00:34:13] Yeah, gender GP has always had a rocky road.

[00:34:16] I think there's so many people who would have loved to see gender GP go down.

[00:34:20] And we know what kind of people those are.

[00:34:23] They still would love to see it go down, I'm sure.

[00:34:25] But gender GP has supported tens and tens and tens of thousands of people throughout their transition.

[00:34:30] I was going to say I've lost count or become used to the fact that so many people say that I, via gender GP, saved their life.

[00:34:39] And it still gets me every time, because being transgender shouldn't be a life-threatening situation.

[00:34:47] And yet, how many people have come up to me and I meet them and say, you know what, you saved my life.

[00:34:51] And then some people will tell me that they've changed that.

[00:34:55] I saved that, our gender GP saved their child's life.

[00:34:58] And I'm like, oh, my goodness.

[00:34:59] Do you know what I mean?

[00:35:00] So it's been difficult.

[00:35:02] And like I said at the beginning, gender GP wasn't supposed to be here for this long.

[00:35:05] We were supposed to be a quick stopgap, because we knew that things were going to get better.

[00:35:09] But it just gets worse.

[00:35:11] And when it gets worse in the United Kingdom, it also gets worse in our neighbouring European countries.

[00:35:17] And even Australia try and look to see whether they should follow us.

[00:35:21] Thank goodness they didn't.

[00:35:22] So it has wide-ranging effects, what happens in the UK.

[00:35:26] And so the demand for gender GP just keeps increasing.

[00:35:29] And therefore, when I started it in 2015, I was the doctor.

[00:35:33] And we did everything on a kind of piece of paper and an email and PayPal, if you like, kind of thing.

[00:35:38] Blood tests.

[00:35:39] It was really homemade, if you like.

[00:35:41] And we've had to adapt.

[00:35:43] You can't help that many people from that many countries on old systems.

[00:35:48] So we've continually had to develop and evolve and to make sure that we can serve everybody and save those lives.

[00:35:55] And we had a big change at the beginning of this year.

[00:35:58] And people don't like change, but we had to do it to be sustainable.

[00:36:02] We've got more changes to come, which are really using the power of digital technology to give people the power back to them,

[00:36:09] put them in charge of their own healthcare journeys.

[00:36:13] That's the whole aim.

[00:36:15] Support the person's doctor in their decision-making rather than have to be centralised.

[00:36:20] So lots of changes.

[00:36:22] Some people don't like it.

[00:36:23] Lots of people have got used to it and now love it, which is fantastic.

[00:36:26] And we've got really nice things coming, which it's always been a bit rocky.

[00:36:31] I'm incredibly proud of GenderGP and all the lives that it's touched and saved and helped.

[00:36:36] I really am.

[00:36:37] You can't tease us and say we've got lots of lovely things coming.

[00:36:40] Give us a little clue.

[00:36:41] That was really naughty.

[00:36:43] No, I know.

[00:36:44] And I'm thinking now that my tech team are going to be like, what are you doing?

[00:36:50] No, but do you know what?

[00:36:50] Just things like people over the years, when they come to GenderGP website, you have to fill in that awful form.

[00:36:56] And anybody who's listening, when you have to fill in that form again and again, I save it from my name and address in every single time.

[00:37:03] And I'm like, don't worry.

[00:37:04] And people have been saying for years, can we just have a portal?

[00:37:07] Can we just have a login?

[00:37:08] Can we just have somewhere where I can look at my history and just update it and keep my own personal journey there visible?

[00:37:18] So something so simple.

[00:37:19] And it's nearly there.

[00:37:21] It's coming.

[00:37:21] And the whole aim is just putting it, like I said a minute ago, putting the control back to the person.

[00:37:27] No gatekeeping, no gates at all.

[00:37:30] Just health care as people need it and want it.

[00:37:32] And lots of support for their doctors.

[00:37:35] It's we want to really start educating, empowering.

[00:37:38] Doctors everywhere are saying, I don't, this is way too specialist for me.

[00:37:42] I don't know what I'm doing.

[00:37:44] I didn't get any training or education.

[00:37:46] And again, I thought by now it would be in medical schools.

[00:37:49] And there would be postgraduate courses.

[00:37:51] There would be postgraduate training posts.

[00:37:53] And they're still not.

[00:37:54] So I'm like, OK, we'll do it.

[00:37:56] So lots of education, lots of empowerment for doctors to realise, like I did all those years ago.

[00:38:02] Oh, actually, this is really easy.

[00:38:06] It must be.

[00:38:07] We've launched a postgraduate psychology and counselling therapeutic qualifications.

[00:38:12] Is it not something similar in the medical field?

[00:38:14] I've been banging my head against a brick wall for so long.

[00:38:17] And actually, the General Medical Council are responsible for the standards of education in the United Kingdom for doctors.

[00:38:24] And that starts at medical school.

[00:38:27] And if you have a look at the medical school curriculum, and then if you have a look at the postgraduate curriculum,

[00:38:32] how to be a GP or the exams you have to do to be a GP or a surgeon or a physician or a psychiatrist,

[00:38:38] transgender health care doesn't exist in those curriculum.

[00:38:42] So it's no wonder that we're producing.

[00:38:44] It's no wonder that today's doctors don't have any knowledge or education.

[00:38:47] And the worst thing is that tomorrow's doctors aren't going to have it.

[00:38:51] And we urgently need to get that education into medical school.

[00:38:55] And then we need to make postgraduate training posts so that, you know, when you finish medical school,

[00:39:00] you can go and learn in a training post in a hospital or a clinic or a GP surgery.

[00:39:05] And it includes how to look after trans people's hormones.

[00:39:09] But basically, the training that we're talking about at the moment, we're just starting with,

[00:39:13] OK, so this person might have this kind of genitalia, but they like their pronoun to be this.

[00:39:19] And I'm like, goodness sake, is that really how basic medical education is?

[00:39:24] That's where we've got to start.

[00:39:26] Goodness, goodness.

[00:39:26] One of the things that we often find with GPs in this country is that, you know,

[00:39:31] A, they won't work with us.

[00:39:33] So actually, let me not overcharacterize.

[00:39:35] Let me just say in my situation that I can't get an appointment at a gender clinic for seven years.

[00:39:41] So I've had to go private and I divulged that.

[00:39:44] And I've said in previous episodes, I go to gender GP and that's all very fine.

[00:39:48] But of course, I can't get shared care because my doctor and lots of doctors say

[00:39:52] they won't do support shared care with gender GP.

[00:39:55] So I guess you have strong views on that.

[00:39:59] But what's the way around that?

[00:40:01] Yeah, it's funny.

[00:40:02] When I started, again, when I started gender GP, I knew that I needed to put things like shared care in place.

[00:40:07] And actually, then it becomes weaponized and it's become weaponized, which I think is really tragic.

[00:40:13] The situation should be is GP acknowledges that they don't have the skills or knowledge

[00:40:20] currently to treat their trans person.

[00:40:22] So they've got two options, either go and get the skills and knowledge or work with someone who does have the skills and knowledge,

[00:40:30] which is what shared care, but that got weaponized because not helping your trans person is not an option.

[00:40:37] However, it is permitted.

[00:40:40] These GPs are permitted, even encouraged, not to help their trans patients at the moment.

[00:40:47] And they're being allowed to say, OK, I'll pop you on a waiting list, which I know is going to be seven years.

[00:40:52] I know in that seven years your mental health will probably suffer.

[00:40:55] I know that it's not the right thing for you, but I'm allowed to do it.

[00:40:59] And it's absolutely not.

[00:41:01] And what we need to be saying is either you go and get the skills and knowledge.

[00:41:04] And actually, that's what good medical practice, that's our kind of the medical Bible, if you like, tells you to do.

[00:41:09] If you don't know about it, you need to go and learn about it.

[00:41:12] Or you work with someone who does have the skills and knowledge.

[00:41:15] And if you don't do one of those two things, we will punish you.

[00:41:18] And that's the bit that's missing at the moment.

[00:41:21] Doctors are more scared to help than not to help.

[00:41:25] And that is just wrong.

[00:41:26] And you can tell I'm passionate about this because I won't stop talking and I won't let you in.

[00:41:30] But can you imagine if you went to a doctor and said, I've got a bad elbow.

[00:41:37] And the doctor says, I'm sorry, I'm not an elbow doctor.

[00:41:39] I don't know anything about elbows.

[00:41:43] Go away.

[00:41:44] Or I don't believe that you've got a bad elbow.

[00:41:46] Go away.

[00:41:47] Or the next appointment for your elbow will be seven years time.

[00:41:52] I'll pop you on that waiting list.

[00:41:53] It's just absurd that this is permitted, but it is being permitted.

[00:41:57] And what we need to do is go right back to the person who sets the rule book for doctors.

[00:42:02] And that's the General Medical Council.

[00:42:04] Please, can you put some medical training in medical schools?

[00:42:08] Please, can you make some postgraduate training available so doctors can learn?

[00:42:12] Please, can you put it in the curriculum so that there's the opportunity for doctors to learn?

[00:42:18] And please, can you punish my doctor if he won't help me or she won't help me or they won't help me and actually causes me harm in the next seven years by not helping me?

[00:42:31] Sounds really simple.

[00:42:32] But and that's what happens in every other part of the body or field of medicine.

[00:42:36] But it hasn't been enforced in trans health care yet.

[00:42:41] And I hope it bloody does before I die.

[00:42:44] Yeah.

[00:42:44] And I'm going to prescribe you some doctors because we need to calm down.

[00:42:48] So we're going to talk about something easier for a second.

[00:42:50] So just let you calm down.

[00:42:51] But before we do, just prod you one more time.

[00:42:55] Yeah.

[00:42:56] It is interesting because the NHS is a mess and you talk about people not getting appointments, but actually you talk about the elbow doctor and you talk about this.

[00:43:02] I know people who waited for hip operations and things for two or three years.

[00:43:06] And I think there's a general mess, isn't there?

[00:43:08] So the transgender thing just gets shunted down.

[00:43:11] I think sometimes we think there's a plot against us.

[00:43:13] I just don't think we're important enough and get shunted sideways.

[00:43:17] I look at friends of mine who I know who are waiting for hips and cancer operations.

[00:43:22] People waiting months to get on cancer waiting list.

[00:43:24] So I think there's a bigger issue.

[00:43:26] But I just wonder if there's a more imaginative solution than trying to fix the NHS.

[00:43:30] Because every time I talk to anybody in the NHS, they can't fix it.

[00:43:34] It's such an enormous problem that we'll talk about, can we just turn a screw here in this hospital to the right?

[00:43:41] Oh, no, because we have to talk to all the other hospitals.

[00:43:43] We have to do this.

[00:43:43] I'm just thinking, shh.

[00:43:45] And I know Gender GP is a response to that.

[00:43:47] It's an imaginative way to solve a problem.

[00:43:48] But I just wonder if there are others as well.

[00:43:50] I see lots of people saying, oh, Gender Care.

[00:43:52] There's a place in Ireland.

[00:43:53] And there are other options rather than the NHS.

[00:43:57] I know you have to pay.

[00:43:58] But I'm just wondering if there's a way of getting cash out of the NHS so they can just fund your care.

[00:44:04] Because there was the thought one time, wasn't there, giving you a budget.

[00:44:07] And then you could go and spend that budget where you wanted to.

[00:44:10] Yeah, it's really interesting.

[00:44:11] And actually, you talked about hips.

[00:44:13] My other favourite is cataract.

[00:44:14] So if you're waiting for a hip operation or a cataract operation, you've waited too long, they will slot you in at the private hospital in Bristol or wherever it is on a Saturday morning and they'll get it done.

[00:44:24] Because they're meeting targets.

[00:44:25] Like, OK, we've got someone who needs a new hip identified.

[00:44:28] They're not allowed to.

[00:44:29] I don't know what the number is, but you're not allowed to wait more than, let's say, 18 weeks.

[00:44:32] If you have to wait more than 18 weeks, we'll pop you on the private hospital list.

[00:44:35] It's easy.

[00:44:36] We're doing that all the time.

[00:44:37] People say, oh, it's privatisation.

[00:44:39] It's actually like we've got lots of people here we need to serve.

[00:44:42] And so I think what I wish the NHS would stop pushing the private services away and say, please, can you help us?

[00:44:48] Because we are struggling.

[00:44:49] We've got so much to do.

[00:44:51] We haven't got the skills in-house.

[00:44:53] Please, can you come and help us?

[00:44:55] And what the other piece of work that Gender GP is doing at the moment is, I'll give you an example.

[00:45:00] When I started being a GP back in 1995, we had this piece of software introduced into the computers when they came in, which I just absolutely loved.

[00:45:08] And so you typed in urinary tract infection, water infection for patients, and it would come up with, these are the three best antibiotics in order.

[00:45:18] So it was like, oh, cool.

[00:45:19] And those were put in place by the people who were in charge of formulary, in charge of bacterial resistance.

[00:45:27] In my area where I was working, these are the three best antibiotics.

[00:45:30] Make sure your patient's not allergic to one of them.

[00:45:32] Give them the best.

[00:45:33] Give them the top one.

[00:45:34] If they're allergic, give them the second one.

[00:45:35] And I was like, that's so cool.

[00:45:37] It's such a supportive tool for doctors rather than go, I don't know which antibiotic to give.

[00:45:42] So that's what we need to do with transgender health care.

[00:45:45] And digital technology can help so much.

[00:45:48] OK, so I've got this trans woman.

[00:45:50] She's on, for example, estrogen and spironolactone.

[00:45:54] And her estrogen level is 200.

[00:45:58] OK, that's too low for her.

[00:45:59] So let's increase her estrogen by one step.

[00:46:03] So if it was, say, if it was two milligrams she was on, let's put it to three milligrams of oral estrogen.

[00:46:07] And her spironolactone, her testosterone level is three.

[00:46:12] Beautiful.

[00:46:13] Perfect.

[00:46:13] We could actually try and decrease her spironolactone if we wanted to give it a go to make sure she's on the lowest dose that does the right job.

[00:46:20] So we've been creating those algorithms in the hope that one day the NHS will say, please help us.

[00:46:28] We can't do it on our own.

[00:46:29] It's too long.

[00:46:30] And digital technology can help so much with this kind of those algorithms can help so much.

[00:46:37] And we see it coming into medicine.

[00:46:38] It's quite slow.

[00:46:39] Medicine is quite slow.

[00:46:40] But we want to speed.

[00:46:41] We're speeding that up.

[00:46:42] We've got it all ready.

[00:46:44] Whenever the NHS open their door and say, go on then, we need you after all, we'll be there.

[00:46:49] But I think it's simpler than that because I think private equity firms investing in that sort of technology would take that out and invest in that area.

[00:46:56] In the sense that Musk probably has this solution already sorted out.

[00:47:00] All you need to do is get Musk on side, get a government contract and away you go.

[00:47:03] I just wonder whether, again, we push at the wrong levers.

[00:47:06] I just wonder whether we have the right policy.

[00:47:09] We're fighting the NHS rather than saying, let's get a private solution to come in.

[00:47:13] We know how to, especially the last government, it was very easy.

[00:47:16] You give them five grand and you'd end up with a £22 million contract for supplying false legs or something.

[00:47:23] And then you could spend it on whatever you wanted.

[00:47:25] Yeah, totally.

[00:47:25] And I agree with you.

[00:47:26] The NHS, I feel, and this is a whole new topic.

[00:47:29] I'm just going to say three words.

[00:47:30] The NHS is broken.

[00:47:32] End of story.

[00:47:33] But at the moment, that's what we're working with.

[00:47:35] And so the NHS should be providing health care at free of charge to trans people and at the source of contact with their GP.

[00:47:44] So that's currently what you should be able to have.

[00:47:47] And that's what we should be working towards.

[00:47:49] I understand that actually, I'm not sure we're ever going to get there.

[00:47:52] But currently, I think that's what we should be working towards.

[00:47:55] I don't let them off the hook.

[00:47:56] I don't think trans people should pay for their own health care.

[00:47:59] I don't want to let the NHS off the hook.

[00:48:00] And I know they can't afford everything.

[00:48:02] Then you've got to put your hand up and say, my model's broken and I can't afford it.

[00:48:06] What should we do?

[00:48:07] Do you know what I mean?

[00:48:07] But that's a whole new discussion.

[00:48:09] That's a very nice big message for the NHS.

[00:48:11] I like that.

[00:48:12] I could cut that and put it on social media.

[00:48:14] That would sound groovy.

[00:48:15] Have you got any messages for politicians?

[00:48:18] It's the same as the General Medical Council.

[00:48:20] These people in very high places have a huge responsibility, not to the trans community,

[00:48:26] but to the whole of the people of the United Kingdom who they are serving.

[00:48:31] And they must do their job properly.

[00:48:34] And they must not be influenced by people who may have a very loud voice or may have a very big wallet,

[00:48:42] may have a very big chip on their shoulder.

[00:48:45] And please, politicians, don't allow yourselves to be influenced by those people.

[00:48:49] And actually draw on experts.

[00:48:52] If we were talking about education, we would get people who are experiencing education in to have a voice, to have a word.

[00:48:59] The ban on puberty blockers was done without consultation with doctors and nurses and psychologists, etc.

[00:49:06] The medical profession, let's call it.

[00:49:08] Atrocious behaviour.

[00:49:09] And the cast review was carried out by a doctor who had no experience of working with transgender people.

[00:49:18] Atrocious.

[00:49:19] And this, my message to people in high places, whether you are on a board of the company that you work with,

[00:49:28] whether you are on the education board of an area of schools, whether you're on a school board,

[00:49:33] whether you're on a HR department, whether you're a politician or a general medical council or an NHS trust,

[00:49:40] you people have a lot of power.

[00:49:42] So please use your power wisely and be guided by experts and not by political, social tattle,

[00:49:51] because that's what it is.

[00:49:53] Otherwise, you're going to fall down.

[00:49:54] You will be eventually held accountable for the wrong that you do.

[00:49:59] And it's also very interesting, isn't it?

[00:50:01] Because if you look at the wider community, the wider, we're back in the word community again,

[00:50:06] because no, but if we put all the letters together and say LGBT, the whole lot.

[00:50:10] And you talk about that grouping of people.

[00:50:13] If you looked at the impact that that group of people bring in the world, including trans people,

[00:50:18] without it, that group of people, IT would be decimated.

[00:50:22] Without that group of people, soft power that comes from the arts and the humanities

[00:50:25] and education would be completely decimated.

[00:50:28] Some of our most impactful work as a UK economy comes from this whole group of people.

[00:50:35] And I don't think we think widely enough about the LGBTQIA plus side of it as well,

[00:50:41] because we do talk about trans a lot, and that's fine.

[00:50:43] We're sometimes quite uneasy bedfellows with that.

[00:50:46] But I don't think we talk enough about what a fantastic community we are,

[00:50:49] how resourceful we are, how committed we are,

[00:50:52] if we redefine ourselves as having impact rather than needs all the time.

[00:50:56] I think that's a message for the trans community and all of us.

[00:51:00] But no one's here to listen to me, Birbalon.

[00:51:02] What's your message for the trans community?

[00:51:04] I think my message to the trans community is that

[00:51:10] I have never worked with a nicer, happier, better group of patients,

[00:51:17] if I put my doctor's hat on for a minute, in the whole of my career.

[00:51:22] I've absolutely loved the people that I've met, that I've worked with.

[00:51:26] So undemanding, so humble, thankful.

[00:51:29] And in many ways, I feel sad that you have to be humble and so grateful

[00:51:34] with the tiniest bit of love or care that you're offered.

[00:51:37] And so undemanding.

[00:51:39] And I'm sorry that you're so undemanding.

[00:51:40] I want you to be more demanding and get what you deserve

[00:51:42] and get what you should have.

[00:51:44] But honestly, I've never worked with a better group of people.

[00:51:48] It really made the end of my career absolutely so rewarding.

[00:51:52] And just, I think, just keep, I don't say keep fighting,

[00:51:57] just keep on at achieving what you deserve,

[00:52:03] which is the same as what everybody else deserves for their health

[00:52:06] and for their life and their wellbeing, which is just to live your best life.

[00:52:10] You totally deserve it.

[00:52:12] You're totally beautiful.

[00:52:13] And just keep asking because it's not a lot to ask for.

[00:52:18] No.

[00:52:18] And the other thing that we talked about just briefly,

[00:52:20] I'm just conscious of your time because I've seen it rocketing past night.

[00:52:22] This is our 25-minute episode.

[00:52:24] This might be episode three.

[00:52:25] We didn't talk enough about non-binary people.

[00:52:27] I just wondered whether we say three things.

[00:52:29] I often think the problem with that term is that it's neither this nor that.

[00:52:33] It almost needs its own word.

[00:52:35] And the woodsmiths need to create something, I think, there.

[00:52:39] I just wonder what your thoughts are on non-binary issues.

[00:52:41] Because I think they have a really awful place

[00:52:45] because at least we get victimised and abused and don't get any treatment.

[00:52:50] But they're invisible, aren't they?

[00:52:52] And it just strikes me that we need to raise the temperature on that

[00:52:54] for those people as well.

[00:52:56] Yeah.

[00:52:57] In many ways, they're not, that group of people aren't bullied

[00:53:00] as much as the trans women that we talked about.

[00:53:02] Trans women get bullied most, I feel.

[00:53:04] But like you said earlier, trans men are kind of ignored

[00:53:06] and they're just like, oh, you're stupid.

[00:53:08] If you want to negate your beautiful femininity and be a trans man,

[00:53:11] you're so stupid.

[00:53:12] I'm all that power and wealth.

[00:53:14] Yeah, exactly.

[00:53:15] And then non-binary people are a bit scared.

[00:53:17] People are a bit not understanding.

[00:53:18] Some people are like, look, can't you just shut up for minutes

[00:53:20] while we just get used to the fact that you switch from one to the other?

[00:53:24] I can't cope with that in the middle bit.

[00:53:26] But you're right.

[00:53:27] And actually, it just makes me think that I've always, I hate boxes.

[00:53:31] I hate saying gay people or homosexual people,

[00:53:35] even though I've said it a few times.

[00:53:36] I just think, just let everyone just be who they are.

[00:53:40] Why do we need all these labels?

[00:53:41] Are they helpful?

[00:53:42] Are they a hindrance?

[00:53:43] And I think in the future, with young people particularly,

[00:53:47] they'll be like, nothing to do with you.

[00:53:49] Just let me be.

[00:53:50] I don't need to tell you whether I'm male or female or non-binary

[00:53:53] or both or some of them are in the middle.

[00:53:55] Tomorrow I'm going to feel slightly different to the way I do today.

[00:53:58] Just absolutely nothing to do with you kind of thing.

[00:54:01] And I'm looking forward to that time.

[00:54:03] But in the meantime, we do need to understand gender identity better

[00:54:08] and the fact that gender identity isn't one or the other.

[00:54:13] It's a whole spectrum.

[00:54:14] And I've seen, the other beautiful thing that I've seen is trans,

[00:54:18] for example, trans women coming to me saying,

[00:54:19] I'm trans women, but I'm female.

[00:54:21] And then a little way into their journey, they're like,

[00:54:23] do you know what?

[00:54:24] I've still got a little bit of that masculinity to me

[00:54:27] that I'm missing a little bit.

[00:54:28] And everyone's like, oh my God, does that mean you're not?

[00:54:30] Peter doesn't.

[00:54:30] Oh my God.

[00:54:32] But it's like, no, it's just a little bit further down the spectrum.

[00:54:34] And then in a few months' time, you might feel a little bit differently.

[00:54:36] What's wrong with that?

[00:54:39] Nothing.

[00:54:39] So I hate these kind of labels, these boxes.

[00:54:42] Let's just make gender identities, sexuality, personality,

[00:54:46] all of those things.

[00:54:47] Let's just let us be fluid.

[00:54:49] Let us be who we are.

[00:54:51] And it might be different today and tomorrow.

[00:54:53] But just acceptance is what we need.

[00:54:57] On that note, I can't disagree with you anymore.

[00:54:59] So I'm just going to just surrender now and say,

[00:55:02] yes, Helen rules.

[00:55:03] And that's absolutely fine.

[00:55:05] So look, thank you for spending so much time with us today.

[00:55:07] Maybe you can come back and record episode four with us sometime.

[00:55:10] I'd love that.

[00:55:11] I would love to.

[00:55:13] Let's put a date in the diary for next year and we'll do that for sure.

[00:55:16] Thank you so much for having me on.

[00:55:17] I've really enjoyed chatting to you.

[00:55:19] Pleasure.

[00:55:19] You take care.

[00:55:20] Thank you.