Samathy Barratt (left) and Alex Roberts say they feel clinicians ‘abandoned’ them (Picture: Nottingham Post/BPM MEDIA)
Alex Roberts, a game programmer in Nottingham, had waited a month for the call. A week before Christmas, their phone buzzed.
It was their GP. All the 32-year-old had asked from their practice was a small change to the medication they had been receiving for three years.
Instead, they were told that in only a few months, their gender-affirming healthcare would come to an end.
‘I felt incredibly let down, the wait to hear from them was horrendous, so stressful and frustrating,’ Alex, who receives testosterone, told Metro.
‘Honestly, I was still expecting it to get resolved amicably because I feel like they’re just abandoning all their trans NHS patients.’
Samathy worries that without access to the medication, she may detransition (Picture: Nottingham Post/BPM MEDIA)
Alex is a patient at Jubilee Park Medical Partnership, which runs practices in the Nottinghamshire village of Lowdham and Carlton, a town three miles east of Nottingham.
Both sites prescribe gender-affirming healthcare, which intends to align patients’ physical appearance with their gender. Treatments include hormone replacement therapy (HRT), medication that the NHS says ‘usually needs to be taken for the rest of your life’.
But Alex, like other trans and non-binary patients, received a letter on December 19 from the surgery saying their healthcare would be withdrawn from April 1.
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Jubilee Park, according to the letter seen by Metro, told patients that it can no longer offer the care as it is ‘not part of our essential services’.
‘Additionally, our GPs do not feel confident in prescribing these specialist medications,’ the letter says. ‘Prescribing such medications requires specific expertise and carries significant clinical responsibility, which we believe should remain with specialist services.’
The surgery also cited funding issues and the treatments not being ‘part of the GP contract’, a document that lists the mandatory requirements and services for all clinics, as reasons.
The letter said that the clinic no longer feels ‘confident’ in providing trans healthcare (Picture: Jubilee Park Medical Partnership)
Samathy Barratt, a 29-year-old software engineer who has been on HRT for six years, said this has left her feeling ‘powerless’.
‘As I am on a testosterone blocker injection, If I stop being able to access gender-affirming care in three months I will begin to experience a forced detransition, with some of the feminising changes I’ve been happy to experience being reversed,’ she tells Metro.
‘Going on HRT had a massive, positive impact on my life, my mental and physical health, I’m really worried about losing it.’
Gender-affirming hormone treatment can lead to decreased levels of depression and anxiety, studies have shown. Some effects from HRT are reversible, such as changes in skin texture, muscle mass, hair growth and fat distribution.
Transgender healthcare in Britain is a three-step operation. Once adults go to the doctors and say they have gender dysphoria and want to medically transition, GPs refer them to Gender Identity Clinics, specialist centres often called GICs, which can diagnose trans people with gender dysphoria.
These centres, which include Nottingham Centre for Transgender Health, cannot prescribe or supply drugs. Instead, GIC staff ask GPs to write prescriptions.
Jubilee Park Medical Centre, among other key services, writes prescriptions for hormone replacement therapy drugs for trans patients (Picture: Nottingham Post/BPM MEDIA)
‘I already struggle with anxiety, worrying about this eventuality has been devastating to my mental health,’ adds Samathy.
‘I’m at a low I have not been at for many years, I can’t imagine it’ll improve come April when my prescriptions cease.’
Alex and Samathy were among dozens of people who attended a protest organised by Nottingham Against Transphobia outside Park House Medical Centre in Carlton on New Year’s Eve.
‘Nottingham Against Transphobia organised the protest simply because we want transgender people to be provided with the care that they have already been prescribed within the NHS,’ the campaign group told Metro.
‘Non-cisgender people can get HRT and blood tests with their GP as a matter of course… We will stand up for fairness and equality in all healthcare provision across Nottingham and will never back down in this fight.’
Both current and future trans patients have three options, Alex and Samathy said. They could switch GPs and ‘hope this isn’t repeated’, Alex said, or go private, but hormonal gels and injections can be costly.
Nottingham against Transphobia arranged the protest (Picture: Nottingham Post/BPM MEDIA)
Appointments can be up to £500. Prices for testosterone gel are around £50 for two months while injections can be £100 for a three-month supply. Oestrogen gel, patches and pills are around £10 for a two-to-eight-week, two-to-four-week and one-to-four-week supply respectively. This does not include additional costs such as prescriptions, blood tests, monitoring and injection equipment.
GnRH agonists, which stop the testicles and ovaries from making sex hormones, can cost £300 for a three-month supply.
The third option is the ‘riskiest’, both admit, ‘DIY HRT’. This sees trans people obtaining HRT without a prescription or medical supervision.
As ‘empowering’ as researchers found the strategy can be for trans people, experts say incorrect dosages, contaminated products and the lack of monitoring from a medical professional can lead to health issues.
‘Jubilee Park has confirmed that they would treat any acute injuries I may sustain from trying to self-inject,’ said Alex. ‘Lucky me?!’
Samathy complained to the NHS Nottingham and Nottinghamshire Integrated Care Board (IGB), which plans and funds Jubilee Park’s services, about the GP stopping her prescription.
According to Jubilee Park, the county’s board does not fund or commission trans healthcare.
In a response she received from the board this month following an investigation, seen by Metro, a board official told Samathy they have written to Jubilee Park to ‘request that they continue to provide this care beyond April’.
For Alex and Samathy, until Jubilee Park sends them letters saying their HRT won’t be cut off, this offers them little reassurance.
‘I hope that with enough visibility, practices across the country will begin to understand,’ Samathy adds, ‘that ceasing treatment for vulnerable patients who have no alternative is not protest, it is just cruelty.’
NHS county officials told Metro trans people have the ‘right’ to access healthcare (Picture: Nottingham Post/BPM MEDIA)
A spokesperson for NHS Nottingham & Nottinghamshire echoed this, telling Metro: ‘NHS Nottingham and Nottinghamshire fully supports the rights of citizens with gender dysphoria to access safe and clinically-led care through their local GP practice.
‘We have written to Jubilee Park Medical Practice to set out our position and to request that they continue to provide this care beyond April 2025. We understand that no change is proposed until that date.’
Dr Katie Bramall-Stainer, chair of GPC UK at the trade union British Medical Association (BMA), told Metro: ‘Patients should never have to resort to self-medicating due to gaps in service and commissioning but trans care is a specialist service, not commissioned from GPs.
‘Trans patients, being a particularly vulnerable group, require urgent action around safe and appropriate commissioning arrangements. We urge NHS England to ensure that such services are available in future service specifications so that trans patients can access the care they need.’
Metro approached Jubilee Park Medical Partnership for comment.
In a previous statement issued on Facebook after the protest, they said: ‘Gender identity clinics are multi-disciplinary NHS clinics consisting of doctors, nurses and psychologists… Unfortunately, these clinics cannot keep pace with the growing demand for these services and the average waiting times are currently more than three years.
‘As GPs, we feel this is an unacceptable level of service, and we continue to campaign for more equitable care for the transgender community. This would involve not only more timely access to specialist care, but also continued resources to fund and train GPs to maintain prescribing and monitoring.
‘Jubilee Park Medical Partnership continues to be very supportive of our transgender patients.’
Get in touch with our news team by emailing us at webnews@metro.co.uk.
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