The real trans scandal is not the failings of one doctor but cruelty by many

http://www.guardian.co.uk/commentisfree/2013/jan/10/trans-scandal-doctor-richard-curtis-transdocfail

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Has your doctor ever laughed in your face during an appointment? Denied that your condition exists? Or simply told you that you're too ugly to merit treatment?

Outrageous? Yes, but also, pretty much par for the course if you happen to be trans. You must expect a world of abuse and humiliation to attend even the simplest of interactions with the medical profession, whether trans-related or not. As for making a complaint, few will risk it: most are cowed into silence by the tacit threat that rocking the boat could lead to a termination of their desperately needed treatment.

Of course, there's little new to this. Wherever there is power imbalance between patients and professionals who control access to resource, there is a risk of an unhealthy relationship developing. From benign paternalism to outright bullying and belittlement, the pattern is repeated time and time again – with women, disabled people and those with mental illness frequently on the receiving end.

Now, however, a wholly unexpected explosion of angry tweets – several thousand in the last 48 hours – may have blown the lid off this issue once and for all. The story began, unpromisingly enough, with a Guardian article revealing that Dr Richard Curtis, one of the few medical practitioners providing support for gender re-assignment outside the NHS, was being investigated by the General Medical Council (GMC) in respect of a number of complaints made about his practice. This touched a raw nerve, in all sorts of ways. Since Curtis offers private treatment, his services are not available to all; nor can he offer the full range of support provided by the NHS. However, as the main – perhaps only – alternative in town, his continuing practice offers a different perspective to the NHS pathway, which is widely regarded as slow, controlling and unsympathetic.

With new commissioning structures about to come into being, fears are heightened that the entirety of trans provision is about to be forced into a one-size-fits-all straitjacket. In such circumstances, "patient choice" evokes but hollow laughter.

Trans anger focused on two aspects of the story: the fact that Curtis, an individual who for all his failings is widely seen as something of a hero of the community, should be coming under attack by the medical establishment; and the fact that, with so much medical abuse of trans folk going on, the news agenda should light yet again on an angle that is positively damaging.

Within a few days, this anger turned into something quite extraordinary, almost entirely due to the sterling efforts of two LGBT activists: Zoe O'Connell and Lib Dem councillor Sarah Brown. Brown's flash of inspiration was to launch the #TransDocFail hashtag on Twitter, asking UK trans patients to relate their experiences (not just of the specialist gender services, but also of how they are treated by medical practitioners in general). Several thousand tweets later, no one can be under any illusion that the biggest problem facing the UK's trans community is some rogue specialist – but rather institutional transphobia in the NHS, in the GMC and among GPs.

Meanwhile, a selection of just a few of these tweets put together by O'Connell illustrates the problem in no uncertain terms: from denial of treatment to outright abuse, there is a certain appalling majesty to this accumulation of cruelty. A few might make you laugh. Most – the rudeness, the rejection, the outright sabotage – are cause for tears. Here are a few examples:

Point blank refusal to refer to me by my proper name, something the non-GIC psychs did without a fuss. #TransDocFail

— Æðelþryð (@ethulhu) January 9, 2013

GP refused to attest that I'd had surgery so I could get a GRC. I had all my hospital notes, and, you know, a vagina… #TransDocFail

— Cheryl Morgan (@CherylMorgan) January 8, 2013

NHS Psych told me I wanted to transition to male cos I was too ugly to live as a woman. Also told me I'd never pass as male #TransDocFail

— Liam (@AutistLiam) January 8, 2013

RT was turned away at reception of gyno who shouted about "it" and "do they have a vagina" - needed external granuloma removed #transdocfail

— Jules LoVecchio (@Diran_Sky) January 8, 2013

3 years after explaining how dangerous (and unlawful) it is, my GP still prints HRT prescriptions for "Mr Emma Brownbill"~ #TransDocFail

— Emma Brownbill (@embrownbill) January 8, 2013

The huge mobilisation triggered by the hashtag's popularity has been the catalyst for new and possibly significant initiatives by the UK trans community. One senior activist commented that they had never seen the community so united behind a common cause. There is a feeling abroad that things must now change, and while a tweet of rage is not an end in itself, still there is a sense that the world at large must finally sit up and listen. One small sign of progress today was the GMC itself camping on the #TransDocFail feed and encouraging trans folk to bring forward complaints about medical personnel.

Surely, now, even those with little or no direct experience of trans issues must realise that the real problem is not the chimera of regret and regretters so eagerly sought after by the tabloid press, but the diet of mundane disrespect dished out daily by doctors the length and breadth of the country. Surely they must. Mustn't they?