Dateline: Brighton, September 2018

Wandering into Conference a leaflet is thrust into my hands. It touches on current Government consultation on the Gender Recognition Act.

One paragraph of the leaflet sets the tone “sex self-ID that would allow any man to get his birth certificate reissues in the opposite sex. Just like that. On demand. With no change to his body and no medical supervision.”

The rest of the leaflet is a list of scenarios each more prurient than the last. None of these scenarios are evidenced as ever having happened, no evidence that a trans woman has ever abused the trust of other women in these sensationalist and inflammatory ways. Just a list of “what if”.

Leaving aside the paucity of the author’s hypothesis there is another consideration, if not sex self-ID then what?

The author suggests “changes to his body” and “medical supervision”.

While this article is not a treatise on the NHS most people recognise that for anything beyond measles that means triage, waiting times, a postcode lottery, financial limits and gatekeepers.

In the context of the current gender recognition process (leading to a Gender Recognition Certificate and a new Birth Certificate) that means two medical practitioners from suitable disciplines with experience in treating gender dysphoria.

Let me tell you about my gatekeepers.

My third psychiatrist was a sincere doctor from Iran. They cared about their patients, understood the genuine and immediate health care implications of gender dysphoria – depression, stress, frustration, anger, self-harm, self-loathing and suicide. They wanted to help not just by treating the symptoms, but the root cause as well. Everything a good doctor should be.

My second psychiatrist (and gatekeeper) was more concerned with gathering data for a doctoral thesis than treating their patients. Non-compliance was never an option, especially when their supervising professor was also my first psychiatrist.

The professor was a truly old-fashioned gatekeeper. Without his agreement there could be no access to hormone treatment, no access to speech therapy, no surgery and no paperwork.

Definitely old school. For him, being a woman meant wearing a skirt or dress – turning up in trousers always a black mark. His concession to modernity was tights, even if he still preferred stockings and suspenders. How could he tell? Well he was not averse to checking the underwear of his patients. And I don’t mean with a multiple-choice question – physical inspection in the privacy of his own office. 

Rumours persisted that inspection was a prelude to worse for patients easily cowed and already desperate for treatment.

Gender identity should not be determined by financial or misogynist gatekeepers anymore than public toilets need staff to check the contents of my underwear.

* Jean Johnson is a pseudonym. The author is known to the Lib Dem Voice team.