Healthcare for trans youth is a human right – it should matter to us all

The independent review of gender identity services for children and young people, known as the Cass Review, was set up almost four years ago to review how the NHS should provide care for trans and gender non-conforming children in response to a steady increase in referrals to gender identity services and criticism of how it’s managed.  

Its long-awaited final report published last week dominated headlines. Sadly, it wasn’t surprising to see the usual pundits who speak against trans children (and adults) even existing spreading inaccurate information and sharing how their views are vindicated by the report.

Revelling in the Cass Review by saying “we can now wake up from this nightmare” or talking about closing a “dark chapter in our history” and calling clinicians who take a gender-affirmative approach “cult members” is simply malicious and has destructive real-life consequences for trans people and their families.

• Trans kids just want to live and be happy. The government has no reason to make their lives harder
• It’s time for trans women to be given space to tell our stories in our own words

These commentators are not interested in what healthcare model could best support trans children, their starting point is that trans children don’t really exist or think they are trans as a result of other issues such as mental health conditions and abuse. Once again young trans people have been spoken about rather than given a chance to express their views on fundamental aspects of their lives.  

The best healthcare for trans youth is a complex matter and it is too often forgotten that all children, trans or not, have a right to healthcare.  

Children have the right to access high-quality services and to make decisions about what’s best for them in the privacy of the consultation room, as we would wish for anyone else who needs to access healthcare services. We often hear that trans children are too young to understand the consequences of their choices and therefore, are not able to figure out what is in their best interest. The truth is that the best interest of a child cannot be determined unless the child can express their views and most importantly, that their views are heard.  

Healthcare for trans people of all ages has been abysmal for a long time, running on few resources and with unacceptably long waiting lists. The most important issue should be ensuring trans people can actually access healthcare.  A child has to wait five years for their first appointment and it’s not clear how that will improve without significant financial investment in services.  

The downward shift in equality for trans people has been fast and, in some ways, unexpected. In 2017, then-prime minister Theresa May announced plans to reform the Gender Recognition Act into an administrative rather than medicalised process and ban conversion therapy. More than five years later the UK’s standing as a country advancing LGBTQ+ people’s rights has plummeted, and large sections of the media and political world have invested in manufacturing moral panic about trans people.  

What’s even more worrying is that anti-trans groups are now firmly established, including as charities, with remarkable access to media and politics. Strange bedfellows have united around the anti-trans cause: evangelical groups, feminists, far-right politicians and conservative think tanks. Some out of conviction and some for political expediency.   

According to a More in Common survey, only 2% of people think that “the debate about transgender people” is one of the most important issues facing the country. This is completely out of sync with how preoccupied the government is with what it calls “the trans issue”. We need to ask what lies behind this disproportionate attention? Of course, it’s trans people who pay the price, facing discrimination, bullying and increased hate crimes.

We can expect the political climate to get worse as we get closer to the general election. Despite anti-trans discourse being so pervasive, and successful, a new government must change course and commit to advancing human rights protections for trans people.  

The dehumanising of trans people is an issue for all of us. We can’t afford to see it in isolation from the wider problem of rights stripping taking place in this country from targeting people seeking asylum to criminalising homelessness, our right to protest and our right to health – an alarming number of human rights are being demolished before our eyes.  

In these uncertain times, we must be united, not divided for the sake of all our rights.  

Chiara Capraro is Amnesty International UK’s gender justice director.

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