What’s Happening: August 2023

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Children and Young People’s Gender Incongruence Service 

There are many stages to the design of the new service that will replace GIDS. The final specification was released in June. In August, NHS England published their proposed Puberty Suppressing Hormones policy, which is open for public consultation until 1 November 2023. The policy defines how the service will make use of puberty blockers: outside of the forthcoming research programme, puberty suppressing medications will not be routinely prescribed to children and young people. There is a clause in the policy which allows for exceptional cases to be considered outside of the research, but it is unclear what would constitute exceptional, and how individuals would apply for this. 

NHS England also shared their proposed referrals pathway policy with registered stakeholders, with this policy due to be published for public consultation in due course. The current proposal is for children and young people to be referred by their GPs to CAMHS or paediatrics, depending on their level of distress. These services will then review the individual’s case, before deciding whether to refer them on to the service. The Trans Learning Partnership are concerned about the proposed changes, and are engaging with NHS England on this matter. 

Trans Safety Network have reported that Great Ormond Street Hospital, due in part to host the new service, has hired Anastasis Spiliadis as a new Education Lead. Spiliadis is a member of Explore Consultation, a group connected with Genspect, and was one of the individuals who delivered training to NHS Trusts in December last year, which many people had concerns about. Spiliadis is also an originator of so-called ‘Gender Exploratory Therapy’, an ‘alternative’ to gender-affirming care touted by anti-trans campaigners but widely considered a form of conversion practice by those with expertise in gender affirming care and trans rights more broadly. Given the recent revelations around the content of Genspect’s internal Discord server, this raises questions about the safeguarding of children in the service.

Sinn Fein’s Northern Irish presence have stated that puberty suppressing treatments should be ‘normal healthcare,’ and the party have affirmed their broader trans-inclusive approach.


Adult Waiting Times and the Northern Region GIC 

It has been announced that referrals and transfers to the Northern Region Gender Dysphoria Service have been paused indefinitely due to the extensive waiting times. This is the adult Gender Identity Clinic (GIC) that serves the north eastern region of England. At present, the person at the top of the waiting list has been waiting five years and five months, and is still yet to be allocated a first appointment; the person at the top of the waiting list for a second appointment (for diagnosis and treatment plans) has waited an additional two years for this second appointment, after waiting four years and two months for their first appointment, and are yet to be allocated this second appointment. The service is pausing referrals in order to create an action plan to tackle these extensive waiting times. However, as noted in the FAQs, trans people and organisations were not consulted on this decision. 

Unfortunately, the legal case regarding NHS waiting times has now been dismissed. The judge has ruled that the 18-week target for NHS referrals is a target, not a legal duty. This is the end of the line for this case, as it cannot be brought forward again. 

While this is disappointing news, it has sparked renewed reporting in mainstream media regarding the absurd waiting times faced by individuals trying to access Gender Identity Clinics. The BBC, for example, has reported on the seven year wait individuals can expect to access the Laurels clinic in Devon, which has the longest waiting time among the English clinics. 

However, FOI data has also revealed a deeper reality surrounding waiting times. With the data provided regarding how many individuals are on the lists, and how many first appointments are being given, it can be calculated that individuals could in theory wait 35 years to be seen by a clinic. This data was last calculated by individuals online in 2021, when the figure was 26 years. In practice, individuals will not wait this long, as system reform of some kind will happen before then, either through collapse or activism. However, this figure reveals how deeply flawed the current system is, and how rapidly these waiting lists are growing against how slowly patients are being seen.

Parliamentary Politics

Labour and gender recognition reform 

The Labour party continue to face criticism for their U-turn on reforming the Gender Recognition Act through self-declaration. Wes Streeting has apologised to Rosie Duffield for how the party has treated her due to her ‘Gender Critical’ views, and has claimed that by pushing for GRA reform in Scotland, the SNP damaged LGBTQ+ rights. He claimed the party refused to listen to critics, and that their failure was legislating with good intentions, rather than for worst-case scenarios. This is despite the Bill being one of the most scrutinised in Scottish Parliament’s history, and research from countries globally already using self-declaration systems evidencing that these fears do not materialise. 

Deputy leader Angela Rayner has stated on BBC Radio 4’s programme Today that trans rights and women’s rights are not in conflict. This is despite Dodd’s article in the Guardian announcing the policy making clear implications that they believe this to be the case (such as reference to the need to safeguard women and girls in the creation of self-declaration-based gender recognition policies, e.g., in Scotland’s Gender Recognition Reform Bill). Rayner’s further comments did not stray from the party line, particularly around their abandonment of the self-declaration model. 

Suzy Eddie Izzard has announced that she will be standing as Labour candidate for Brighton Pavillion, the seat currently held by Caroline Lucas for the Green party, who will be standing down at the next election. 


SNP and trans rights 

SNP MP John Nicolson, who has been a firm and consistent ally, has warned that Scotland is facing an explosion of transphobia, with this imported from the US. Similarly, SNP MP Mhairi Black has called for the media and politicians to ‘leave [trans people] the hell alone’. She went on to name ‘the trans issue’ as a wedge issue, with campaigning being funded by far-right Christian groups in America since at least 2016. 


Electoral Commission hacked 

The Electoral Commission has admitted that their systems have been victim to a series of cyberattacks, beginning in August 2021, with unknown ‘hostile actors’ gaining access to personal information such as names, addresses, email addresses, and more. The Electoral Commission, following guidelines from the Information Commissioner’s Office (ICO), have advised that this attack does not in and of itself present high risk to individuals. However, it remains to be seen who accessed this information, and for what purpose.


Gender Recognition Reform (Scotland) Bill vs Section 35 

The court case regarding the Westminster Government’s use of Section 35 of the Scotland Act to block the Gender Recognition Reform (Scotland) Bill from going to Royal Assent is due to take place next month. It has now been announced who will be intervening from the LGBTQ+ sector to share our expertise on the matter. Stonewall, as the largest LGBTQ+ charity in Europe, and Gendered Intelligence as a trans-led charity will be leading the interventions, alongside the Institute for Constitutional and Democratic Research (ICDR). They will also be complemented by a number of legal experts, including Robin Moira White, the foremost trans lawyer in the UK. The case is due to begin on 19 September 2023. 



Minister for Women and Equalities, Kemi Badenoch, has announced that she is launching a ‘crackdown’ on gender neutral toilets, with all new buildings being required to have separate male and female toilets. This is despite the consultation responses from the Government’s 2021 consultation on the matter finding that 83% of respondents were in favour of gender neutral toilets, 12% in favour of single-sex toilets, 6% in favour of gender neutral and single-sex options. Furthermore, trans and non-binary people had the highest safety concerns as 79%, followed by women at 75%. 

Labour’s shadow minister Anneliese Dodds has criticised Badenoch’s priorities in this regard. In particular, Dodds highlighted the failure to bring forth the schools’ trans inclusion guidance and a ban on conversion practices. Labour MP Kate Jarrow has also criticised the Government, telling PinkNews “At a time when millions are living in poverty unable to afford bills or food, NHS waiting lists are growing and businesses are collapsing, this government is focused on stoking a culture war, whipping up hate and discriminating against trans and non-binary people”. 


Lib Dems are battling period poverty 

At their annual conference this autumn, the Liberal Democrats will be discussing an item on providing free menstrual products in England as part of a policy called Ending Period Poverty. It has been explicitly stated that this will include trans and non-binary people, with Lib Dem leader Ed Davey stating that ‘menstruation is not just a women’s issue.’ 



Parliament has been on their Summer recess, and will sit again on Monday 4 September.

Hate Crime

On Sunday 13 August, two gay men were stabbed outside of the Two Brewers, a gay bar in Clapham, London. The attack is understood to be a homophobic hate crime. Thankfully, both men survived with relatively minor injuries. The staff at the venue have been praised for their swift, calm action ensuring the men were treated by an ambulance and the incident reported to the police. Police have released images of a man they would like to speak to in connection to the attack – no arrests have been made at this time. Since the reporting of the incident in the press, another man has come forward claiming that he was attacked outside the venue a week prior, leaving him with a black eye and bloodied nose. 

Two men were targeted in a violent homophobic attack in Brixton on Saturday 19 August. While waiting at a bus stop after celebrating Black Pride, an unknown man approached them and punched each of them a number of times, with one of the men requiring stitches on his lip. The police are treating the attack as a homophobic hate crime. The attack comes less than a week after the stabbing of two men outside the gay bar Two Brewers in Clapham, also in south London. The police do not think the two attacks are linked. 

Drag Race star Pixie Polite, while waiting at a bus stop in Kennington, was approached by a man who verbally abused her and threatened to stab her with the whiskey bottle in his hand. 

In Scotland, bisexual co-leader of the Scottish Green Party Patrick Harvie was called a ‘deviant’ during a live TV interview. Harvie responded by calling them a ‘bigot’ and continued the interview: “There are some pretty toxic forces in politics at the moment that have unleashed homophobia and transphobia in a way that we haven’t seen in many, many years. Those who have cultivated this nasty kind of culture war against minorities need to take responsibility for verbal abuse like that, but also for violence that we’ve seen rising against LGBT+ people.” 

Despite the summer break from Drag Queen Story Hour events at the south London pub Honor Oak, far-right protesters have continued to target the venue. However, at their last protest, they were vastly outnumbered by local counter-protesters, largely from anti-racist, pro-LGBTQ+ groups, activists, and individuals. 

An anti-drag protester who stormed a Drag Queen Story Hour at the Tate Britain has been found guilty of a public order offence. His language included the deeply homophobic and transphobic rhetorics around paedophilia we are seeing a rise in. The judge stated that his language went beyond freedom of speech and was hate speech.


The Independent Press Standards Agency (IPSO) have published their revised guidance for journalists for reporting on sex and gender. PinkNews has provided a succinct summary of the changes.


Sarah Jane Baker, who made a speech at London Trans Pride with the phrase ‘if you see a terf, punch them in the f***ing face,’ has been recalled to prison. She had been released on licence after serving around thirty years of a life sentence in a male unit. The police initially ruled that there had been no crime in the comment Baker made, and her parole officer issued her a warning. However, Home Secretary Suella Braverman did not agree and called on police to arrest Baker. Baker’s partner and other activists argue that Baker is a political prisoner. Baker is being held in a male facility, and is currently on a hunger and liquid strike until she is moved to a female unit. A trial on 31 August found Baker not guilty of incitement to violence, but she will continue to be held in prison until a parole hearing, currently scheduled for March 2024.


British Rowing 

British Rowing have introduced a new gender policy, which comes into effect in September. The policy will introduce a ‘women’s category’ exclusively for ‘people who are assigned female at birth,’ and an ‘open category’, in which trans and non-binary people can compete. The policy references their anti-doping policy in regard to use of HRT. Interestingly, the women’s category doesn’t explicitly state that competitors must be women, just that they must be assigned female at birth. 


Badminton England 

Badminton England has issued a new policy that will ban trans and non-binary people from sanctioned and unsanctioned female tournaments. The men’s category will now be an open category, accepting all individuals who were not assigned female at birth, and presumably also people assigned female at birth who are not women (essentially a category for cis women, and a category for everyone else).



The International Chess Federation (FIDE) has stated that trans women cannot compete in the women’s category, but can compete in the open category. The policy also states that individuals who win titles in women’s competitions but then transition to men will be stripped of those titles, but those titles would be reinstated if they detransitioned again; individuals who win men’s titles and then transition to women will not lose their titles. 

Thankfully, the English Chess Federation (ECF) have stated that they will not adopt this policy, and a number of other countries’ federations are taking the same position. 

Chess has historically been divided into gendered categories for much the same reasons as other sports: women often have much less access to resources to excel in the sport than men, which research shows is the biggest factor affecting any gendered differences in skill. To imply, however, that there is an inherent gendered difference in an individual’s ability at chess is nothing more than bioessentialist sexism (i.e., sexism based on the idea that men and women (the only sexes recognised by this ideology) are fundamentally different due to their biology).

The Culture War

The Equality Act 

Lawyer Robin Moira White has shared on Twitter a screenshot from the civil service’s internal job postings, which states that, at the request of the Minister for Women and Equalities, a role is being hired to research how legislative changes could be made to the Equality Act. They intend to complete this project by July 2024. While this is concerning, it is still unlikely that any changes would be possible before the next General Election. 


Anti-trans organising 

While from 2017, an article from the Southern Poverty Law Centre was reshared on social media this week that, for some, might clarify a huge amount of how this moral panic happened. The article covers discussions that took place at a far-right conference in regards to fighting pro-trans policies in schools and beyond. They identified their key strategies as: 

  • Presenting their rhetoric as progressive, and depicting trans rights as anti-feminist, hostile to minorities, and disrespectful to LGB people; 
  • Creating a divide between LGB and trans people; 
  • Never attack trans people or their families on a personal level, so that trans people can be painted as the bullies, not the victims; 
  • Focusing on arguments around ‘biology and reason’ rather than religion, peddling debunked pseudo-scientific arguments instead. 

Reading this in the light of 2023 was rather sobering. Unfortunately, as we can see, these strategies have largely been very effective.

Calls and Consultations

NHS England have released their puberty suppression policy for public consultation; the policy being that outside of the research protocol into ‘early onset gender dysphoria’ (a term that isn’t currently used in clinical settings, and the NHS is yet to define), children and young people will not be routinely prescribed this treatment. The policy leaves a clause for exceptional circumstances. The consultation is open until 1 November. This blog reviews the relevant research on this form of treatment. 

A new call for input has been published by the UN. The Special Rapporteur on freedom of religion or belief is collecting inputs for a report on Advocacy of Hatred Based on Religion or Belief. The Independent Expert for Sexual Orientation and Gender Identity has reshared the call on twitter, asking advocates in the LGBTQ+ sector to consider submitting. The deadline is 29 October 2023.


A new book has been published, Gender Confirmation Surgery: A Guide for Trans and Non-Binary People. It does what it says on the tin, and may be a very helpful resource for members of our communities.

Data and Research

YouGov Polling 

YouGov has released polling data on how LGBTQ+ people think Brits feel about our communities. They found that gay and lesbian people felt more assured that Brits think favourably of them than bisexual and trans people. Unfortunately, the general public has a less favourable attitude towards trans people than 2021 polling suggested. However, the polling also reaffirmed that cis lesbians are the strongest supporting community of trans people. 


Top Surgery Regret is Low 

In a study of 139 individuals who had undergone gender affirming mastectomies at a US clinic, none of them regretted the procedure, and of those eligible for the study who did not respond, none were registered as having had reversal surgeries. Those eligible for the study had undergone surgery any time between two and 23 years prior to the study. This reaffirms previous findings of consistently low levels of regret for this form of care. 


LGBTQ+ Retirement 

Scottish Widows have found that LGBTQ+ people are at high risk of poverty and financial hardship following retirement, with 44% of LGBTQ+ people on track to be unable to cover their basic needs following retirement. 


Parent Support for Trans Teens 

This study identifies key challenges that parents face when their adolescent children come out as trans: in clearly identifying these challenges in this way, we can consider how our approaches to support interact with these challenges. 


Mental Health Impacts of England’s GIC Waiting Times 

This study looks at the impact of the current gender-affirming care pathways in adult health in England on trans people. This will provide extremely useful, solid, citable data as we challenge the inaccessibility of care. 


Trans People and Sport 

This study is a discourse analysis of petitions against trans women competing in women’s sports: the useful outcome is the clear identification of these petitions leaning heavily on biomedical science to reify bioessentialism, while ignoring the sociocultural factors that are understood to have a far bigger impact on gendered differences in sport. These two articles explore trans bans in sports: how these are a human rights issue, and consideration of what factors lead to trans athletes dropping out of sporting spaces. 


How Did Our Assessment Criteria Come About? 

This study explores assessment criteria for accessing gender affirming care from the 1970s to 1990s. This may be helpful in contextualising the history of how our healthcare has been provided, and therefore why it looks like it currently does. 


Safeguarding LGBTQ+ Lives in an Epoch of Abandonment 

This academic comment piece considers the current shift in attitudes towards LGBTQ+ people, and how we can look after our communities as a result, including policy recommendations in the face of this rising queerphobia. 


Confronting Disinformation 

Disinformation is one of the many key barriers our communities face currently, as it is actively spread far and wide. This article outlines common scientific disinformation seen around gender affirming care, and how to combat this; while this article aims to debunk disinformation that is vital for paediatric surgeons to be knowledgeable on. 


Contraceptives for Trans Mascs 

This article explores the use of contraceptives in trans people with the ability to get pregnant, and notes that there is a relatively low uptake. Their recommendation is that family planning is discussed more thoroughly with individuals, and that further research is undertaken to consider what barriers there may be to accessing contraceptive care. 


The Intersex/Trans Crossover 

This article finds a low but clinically relevant prevalence of intersex individuals and individuals with Differences of Sexual Development (DSDs) among trans populations, with the recommendation that care must be individualised. 


Improving healthcare 

This article argues that poor treatment of trans individuals in healthcare settings is not always a result of societal stigma per se, but is more commonly a result of healthcare workers’ knowledge and attitudes towards trans people. Meanwhile, this article discusses how we can improve LGBTQ+ youth healthcare more broadly. 



This ‘tales from the clinic’ article discusses the phenomenon of the ‘tranopause’ using case studies. Specifically, they argue for developing more holistic care routes for trans people on hormone therapies. 


Gender-Affirming Pharmacists 

This article argues for the key role pharmacists can play in trans people’s care, and the need for better training to enable this to be the case. 


Screening for Intimate Partner Violence 

This article explores a pilot programme screening trans individuals for potential signs of intimate partner violence, and how this can be integrated into healthcare settings. 


All-Gender Toilets Reduce Transphobia? 

This article finds that all-gender facility signage in workplaces can play a role in improving adults’ attitudes towards trans people. This is a particularly interesting outcome given the Government’s current proposals to remove gender neutral facilities. 

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