For clarification wrt what surgeons doing gender-affirming surgeries do in general - there are only a handful of surgeons with NHS contracts to do gender-affirming surgery, and a few more who only see private patients. Trans people are such a small group of people that most surgeries done by these surgeons are utterly mainstream surgeries on cis people - eg, surgeons doing top surgery will also do breast reconstruction for breast cancer patients for example, or surgeons doing facial feminisation surgery will do general maxillofacial surgery as part of an ENT department. It's not a situation where these are specialised Gender Surgeons™️ making a fortune from Trans Surgeries™️ - it's just normal surgery by regular surgeons.
I just... really struggle with how quickly this is all happening. It's like there were transphobes in key positions just waiting for the political weather to give them an opening. It's hard to credit just how compromised the NHS is in this regard. I'd always thought that the NHS was, for the most part, evidence-based and largely immune to ideological restrictions on medical care. That trust is waning rapidly, and I fear the lack of it is going to cause a great deal of harm.
I'm not sure how much Westminster MPs from outside of Wales can do about this, but this is such a frightening situation wrt how little is needed to now impact adult trans healthcare that I definitely intend to contact my (LD) MP about it.
I just... really struggle with how quickly this is all happening. It's like there were transphobes in key positions just waiting for the political weather to give them an opening. It's hard to credit just how compromised the NHS is in this regard. I'd always thought that the NHS was, for the most part, evidence-based and largely immune to ideological restrictions on medical care. That trust is waning rapidly, and I fear the lack of it is going to cause a great deal of harm.
Yes, I'm sure there were people in Weimar Germany who couldn't believe what was happening too. But once you've noticed... how do you fight it?
My trust in the NHS is at rock bottom following my experiences as the parent of an autistic person with CFS and multiple mental health issues. I am not at all surprised that someone seized on the excuse to cancel these operations. Depressed, but not surprised.
I remember being shocked by the way Hilary Cass's dangerous anti-trans briefing was embraced in Scotland- despite it being an obviously bad ideologically-motivated NHS England project that there was no medical reason for us to follow. She was never an expert in this field and should have been ignored.
People like Patrick Harvie MSP who correctly spoke out against her harmful and ignorant intervention were attacked and NHS Scotland began to implement her nonsense which was then further forced on us by UK legislation which we never consented to. The then First Minister Humza Yousaf shamefully abandoned the Scottish Greens when it came to this. There were surgical referral pauses here too but for under 25s because of her.
The culprit behind the Scottish report on Cass seems to have been one of the Deputy Chief Medical Officers who is a geriatrician with no expertise that I can see in gender affirming treatment. These people advise the Scottish government
I realised a while back when I wanted to complain about NHS Lothian using poor practice on an issue that affected me that it seemed to be opaque how you could get policy changed and challenged and not very accountable.
When you're relatively privileged you just see the NHS working, until suddenly it doesn't and then you realise that there may be cosmetic avenues of complaint but it's not clear how you can really get things to change.
I'm not clear, for example, how much power health secretaries in devolved nations actually have? Can they just tell these NHS boards to come off it? Can they replace or bypass Chief Medical Officers who are biased or out of their depth on a subject? Do parliaments need to legislate to stop NHS boards joining in on attacks on marginalised people? Is there legal recourse when they behave in bigoted discriminatory ways?
Fat chance of our bigoted media who think there's clicks in joining in this persecution informing people how to take action or campaign against this.
But it should be a wake-up call to all of us that the NHS is vulnerable at high levels to the hate being spread - there's a reason we talk about and historians study Nazi Doctors. Being intelligent and scientifically educated doesn't mean that people cant or won't embrace bigoted eugenicist or misogynist or racist or transphobic views. Wrap it in pseudoscience and make it sound 'sciency' and a lot of people will seize that figleaf for bigoted views and not question it too closely. Cass legitimised this in the UK and the devolved nations are turning out to have inadequate defenses against it.
Brexit makes it harder for people to escape but we should all be thinking about how we help trans people get access to modern medicine. Perhaps we need a trans equivalent of Women on Waves so people can access treatment from our benighted shores
But in the meantime I guess we're going to have learn more about how we push back when the NHS is no longer our friend but a danger.
(What an appalling thing to feel I have to say... and under a Labour UK government who could have stopped and reversed this but instead enthusiastically embraced it)
Update: looks like Plaid are going to do nothing but wring their hands a bit over the Joint Commissioning Committee's cruelty and ignorance with which they’re harming Welsh trans people.
A Welsh speaking historian I follow on Bluesky was saying that the S4C Welsh language news wasnt doing the transphobia but that
The really odd thing is that BBC Cymru / Wales produces the S4C Welsh news. So this is the same set of resources being used to gather stories, but a hefty dollop of transphobic editorialising has to be mixed into the English content before distribution
It's a sad commentary.
Plaid Cymru backbenchers have written a letter protesting and asking for this to be reversed but their Health Secretary seems to be doing nothing.
Cwiar Cymru on Bluesky have been a good source on it
We have that in Scotland too - right wingers who hate both Scots and Gaelic. There used to be a form of unionism which was dual nationalism- Scottish and British and very proud of both, but it's much less common nowadays, and there's a nasty and increasing overlap between unionism and the far right - as can be seen with the Scottish Labour party and their adoption of the agenda of persecuting trans people and anti-migration stances and the rise of Reform.
I think anything that differs from an elitist norm - run from the centre of the 'Empire' by white straight English-speaking privileged men (or the similar women who uphold their power) rouses the authoritarians - who want conformity and obeisance to that 'norm' and supremacy for those who embody it. Trans people are the group most in danger from them, but they've such a broad spectrum of hate nowadays that if you don't belong to this particular elite, then you're one of their targets.
Comments
Yes, I'm sure there were people in Weimar Germany who couldn't believe what was happening too. But once you've noticed... how do you fight it?
My trust in the NHS is at rock bottom following my experiences as the parent of an autistic person with CFS and multiple mental health issues. I am not at all surprised that someone seized on the excuse to cancel these operations. Depressed, but not surprised.
People like Patrick Harvie MSP who correctly spoke out against her harmful and ignorant intervention were attacked and NHS Scotland began to implement her nonsense which was then further forced on us by UK legislation which we never consented to. The then First Minister Humza Yousaf shamefully abandoned the Scottish Greens when it came to this. There were surgical referral pauses here too but for under 25s because of her.
https://transsafety.network/posts/chalmers-gic-pauses-gender-surgery-referrals-under-25s-cass-review/
The culprit behind the Scottish report on Cass seems to have been one of the Deputy Chief Medical Officers who is a geriatrician with no expertise that I can see in gender affirming treatment. These people advise the Scottish government
I realised a while back when I wanted to complain about NHS Lothian using poor practice on an issue that affected me that it seemed to be opaque how you could get policy changed and challenged and not very accountable.
When you're relatively privileged you just see the NHS working, until suddenly it doesn't and then you realise that there may be cosmetic avenues of complaint but it's not clear how you can really get things to change.
I'm not clear, for example, how much power health secretaries in devolved nations actually have? Can they just tell these NHS boards to come off it? Can they replace or bypass Chief Medical Officers who are biased or out of their depth on a subject? Do parliaments need to legislate to stop NHS boards joining in on attacks on marginalised people? Is there legal recourse when they behave in bigoted discriminatory ways?
Fat chance of our bigoted media who think there's clicks in joining in this persecution informing people how to take action or campaign against this.
But it should be a wake-up call to all of us that the NHS is vulnerable at high levels to the hate being spread - there's a reason we talk about and historians study Nazi Doctors. Being intelligent and scientifically educated doesn't mean that people cant or won't embrace bigoted eugenicist or misogynist or racist or transphobic views. Wrap it in pseudoscience and make it sound 'sciency' and a lot of people will seize that figleaf for bigoted views and not question it too closely. Cass legitimised this in the UK and the devolved nations are turning out to have inadequate defenses against it.
Brexit makes it harder for people to escape but we should all be thinking about how we help trans people get access to modern medicine. Perhaps we need a trans equivalent of Women on Waves so people can access treatment from our benighted shores
https://en.wikipedia.org/wiki/Women_on_Waves
But in the meantime I guess we're going to have learn more about how we push back when the NHS is no longer our friend but a danger.
(What an appalling thing to feel I have to say... and under a Labour UK government who could have stopped and reversed this but instead enthusiastically embraced it)
Incredibly depressing.
And now even Amnesty back away from calling out transphobia when Queen Lawfare jangles her sack of gold.
https://owenexiehurcum.com/2026/08/30/dim-bradwyr-yma-the-first-test-of-plaid-cymrus-trans-equality-manifesto/
Plaid have a trans affirming manifesto and now it will be put to the test
It's a sad commentary.
Plaid Cymru backbenchers have written a letter protesting and asking for this to be reversed but their Health Secretary seems to be doing nothing.
Cwiar Cymru on Bluesky have been a good source on it
https://bsky.app/profile/cwiar.org
English supremacism is a hell of a drug.
I think anything that differs from an elitist norm - run from the centre of the 'Empire' by white straight English-speaking privileged men (or the similar women who uphold their power) rouses the authoritarians - who want conformity and obeisance to that 'norm' and supremacy for those who embody it. Trans people are the group most in danger from them, but they've such a broad spectrum of hate nowadays that if you don't belong to this particular elite, then you're one of their targets.