In the UK treatment for gender dysphoria is available on the National Health Service (NHS), and the Gender Identity Clinic located next to Charing Cross Hospital, London, has been diagnosing and treating people for over four decades. Its leading clinician, until his recent retirement, was Professor Richard Green. Gender Re-assignment Surgery (GRS) takes place at Charing Cross and a number of regional NHS Trusts. Some trans people used to complain that NHS protocols and waiting times were unbearably slow, but one hears this less and less. In the past, however, it often led those who could afford it to turn to private medicine.
The main UK private practice, also based in London, used to belong to Dr Russell Reid, who has treated many trans people, myself included. Highly respected in the trans community as a compassionate, skilled practitioner, he has just emerged from a protracted set of hearings before the British Medical Association, accused of flouting the Harry Benjamin International Guidelines. Dr Reid routinely prescribed hormones to patients as a diagnostic test, arguing that those who are not trans would be unhappy with the changes; and there was criticism of his practice in a few cases, though he was not struck off. He is retired now and Richard Curtis, a trans man and former GP, has taken over his practice.
The NHS GRS surgeons also have private practices, but many trans women go abroad for surgeries, Thailand being a popular destination.
It’s only eight years since the Sex Discrimination Act was amended to protect transsexual people who are ‘intending to undergo, undergoing, or have undergone’ gender re-assignment. Prior to that people who transitioned often lost their jobs (as well as partners, family and friends), so this change has been important for the economic stability of trans people, and has enabled employers and colleagues to appreciate that we are not a threat in the workplace.
This legal support was a great help to me when I transitioned while working as a healthcare chaplain, in the summer of 2001, as the hospital personnel department was familiar with the law and its implications. Unfortunately, the Church of England, as my sponsor, seemed to lag behind, perhaps because it has a habit of trying to negotiate exemptions to equality legislation (despite being the national church ‘by law established’).
The Gender Recognition Act 2004 has been the most significant piece of legislation for trans people in the UK, allowing us to change our birth certificates and to marry in our ‘acquired gender’ (to use the quaint phrase used in the Act itself). Prior to that trans people could change their name and gender on passports, bank accounts and other personal documents, but transition was never quite complete. Now it can be, and the Act also protects the privacy of trans people; though here again, the Church of England, along with other faith groups, has managed to obtain certain concessions, for the time being, at least.
Society and Theology
The legal changes that continue to improve trans people’s lives in the UK owe much to the work of dedicated campaigners, particularly Stephen Whittle, Christine Burns and Claire McNab of the trans campaigning organisation Press For Change. These changes also reflect increasingly sympathetic attitudes to trans people, often promoted by the media, whether through ‘scientific’ documentaries, soap opera storylines, or interviews.
So far churches in the UK have been cautious about these developments, at any rate, in their official statements. The Evangelical Alliance (EA) was the first to comment in its report Transsexuality, published in 2000 (possibly in response to the amendment to the Sex Discrimination Act in 1999). Entirely opposed to transition on the simplistic, and, supposedly, biblical ground, that male and female are immutable, God-given categories, its conservatism was in keeping with the EA’s earlier reports on homosexuality.
The long-standing focus on sexuality in the Church of England and in the Anglican Communion is also the background to Some issues in human sexuality: A guide to the debate (2003). The work of four Church of England bishops, this document attempts to address the inclusion of LGBT people in the Church and has a chapter on Transsexualism. My own contribution to ‘the debate’ was to write an article for the English journal Theology (September/October 2005, Vol. CVIII, No 845) critiquing this chapter, especially its omissions.
I have occasionally heard trans people say that we should avoid being mixed up in the sexuality debate in the church; that our ‘issue’ is one of gender, not sexuality; and that the Church seems more ready to accept us than it does lesbians and gays. I can’t go along with that, for while sexuality and gender can be distinguished, they are often linked inextricably; nor would I want to belong to a church that included trans people while rejecting other minorities. Perhaps this has personal roots in that I identified publicly as gay (in 1989) before I accepted myself as a trans person.
Whatever the reason, in 2005 I was pleased to be invited to serve as the trans spokesperson and trustee for Changing Attitude, the Anglican campaigning organisation which has recently broadened its mission from lesbian/gay to LGBT inclusion. Likewise, this summer, it was an honour – especially given the suspicions of trans women in certain lesbian circles – to be elected the female co-convenor of the Anglican LGBT Clergy Consultation. Since taking up these roles I have met with Canon Phil Groves of the Anglican Communion Office, a sign that the listening process in the Church of England is being extended to its trans members.
The social revolution in which we have been living in the UK during the past few decades has affected the medical treatment and legal status of transsexual people as well as theological reflection about gender and sexuality. There has been a shift from paternalism to participation, from exclusion to inclusion. In many ways it has been the best of times for trans people, even though, in Christian circles, it has sometimes seemed the worst of times, mainly because the Church is often so reluctant to accept what God is doing in the wider world.
The Rev'd Dr Christina Beardsley