Pathway to care achieved

Trans* Jersey met with Helen O’Shea, Managing Director of the General Hospital, and Richard Jouault, Managing Director of Community and Social Services, today. As a result, we have now had the pathway to care for trans* islanders confirmed, and it is as shown.

Trans* Jersey will be working on getting this into a form that can be distributed to all GPs’ surgeries so that, as the first point of contact for trans* people, doctors know who to refer to and can advise their patients on the pathway to care.

This is the first of our 2014 manifesto goals to be realised. We are, therefore, grateful to the States of Jersey’s health service professionals for their openness and time to assist us, and to those trans islanders who shared their experiences of the health service in Jersey and the UK.


Pathway to care – we think…

The infographic below is a first attempt to map the pathway to care for transgender/transsexual Jersey residents seeking to transition. It is based on personal testimonies of islanders who have transitioned and, due to the confusing nature of the system at present, may not match your experience. Please email us if you think you can contribute to our findings.

Apart from cost, the main difference between the public and private routes to care is choice of practitioner and speed. There are set procedures that the public system have to follow when treating trans* patients that include statutory waiting times where the patient must live as their preferred gender before being permitted hormone therapy and/or surgery. These waiting times, largely, fall away when going the private route.

Trans* Jersey is working to clarify the pathway below with the States of Jersey Health and Social Services Department. The question of funding is particularly unclear.


Medical treatment of trans* people

Because there are no specialist gender healthcare professionals in Jersey, all trans* islanders have to go abroad for treatment. Most will, at least initially, go to the UK. Therefore, any issues that trans* organisations have with the UK healthcare system are shared by Jersey trans* individuals.

In addition to producing a report on the health of trans* individuals, GIRES also identifies three main areas of concern:

Multiple referral for treatment 

Current treatment protocols often require two referrals before cross sex hormones, or chest reconstruction, or genital surgery, etc are authorised. This causes delays. No other medical treatment requires two referrals so why are trans people singled out for a “special” treatment protocol.

Man and psychiatristRefusal to treat

If a trans person has been treated for gender dysphoria in the private system or overseas, that person’s treatment on the NHS may be delayed. No other such patient is refused treatment on the NHS for any other condition.

Health providers must be challenged to provide the equality analysis that justifies treating trans people in a different manner from other service users.

Delays in receiving treatment for young people

A young trans person can benefit hugely from an early medical intervention to ensure that the damage done, both physically and psychologically, from an inappropriate puberty can be minimised, where there is a clear clinical need established.

Delaying treatment for young people can have a disproportionate impact. A delay of (for example) three years in treating a 30 year old gender dysphoric person will not significantly change the physical outcome on the transition as the individual will have already developed adult sexual characteristics. However, for the 11 year old, the situation is completely different. However, both patients will suffer psychological stress due to the delay.

Again, Health providers must be challenged to provide the equality analysis that justifies treating trans people in a different manner from other service users.

As we have stated elsewhere, it should be noted that Jersey trans* people can avoid some or all of the above problems if they have the resources to navigate the system privately or semi-privately. In which case, they may not find the above to be an issue in their transition.