National Health Service England has acted unlawfully by making thousands of gender dysphoria patients wait “extreme” periods of time for treatment, the high court has heard.
The transgender plaintiffs, who have suffered distress as a result of the delays, want the court to find that NHSE broke the law by failing to meet the target of 92% of patients starting treatment within 18 weeks.
Figures from the NHSE show that there are 26,234 adults waiting for a first appointment at an adult gender dysphoria clinic, of whom 23,561 have been waiting for more than 18 weeks. The number of children on the waiting list is approximately 7,600, of whom some 6,100 have been waiting for more than 18 weeks.
In a witness statement, one of the claimants, Eva Echo, said she received a referral in October 2017 but had not yet been given a first date, leaving her in “indefinite and painful limbo.” A co-plaintiff, Alexander Harvey, who has been waiting for a first date since 2019, said the delay “means I have to continue to live in a body that I don’t feel is mine and doesn’t reflect who I am.” ”. He said that he had attempted suicide twice.
The wait was also having a negative effect on the mental health of two co-plaintiff boys, ages 12 and 14, whose names could not be identified, the court heard.
In written submissions for Tuesday’s hearing, David Lock KC, representing the plaintiffs, said the delays in puberty block treatment (the current wait time for children to access services is more than two years) could cause adolescents “intense anxiety and distress” as a result of experiencing “permanent and irreversible bodily changes.”
The statement requested by the plaintiffs, who also include the Gendered Intelligence charity and campaign group the Good Law Project, would apply to the NHSE’s performance across all commissioned health services. Through August, only 60.8% of patients across all services received appointments within 18 weeks.
Lock said: “A declaration would have the important effect of flagging and acknowledging continuing unlawful conduct in respect of the provision and delivery of public health services by England’s NHS and ensuring that future budget allocations are sufficient to fund the services to meet NHS England legal requirements. homework.”
Describing the waiting times as “extreme”, Lock told the court that the NHSE had also breached the public sector’s duty of equality and that the four individual claimants were unlawfully discriminated against because they waited much longer than patients seeking other treatment of Health.
While the NHSE accepts that it has not achieved the 92% target in the patient cohort for which its health services are commissioned, it asserts that a breach does not give rise to enforceable individual rights.
Its defense attorney, Eleanor Gray KC, said in written arguments that the regulations created “obligations that necessarily shape the design of their commissioning arrangements, but are not absolute obligations to achieve a specific result that would result in immediate non-compliance if not are achieved, nor demanded. … [by] …individuals”.
Gray said the NHSE had increased funding for dysphoria and gender identity services, but the main constraint was staff shortages.
Given the steps already being taken, he said a declaration of illegality would be “useless” and could be damaging by prompting the health secretary to abolish the 18-week target.
Gray said the NHSE denied discrimination because the delays were not the result of the protected characteristic of seeking gender reassignment, but due to “rapidly increasing demand and limited specialist services”.
The hearing is expected to conclude on Wednesday.
