XVI Harry Benjamin International Gender Dysphoria Association Symposium
17 - 21 August 1999, London

Reflections on "Transsexualism and Sex Reassignment" 1969 -1999

Professionals Attitudes to Gender Dysphoria—Results from a Scottish Survey

Carr, Susan, Consultant in Family Planning & Sexual Health, Centre for Family Planning & Sexual Health, Glasgow

• Methods
• Results
• Discussion

A needs assessment was carried out in order to describe the service requirements for transsexualism in Scotland. As part of this exercise, comments were invited from the survey respondents. Their replies showed an interesting diversity of attitudes to gender dysphoria and its provision of care.

METHODS: Short questionnaires were sent to all psychiatrists, general practitioners, speech therapists, consultant psychologists, family planning services and directors of public health in Scotland. They contained questions on number of transsexuals seen, new presentations in the last 12 months and whether or not there should be a Scottish Centre for gender dysphoria. General comments were also invited. The qualitative part of the survey is reported.

RESULTS: The overall response rate was high (84%). About 26% added written responses. The majority commented on the need for more locally accessible centres, and a lack of expertise in dealing with gender dysphoria patients. A substantial minority, however said that services for transsexuals were either a low or zero priority for the National Health Service. There were also comments on the validity of gender dysphoria such as "this is an iatrogenic disorder encouraged by voyeuristic therapists".

DISCUSSION: Although few, the negative comments from highly trained professionals were disturbing. Judgmental and moralistic attitudes are unethical and can interfere with appropriate clinical care. In a National Health Service professionals are the ‘gatekeepers’ to tertiary care and their attitudes have a profound effect on the life of the patient. This survey demonstrates a need for further education and debate amongst key professionals in order to streamline pathways of care for the transsexual within the community.