I want to talk about trans healthcare in England, and how it's particularly fucked if you're disabled. I think TERFS and their "think of the poor disabled girls" retorique around trans men have a lot to do with this. My ongoing top surgery saga is a pretty good example of what it's like being a disabled person seeking surgery.
My first top surgery was cancelled 4 days before it was due to happen in 2017. It was cancelled purely because I use a wheelchair. They were totally fine with me using crutches and having conditions that actually impact surgery, but using a wheelchair for a different condition was a step too far. My specialists (experts in my condition) didn't see a medical problem with me having top surgery, but my GIC doctor, (who saw the word wheelchair and googled my new condition for all of ten minutes) panicked.
I fought that clinic for three years. It got silly. Here are some real things a qualified GIC doctor told me:
"maybe you're not trans, and you're just sad you can't walk" (I became totally unable to walk age 18, and transitioned when I was 15... I'll let you do the maths)
The Daily Mail will write mean things about us they find out we let you, a poor disabled little girl trans man, have surgery (because apparently right wing newspapers are the definitive authority on trans healthcare /s)
Although my diagnosed mental health problems weren't an issue for them before I started using a wheelchair, simply being a wheelchair user and wanting top surgery was a symptom of a mental health problem so severe it alone disqualified me from surgery. This was because:
being okay with the truly microscopic chance surgery would make my disability worse is apparently "irrational", and shows a disregard for personal safety (it doesn't)
I, a person with experience of both, said that for me crushing dysphoria is a worse experience than getting round in a chair with wheels on it. And having different priorities than the ones my cis, abled doctor expected was somehow "alexithymia" because if I don't know that using a wheelchair is the worst thing that can happen short of dying, I must be totally unable to recognise my emotions (clearly bullshit).
You, a twenty one year old adult, need to bring your parents to your appointments so we can explain to them how unreasonable you're being. (Suspiciously close to TERF arguments about the age of capacity)
In the end I caused a massive schism in my GIC. The psychologists agreed that wanting top surgery while being disabled isn't a mental illness, that I had clear capacity to consent, understood the risks and benefits and that ultimately if I said I needed surgery, I should have it. The medical doctors (the ones that sign the referral) disagreed on every point. It got heated between them towards the end.
The head psychologist realised I was never going to get surgery if I stayed with that GIC, and that would obviously fuck up my mental health, so she wrote a letter to literally every GIC in England asking if they'd take me as a patient. Only one (out of like 7) agreed to take my case.
So I'm now with a new GIC. They're so far way better than the last one, but the bar is low. They re-referred me for surgery pretty much straight away, trusting that I obviously had a better insight into how my disability and my transness affect me than anyone else.
Unfortunately the surgeon they referred me to turned me down (for genuine reasons this time). Basically in the time wasted arguing with my GIC I developed a few new conditions that will actually have an impact on surgery and we've agreed that when I have surgery there has to be an intensive care bed available just in case. (To be clear, this was not the case when my first surgery was cancelled or for the majority of the fight with my previous GIC). Now I'm being referred (referral number three) to one of only two hospitals in the country that do top surgery have access to an intensive care bed
So despite having a date for my top surgery in 2017, I'm still waiting on it because doctors are transphobic, misogynistic and ableist with awful consequences.
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