TransActualCIC
@TransActualCIC
Followers
2K
Following
498
Media
51
Statuses
738
Advocating, informing and empowering. By trans people, for trans people. Press: [email protected] Social media policy: https://t.co/HKqhbTzaeh
United Kingdom
Joined March 2024
We're hearing increasing reports of GPs refusing to prescribe HRT for trans people, even when they have a letter from an NHS gender clinic. If this happens to you or has happened to you in the past year let us know: #Trans #Transgender #Nonbinary
1
305
556
We're in the Royal Court of Justice today challenging the ban on private prescriptions of puberty blockers. We have permission to live tweet, and will capture what we can. Follow this thread for live updates throughout the day.
24
401
3K
We’ve seen some tweets referring to Chay, our Director of Operations and we’d like to offer a response. 1. Chay spent 20 minutes talking to LGB Alliance at the event they referred to. He was polite as he always is. He was neither trembling nor on the verge of tears.
2
144
971
The case on the blocker ban has been heard. The judge appears to have understood the seriousness of the case & we trust that she will be careful in coming to her judgement. We now await a ruling which, we hope, will be handed down before the end of July.
0
231
860
We’re in court tomorrow. Please do support. We’ll be live tweeting on the day, so do follow us for updates.
We’ll be in court in two days to stop the Tories’ ban on puberty blockers. But we need your help 🏳️⚧️✊.
0
149
590
This man founded our organisation. He is responsible for its day to running. That Kate does not appear to be able to conceive of a trans man who is resilient and able to think for himself says a lot about what that she thinks about people with two X chromosomes.
1
28
588
The judge has now given her ruling in the legal challenge against the puberty blocker ban. She has ruled that the ex Secretary of State did not ban blockers unlawfully. We are taking advice about the next steps in challenging the ban.
1
129
522
The judgement leans heavily the widely discredited Cass review. Experts at the world-class Yale School of Medicine evaluated the Cass review and report that it ‘repeatedly misuses data and violates its own evidentiary standards by resting many conclusions on speculation’.
1
71
447
3. It was very telling when the person whose tweet this is, when speaking to Chay, referred to him as being “wheeled out” for media appearances. It’s very telling that she refers to him in her tweets as “fragile”.
1
14
436
2. TransActual sent a pre pre-action letter to the Secretary of State for Health and Social Care the day after she announced that she intended to bring in a ban. Good Law Project, who are valued partners in bringing this important legal case, became involved after that.
1
12
419
And we’re up and on our way to court for the puberty blocker hearing. We’ll be live tweeting so do follow along on this account for updates.
1
28
364
We've written, with 100+ others, to Wes Streeting to express our lack of confidence in the Cass Review and our concerns over the DHSC's implementation of it. Full letter at: . #Trans #TransHealth #Transgender #Nonbinary
0
139
425
Happy International Nonbinary People’s Day to our nonbinary siblings around the world. Nonbinary people have always existed and always will do.
0
113
366
We’re highly concerned at the continuing and increasing politicisation of trans young people’s healthcare, as evidenced by the publication by the DHSC late yesterday afternoon of a report dismissing claims that restricting treatment has led to an increase in suicides of trans yp.
1
82
294
We've been hearing an increasing number of reports of trans people's GPs refusing to prescribe their HRT to them - even if they have a letter from an NHS gender clinic. That's why we're created our new My GP is Refusing to Prescribe My HRT resource:
1
146
238
We've taken the next step to challenge the ban on puberty blockers. In partnership with @GoodLawProject TransActual and an anonymous trans young person have issued court proceedings and asked for an urgent hearing on the case. Donate to the cover costs:
1
77
233
We have brought this judicial review against what we believe is an unlawful use of Section 62(1) of the Medicines Act 1968, targeted at preventing new private prescriptions of puberty blockers, without consulting impacted groups.
1
10
195
The emergency ban will expire in September, and a consultation process is required to make any ban permanent. We will be strongly advocating for the voices of trans young people and their families to be listened to.
1
13
185
Housekeeping: The first thing which will happen is the determination of whether this case will be heard, followed by submissions from the respective legal teams. We are unlikely to receive a ruling today.
1
3
187
As we will argue, this has had further reaching consequences, with even those still legally accessing puberty blockers being denied them by GPs due to the chilling effect from this criminalisation of trans healthcare.
2
9
186
TransActual and our partners in the LGBTQ+ sector and beyond will continue working to advocate for the needs of trans people of all ages.
1
10
183
Trans young people, you are loved and you are special. What is happening to your healthcare in this country is appalling, and we will keep working until all trans people can access the healthcare they need when they need it.
1
21
177
If you’re trans, or you’re the parent or carer of a trans young person, talk to your MP and ask them to speak out against the ban.
0
23
176
TransActual is one of two claimants who have brought this judicial review, the other being an affected young person (referred to as claimant YY) and their ‘litigation friend’ (claimant ZZ).
1
8
167
This thread will be an account of what happens only, we will offer further commentary when it is appropriate.
1
4
164
JC: The Cass report recognised a proven benefit of puberty blockers. It was clear it was not recommending a complete ban on puberty blockers.
1
14
149
@boymoderology Please could you send a copy of this to info@transactual.org.uk so we can look into it?. Also, anyone who has their prescription refused, please help us document and track the issue by completing our form:
4
25
154
The announcement of an NHS review into healthcare for trans adults causes us great concern. We've 'seen how the Cass Review has been misrepresented & misused to severely restrict healthcare for trans young people, even though the review is deeply flawed.
1
48
142
Thanks for bearing with us as we and our partners in the LGBTQ+ sector have taken time to digest the content of the Cass Review's Final Report. In short: The Cass Review is bad science and should not be taken seriously by policymakers. Full statement:
1
70
131
JC: That is absolutely consistent. The Cass report did not find a danger to patients from Puberty Blockers (PBs), but that there was not enough evidence of their benefit.
5
5
136
JC: The evidence is simply not there to justify a ban. Cass advocated for the prescription of puberty blockers within a research protocol.
2
4
125
The Applicants (us, TA, as well as YY & ZZ), are represented by Mr Rob Harland (RH), and Mr Jason Coppell (JC).
1
4
128
JC: our grounds is that there were defects in the decisionmaking process, "a number of demonstrable flaws" in the reasoning of the SoS. We do not know why the SoS decided that there was a seriuos danger to health.
2
3
127
JC: Will first discuss the regulations, and then the Cass review, before the Secretary of State (SoS)'s statements.
6
3
119
JC: the exception to the requirements in Section 62(3) states that the SoS can bypass the consultation if the SoS considers it is essential to make the order with immediate effect to avoid serious danger to health.
1
4
116
JC describes the power of the act - to restrict supply of medications. The act details the requirements for consultation.
1
3
113
A reminder that you can support us in taking this action via:
5
32
107
JC: what was meant is that puberty blockers should only be prescribes *on the NHS* as part of a research protocol.
1
4
106
That concludes the hearing, and this thread. Thank you all for joining us here.
10
0
106
JC: this has been allowed previously on two occasions.
1
3
105
Thousands upon thousands of people marched at London Trans+ Pride this year. Thanks to our volunteers and supporters for marching with us. Anyone know what the estimated number of marchers is?
1
12
98
JC: the review found that not enough is known about the longer term impacts of puberty blockers about whether they are safe or not. Notes that medicines are only banned on safety grounds.
1
3
103
JC: Secondly, the Cass report. (CR). In the defendants arguments that the Cass review 'concluded that puberty blockers should only be prescribed as part of a research protocol'.
1
4
101
JC: it does also make recommendations about private prescription of puberty blockers. These are recommendations in the context of how private provision may impact provision on the NHS.
1
3
96
JC: For example, one discusses the potential impact of private provision on research protocols. And the other refers to concerns about the use of unregulated medications and providers not regulated within the UK.
1
3
90
We’ve sent a pre-action letter to the health secretary in relation to the ban on blockers. Please donate to help cover the legal costs.
We’ve been receiving email after email from desperately worried parents after the health secretary suddenly banned puberty blockers for trans young people. We will issue a case in court as soon as possible – but we desperately need your help 🏳️⚧️✊ .
0
44
87
We too are concerned. Trans people are being let down. We’re seeking a meeting with @rcgp and are also currently working on a resource for trans people about what you can do if your GP refuses to prescribe your medication.
We are deeply concerned by the new @rcgp guidance, which depends on a number of concerning false narratives spread through the media to propose severe interruptions to trans people's access to care through general practice.
0
24
85
We’re at #TransPrideBrighton and ready to march. Sending love and solidarity to trans people everywhere. We’ve always been here and always will be.
0
11
77
JC: However SoS did receive advice that ending treatment to patients carried significant risk. Clinical advice from NHSE noted that patients taking PBs are highly vulnerable, liable to self-harm, and that there are insufficient capacity for support services.
1
13
86
JC: this process was the antithesis of an informed and evidenced approach. Based on misreporting in a newspaper, the SoS pursued an approach which carried risk of harm to patients, referred to repeatedly in memos to the SoS.
1
11
82
JC: it's clear that other stakeholders (pharmacists etc) were consulted, and the only groups left out were the ones representing patients.
1
17
82
JC: Note in the submission from Dr Pasterski, the practical impact of this ban is wider as a result of a chilling effect. Includes for those already started treatment. There was no consideration of risks to this patient cohort.
1
7
79
KC: there is no explanation or acknowledgement of the decision from SoS not to consult patient groups.
1
5
72
📢Legal challenge update 📢.The legal challenge to the puberty blocker ban is due to be heard on Friday 12 July. We're bringing the case with a second claimant and in partnership with @GoodLawProject . Donate to cover legal costs:
1
34
68
JC: We have searched beyond the studies mentioned and found nothing which establishes long term risks or consequences. CR did not conclude any risks of long term consequences at all had been established, only hypothetical risk.
1
3
67
JC: There are international and other professional organisations of medics who have criticised the CR. Endocrine society, WPATH (describes CR as an "outlier") and EPATH. (World/European Professional Associations for Transgender Health).
1
6
68
We say to the government that, while we didn’t expect things to dramatically improve the moment you came into power, we did expect that you would stop fanning the flames powering the anti-trans narrative. This is why so many trans people are . angry with you.
1
9
72
Olympic boxer Imane Khelif has been subjected to online abuse based in racism, misogyny, transphobia and interphobia. We all need to speak out against this online misinformation and against hatred. For an action you can take, read:
1
20
73
You can support TransActual and @GoodLawProject in our case against the ban on puberty blockers by donating to the crowdfund:.
0
27
62
JC: recent approach adopted in Liberty was to consider 'serious', in context of pharmacovigilance, a 'serious' adverse reaction should result in death, risk of death, hospitalisation, or persistent disability or incapacity'. This is not what the CR says of PBs.
1
6
70
-sed. JC: It cannot be the case that they say that Cass is the evidence base for this. CR did not recommend the ban.
1
11
67
We have significant concerns over the data used for the so-called “independent” report, data which has not been forthcoming despite many FOI requests from others. We also note that the data examined appears to ignore those thousands of young people on waiting lists.
1
7
65
KC: Notes that defendant made mention that the ban would not impact UK private providers - but there are no UK private providers. So they were misinformed about the impact of their ban.
2
3
64
JC: SoS was advised that there was a known, serious danger to patients who would be required to cease treatment. And possible risk of harm highlighted in the CR. SoS lacked the essential info to allow these to be considered against each other.
1
3
64
The press are trying to (once again) whip up a moral panic. The timing is no coincidence - the consultation on the NHS constitution closes on Tuesday at 11:59pm. More info and guidance on how to respond at:
0
25
69
To young trans people: you are loved and you are special. What is happening to your healthcare in this country is appalling, and we will use every tool at our disposal to get to the point where all trans people can access the healthcare they need when they need it.
1
13
66
JC: CR found no serious adverse effects reported, despite a history of their prescription over 10 years.
1
4
64
JC: there has been no response in the defendant's argument regarding what specific risks to patient safety were the grounds for this order. The implication that it was "all of the CR". But this is not acceptable when Cass' conclusions are so equivocal.
1
4
59
JC: It is clear from impact assessment that they did not know how many patients would be impacted. They did not know if there would be GPs and clinics willing to provide still-legal prescriptions.
1
2
63
JC: these are not malign actors, they are applying the world consensus position on best practices. Yet defendant describes the sourcing of private sector PBs as a 'loophole'.
1
5
63
We start from the point that any suicide is a tragedy – as well as the loss of a loved person’s life, there are significant impacts on family and friends. We do what we do to eliminate such tragedies.
1
4
61
On Friday (21st June 2024) we were contacted by a journalist from the Telegraph with the suggestion that we have behaved improperly. We have done nothing wrong and stand by the work that we’re doing for trans people.
1
20
55
JC: For the state to decide that claimant YY should not be able to access this medication, this is contravening their right to autonomy.
1
2
59
JC: it having been identified to the SoS that there was a fundamental patient safety risk resulting from the ban, and uncertainty on whether there would continuity of care. Did not then seek to find out whether there would be continuity of care.
1
2
57
JC: This is why human rights are relevant. And no answer on which impacts noted in Cass constitute serious risk.
1
1
62
JC is summarising. On ground 1, we have covered already that SoS's personal position was that the CR gives rise to the evidence serious danger to health. We say that the findings of the CR fall far short of demonstrating serious danger to health as required by section 62(3).
1
3
60
JC: the real reason this was pursued is found in correspondence between officials, which says "the view from parli colleagues, is that the section 62 order is not urgent." and can be laid after dissolution.
1
4
60
JC: there is further misrepresentation by the defendant when they say that the review identified very "serious risks". There is no evidence in the report of the studies it analysed that any young person has come to significant harm as a result of taking puberty blockers.
1
2
61
JC: the defendants have claimed that "the Cass review describes a model of care that was causing harm to patients", but does not cite a part of the CR. This is a misrepresentation of the findings of the CR.
6
2
60
JC: refers to advice they recieved from NHS England. But it notes explicitly that advice is not related to specific risks of PBs. So why was that advice not obtained from anyone?.
1
2
61
We feel you have let trans people down badly. We urge you to talk to trans people, listen to our stories and struggles, and stop treating us as a philosophical issue.
1
1
61
In addition to our ongoing work responding to the Cass Review, this week TransActual have started to co-ordinate work around the potential threat to transition related care for adults in the UK.
0
10
57
JC: there is much emphasis from the defendants on the need to implement a ban prior to the general election. But it is not said why they must act before parliament is dissolved. When the law says that in an urgent situation they can bring a statutory instrument (SI) into force.
1
4
59
Judge asks about whether level of scrutiny depends on whether human rights issues are considered. JC: protected characteristics of patients involved, risks to their safety, and also of their privacy and dignity. So scrutiny standard should apply.
1
3
57
JC: SoS made the decision without 2 key pieces of evidence. First clinical or scientific advice on puberty blockers and whether their prescription constitutes a patient safety risk. Was not said in the Cass report, therefore advice needed.
1
2
56
Response is over. Judge: I will not be giving judgement now. You will receive that in due time.
1
2
58
JC: The defendant highlights a risk hypothesised a risk to neurological maturation. And risks to bone density. But it is unclear whether this is long term, there is a lack of evidence.
1
2
56
We’re part of the Trans Healthcare Coalition, a group of organisations and individuals that have come together to provide a collective and coordinated effort to respond to the NHS review of Adult Gender Dysphoria Services. Find out more at:
1
16
58
JC: Using the emergency process in section 62(3) should therefore require a very clear/obvious risk to safety.
1
1
58
JC: There's a series of hypotheses about possible risks in CR. It was incumbent upon somebody at some point in the decisionmaking process, what was the danger to health this order was acting against. We can't find where that happened.
1
2
55
JC: Officials wanted more time to consult on supporting the patient population and develop stronger evidence base, but the SoS rejected advice, took an early decision to ban PBs based on CR.
1
6
56
JC: second piece of evidence SoS proceeded without, was information on how many patients were being caught by the ban, and whether in practice these patients would be able to access prescriptions.
1
2
54
Judge is taking time to read submission on this. JC notes relevance in terms of withdrawing treatment from trans prisoners being a human rights violation. Judge asks about withdrawal vs preventing new provision.
1
2
56
KC: And failed to make an assessment of balance of risks. This goes to the point previous about balancing risks of harm from the ban vs from the PBs being banned.
2
1
55
JC: The reason it is necessary to consult more widely is that the safety of a medicine is largely a matter of science. But there are some inputs into that decision from patient groups based on the benefits a medication may have.
1
2
55
Judge: there's a gap here. the reality is that services are overwhelmed by large numbers of people waiting months and months for treatment.
3
2
56
JC: Moving to grounds 3. The strasbourg case (regarding access of prisoners to HRT) is highly relevant given it being about the impact on trans people of withdrawing medications, mental health impacts and consequences thereof.
1
3
53
JC: At the end of May, defendant is quoted as saying "there is a huge amount to do" to finalise this policy. Including exceptions, mitigations, protecting patients. The very things it would be valuable to seek wider views on.
1
3
54
JC: this is a demonstrable flaw in the reasoning of the SoS. with reference to the high bar for 'serious' danger to health. SoS must have misunderstood the legal test she was required to apply.
1
3
54