With respect, Health Secretary, we are running out of time.

I refer, of course, to my patients who have been

In a state of dysphoric meltdown

since I first referred them to a gender clinic

in the year two thousand and sixteen.


The average waiting time in some clinics

has now exceeded three and a half years:

that's a total of 42 months, 182 weeks,

or approximately 1,274 days. 

Have you the slightest idea what that might feel like? 

Do you even have a clue what I’m talking about? 

I doubt it.  Dysphoria probably isn’t something

that you think about a lot.  Don’t be offended,

but perhaps an example will bring it home to you.

Imagine waking up one day and finding –

certain parts of your anatomy had gone missing,

replaced by something that wasn’t meant to be there.

Don’t try to tell me you wouldn’t care.  Even pissing

wouldn’t happen the way it was intended.


Now imagine you had to wait 1300 days to speak

to someone who would make you an appointment to speak

to someone else after another nine months to a year,

and at that second appointment

they’d make a third, at which (after yet another year)

you’d talk to them to them both and they’d interview your wife,

 (which is absurd, you have to admit, but hey, that’s life). 

And even after all that, they’d still say, ‘Wait a bit…’ 


So you’d try to complain

but it would all be in vain and you’d write a letter

to the Health Secretary –

oh, sorry, you are the Health Secretary – I mean the Prime

Minister, and say, ‘With respect, Prime Minister,

this is shit, and I am running out of time, and it isn’t

a matter for debating; the simple fact is that no human being

can possibly endure this much waiting,’

And the Prime Minister would simply shrug and say,

‘That’s life, I’m afraid, but don’t worry,

it will all be so much better after Brexit. 

I simply don’t understand why you’re in such a hurry to fix it.’

And you’d give him a despairing look

and say, `All I want is to be me,

to be complete, the way that I was meant to be. 

Is that really such a crime?’

With respect, Health Secretary,

this is the unendurable situation

of the patients that I referred to the gender clinic in 2016. 

Perhaps you’ll have a little more empathy,

now you understand exactly what I mean?


There are certain things that one can do,

of course, behind the scenes,

which provide temporary relief for a couple of years. 

But one dares not speak of those.

(One is likely to get some grief if one interferes

with the cash cows that are shamelessly milked

by members of the Establishment, I suppose.)


I am not saying for a moment that I condone

such practices.  But I have to concur

that my patient would not have been alive today,

without a brave ex-colleague who must remain nameless;

and in private, I am grateful to her.


With all due respect, Health Secretary,

you are not blameless in this mess.



If patients with cancer were being told to wait

a minimum of five years just to get a date

for their life-saving surgery to be carried out,

and by that time it was tragically too late,

you’d certainly have to answer to the press. 


‘Ah well,’ you say.  ‘You can’t possibly compare the two. 

Dysphoria doesn’t kill.’

But I tell you, we are running out of time;

and if you don’t do something soon,

it will.