Should The Nhs Even Be Doing Tg Operations?...

[ToraToraTora]

http://news.sky.com/story/1622257/nhs-failing-transgender-people-report-says
Lot of moaning here but surely the NHS is designed for real medical issues not for those who have decided they want to change sex. If they are that desperate they can pay privately.

[gness]

Maybe that's our fault, Grass.......must be damned difficult to live with some of the attitudes shown here.

[sunny-dave]

So - I happen to think there are enough children in the world already - and therefore the NHS shouldn't fund IVF at all, ever.

Is that defensible?

Is it right?

I bet your answer depends on whether the inability to conceive has ever affected you (or your family).

Which is kind of my point - everyone wants funding for something that affects them or theirs - and the rest can go hang (especially if they are an "easy to pick on" minority).

Which is why we need decisions to be made on evidence, not prejudice and partiality.


[ and, just for clarity, I gave my views on IVF when I was asked to do the work I have referred to earlier and never took part in any panel which considered funding relating to artificial conception ]

[sunny-dave]

Don't be ridiculous - the NHS uses every single transplantable organ it can get - the reason people are waiting is the lack of donors, not NHS funding.

[gness]

Well that will make our pint/s interesting, Dave...as I think you're so wrong there.....but....

I promise I won't use coarse and grubby language when I put you right.... ;-)

Fender.....MrG lived for many years at...as you put it...death's door waiting for a kidney......but thankfully he was a lovely man...kind and caring.... and would never have posted what you have today.

[Mamyalynne]

Another huge problem is the Drug Companies loudly announce some amazing new drug and those who think it may help them quite rightly rush to ask for it.

Then it transpires that the cost is prohibitive and panels as Dave has suggested have then to weigh things up from a monetary point of view.

[Sqad]

Jim.

http://www.ncbi.nlm.nih.gov/pubmed/21364939

[sunny-dave]

Worse than that, mamya - they are also happy to orchestrate public pressure groups for these new treatments - often leading people to have unreal expectations of the efficacy of an expensive new drug.

Very cynical and very wrong.

[venator]

I have a deep and sincere longing to be rich, and it's affecting my wellbeing.

A tg operation and all the associated proceedings must cost at least a quarter of a million.

Where do I go to get treated?

[Mamyalynne]

I agree.

[Mamyalynne]

Reply was to ^^ SD

[pixie374]

The problem with that, sqad, is there is no way of comparing the suicide rates if it hadn't been done. Although it does show it clearly isn't always the solution.

[jim360]

Thanks, Sqad. At first reaction the two main comments I would have are that:

a) a better control group might be transgender people who haven't undergone SRS -- or better still, the unknown number of people who have gender dysphoria but haven't yet been open about it. It seems inevitable that gender identity issues are associated with an increased risk of depression/ suicide, so the question ought to be whether or not post-op transpeople are more at risk than pre-op. Not an easy one to assess, particularly as, realistically, society still isn't entirely accepting of transpeople (witness fender's astonishing tirade, or TTT's various ill-informed musings on the subject), a situation that only serves to add pressure.

b) the study itself concludes not that surgery isn't the answer but that it can't be seen as the complete answer. Again, not surprising, as this is what the NHS report published was saying too.

[woofgang]

I mean this nicely but what Sunny-dave has described is also a big problem with local patient and public involvement which I have been involved in. If the forthright and articulate member(s) of the group have relatives who have had eg strokes, then the outcome will be increased stroke care. Some relatives actively seek out opportunities to be involved in such groups and studies. I can see why they do it, totally understand and sympathise but it doesn’t result in equitable commissioning decisions. When we were a PCT we had one senior manager whose mother had had a stroke and had benefitted from speech therapy. Therefore he knew about speech therapy and approved of it, therefore, for the short time he was in office, speech therapy did well out of the budget pot and everyone else lost out. Conditions that don’t have strong advocacy or where the sufferers may not feel they can come forward, don’t get such support. The other issue is which patient groups have the best “image” We used to call it “sexy medicine” Transplant surgery is sexy medicine, continence management isn’t.
I am very impressed with the excellent job that has been done on the image of what used to be called senile (or pre senile) dementia and is now generally known as Alzheimers. I mean no disrespect. Its a terrible condition and sufferers and their families need all the help they can get....I am just saying i bet they wouldn’t be getting it without the image makeover.

[woofgang]

maybe not cold and cruel, but definitely uninformed....

[Togo]

It is stated that this was a 'nasty' op. ie not nice. Talking N.I.C.E. they decided that the drug Kadclyma was not cost effective, I wonder what their stance would be regarding the question.

//Kadcyla is a treatment for HER2-positive breast cancer which has spread to other parts of the body that cannot be surgically removed and has stopped responding to initial treatment.//

[ummmm]

Fender...this isn't about migrants!!

[Mamyalynne]

Togo, it is hard isn't it - Kadcyla is yet one of a number to be affected by pricing issues and as said it is impossible to comprehend how many people's hopes have been crushed when this happens.

https://en.wikipedia.org/wiki/Trastuzumab_emtansine#UK_pricing_issues

[Orderlimit]

Orderlimit - //Should The Nhs Even Be Doing Tg Operations?

A simple no from me. //

But as this post has shown, expecially the illuminating posts from sunny-dave - 'simple' is exactly what this is not.


Life is rarely simple, orderlimit - 12 years making decisions in the NHS taught me that ...

Agree, but I mean I personally don't think the NHS should be doing TG ops, unless self funded by patient.