In times past, much has been made of the SNP’s progressive credentials. The 2010’s were a time of unparalleled success for our party for a plethora of reasons – the natural desire of Scots to seek self-governance, the inclination towards a party of government that had proven themselves capable, and of course – the aftermath of the 2014 Independence referendum and the chaos with brexit that soon followed.
Unfortunately, as the 2024 election has shown us – something has gone a little awry along the way. There was a time in Scottish politics where our party reaped the rewards of backing progressive social, economic, and political reforms – Indeed, I would make the argument that this is where the largest groundswell in support for Independence could be found – the idea that together, we could build a Scotland for all of Jock Tamson’s bairns, a society where no matter your background, creed, colour, or lifestyle – you would be treated equitably as a citizen in a modern democracy.
In times past however, there has been a shift in tone. As the momentum of both the Indyref and Brexit has begun to slow, as has our ambition in delivering an Independent Scotland truly worthy of such a status. To the average progressive voter – who could easily be anything from a young apprentice at the copperworks, to the veteran party activist still chapping the doors at 80 – an almost desperate shift has appeared as our party attempts to draw in more voters from anywhere that it can.
It is often far easier to cast aspersions, blame others, or get angry with the circumstances for things not necessarily going our way. It is often far harder to look inward and discern whether or not we ourselves are doing something that does not align with the electorate’s expectations, despite this being the most necessary and logical step in righting a ship that is in trouble.
There was a moment in time when our country was touted as a world leader on LGBT issues. During a time of outrageous bigotry, slanderous headlines, and evangelical Christian businessmen pouring millions of pounds into anti same-sex marriage campaigns, our SNP government followed the popular sentiment of ordinary Scots and equalised marriage for all in our country – with all the civil and legal rights that accompanied.
We face a similar challenge today on the issue of transgender rights – with the setting being all-too-familiar. Outrageous bigotry, slanderous headlines, and once again – the evangelical right and supposedly secularist billionaires funnelling millions into campaigns that endanger, demonise, and unjustly target a vulnerable minority group.
We have been here before – but this time the SNP finds itself on an uncomfortable fence – rhetorically defending transgender people and seeking to expand their civil rights on one hand, and on the other – placating the centre-right within our party in the hope that by some miracle, appeasing them will turn centre-right Unionists and Alba voters into loyal SNP voters.
It is as daft as it sounds frankly, and means sabotaging (through inaction, let’s be clear) the electoral coalition that allowed us to dominate both Holyrood and Westminster seats in Scotland for a decade. It is a coalition made up of young people, LGBT people, progressive voters, the working class, and university graduates – it is not, nor has it been for many years, a patchwork of centre-right bigots who ‘mibbe will, mibbe wilny’ vote SNP if the party sits on it’s hands regarding it’s commitments to Scotland’s vulnerable communities.
The culture war is a poison, and is a useful tool for the far-right and their centre-right apologists in the tartan Tory wing of our movement, as well as that of the actual Tories, to implement austerity by stealth and undermine the social contract. In allowing our party to be blindsided by the propaganda of hatred, we have begun to neglect one of the core reasons that Scots started backing Independence and our party en-masse in the first place – the vision of a Scotland where all have a place to live in peace, tolerance, and security.
The motion today is not, as the newspapers or certain individuals would have you believe, especially controversial. The informed consent model is currently used on ‘normal’ people for the exact same medication that trans people have been begging for access to for some time. Some would argue that this medication is dangerous and that strict guidelines should be in place for its prescription – yet doctors are more than willing to use testosterone, progesterone, and oestrogen to treat everything from irritable male syndrome to menopause. The reality is that the informed consent model is widely used around the world for transgender patients, and results in far superior mental and physical health outcomes for patients than our current system.
I say this as a trans person who has had their own issues with our health system with regards to transition related care. I can say in all honesty that the current ‘gatekeeping’ model of care for trans patients has actually put my health and wellbeing at far greater risk than could ever be envisioned by the informed consent model.
To give you an example, here is my own story:
When I was finally able to articulate that I was transgender, I went to see my doctor as soon as possible at a small GP’s practice in the foothills of Clackmannanshire. I was told that I would be waiting at least 5 years for my first appointment at the Sandyford Sexual Health Clinic in Glasgow. This appointment wouldn’t provide any medication, nor clarity, nor any psychological support for me – it was merely an administrative meeting.
I’ve telephoned Sandyford multiple times over the years to see how my application is doing to no response. There isn’t even anyone at the GIC employed full-time to answer the phone, never mind take care of the mental and physical health of patients who have waited many years for a first appointment. I still have not heard from them – nor do I know if my referral has been conveniently ‘lost’ – as many transgender patients are, because no one is paid to communicate with us.
Knowing that the waiting list has rapidly climbed beyond 7 years since the isolation of COVID-19 led many people to uncover their identities (of which I was one), I decided to seek an alternative solution. I went with who I believed to be a reputable provider of gender-related care, the now (among trans people) infamous GenderGP – well renowned for gleefully making money at the expense of people desperate to feel at home in their bodies for the first time in their lives.
After paying over £500 for a diagnosis (following a one-hour appointment with a mental health professional), I was finally given my diagnosis of gender dysphoria. I had discussed with my GP what the next steps would look like prior to embarking on this journey, and they had indicated that a shared care agreement would be reached now that I was diagnosed, with me qualifying for blood monitoring tests at his office, and regulated prescription medication free from my local pharmacy (thank you, SNP government!)
Three months into this agreement, I received an extremely distressing telephone call. I was informed by the practice receptionist that my shared care agreement had been suspended by the practice director – who had read a sensationalist headline about how GenderGP were an untrustworthy company based in Hong Kong, and not the sort of people that they trusted to give out a diagnosis.
One would imagine that they terminated the agreement out of concern for my health – perhaps they would have continued to monitor my bloodwork or at least let me ease off the hormone replacement therapy I was already three months into – my body already irreversibly changing.
That, unfortunately – isn’t the world that transgender people live in. Even in Scotland. Even nowadays.
My practice washed their hand of me – I had paid good money to get medical help in a way that was legitimate, only to have been told that vested interests at the top of the practice had bought into anti-transgender rhetoric hook, line, and sinker, and had put my health at risk.
I’m a working-class woman – I’ve never had much money. I soon found myself paying over £100 a month buying medication privately from GenderGP to ensure that the HRT I was receiving was of a high quality and from a legitimate source.
I remind you, dear reader – that these are medications handed out like sweeties by doctors to ‘normal people’. I ask you that in our Scotland, with our SNP government, in our current year – Where is the fairness? How in any society that calls itself progressive can a vulnerable group at risk of housing and employment discrimination be treated like this?
I appealed all of this of course, and it went nowhere – as I had been told to expect by older trans people.
There came a time where I moved out of my parents house and into my first real flat at the age of 23. We no longer had the money to pay Gender GP’s £30 a month membership fee, nor their over £100 a month on medication, nor the additional £225 they wanted to charge me for a ‘follow-up’ counselling session (2 years after starting treatment!) before they dispensed any more medication.
I could write at length about my experiences with black and grey market HRT, but I will save you the gory details. To cut a long story short – nobody in our society should have to depend on other people’s prescriptions, medication made in bathtubs, or untraceable pills from Turkey in order to stop their body and mind from crumbling around them. To this day, I do not know if any of this has poisoned me or caused me irreparable damage, as our NHS still refuses to review my bloodwork. It is cheaper than using GenderGP (at around £50 per month), but to this day I have no idea if it is any safer – or what is actually in the circumstances that are forcing me to take.
I would like to pause for a moment.
All of this could be avoided. What scant NHS resources there are dedicated to gatekeeping transgender healthcare could be repurposed to alleviate some of the burden on the rest of our health service.
Transgender adults could receive danger-free, inexpensive, timely care by having a frank 20-minute long talk with their pharmacist or GP and taking a pamphlet. I remind you again that this medication is regularly doled out to people with age-related hormone issues, and has been proven safe for transitioning individuals time and time again.
Instead, we are left with the worst of all worlds. A party and government with an unclear and alienating position, a vulnerable group left feeling as though the walls are closing in on them, and right-wing demagogues circling like vultures desperate to stir up hatred and make our society unliveable for people who don’t fit their ideal.
I would like to leave you with one final thought as we close this article. Endorsing the motion that I myself will be seconding to introduce the informed-consent model in Scotland for transgender patients this upcoming party conference will re-invigorate our core base, those who believed in Independence for all the positive change it could give our country – rather than those who just clamour for Independence for its own sake. We will show the voters who saw us through 2015-2022 that we are still their party, despite all the humps, bumps, and hurdles along the way – and, at long last, transgender people in Scotland will be empowered to receive the healthcare that they deserve as citizens of the Scotland to come.
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Kind Regards,
Eilidh Eden McIntosh
