In light of the Supreme Court ruling, Dr Kamilla Kamaruddin shares how her experience of being a transgender GP has changed over time
I previously wrote about my experiences as both a transgender GP and a patient in 2017. At the time, I was commended by many health professionals and organisations for being brave enough to share my story. I received awards for inclusivity, including the RCGP Inspire Award in 2019. It felt like a time of real progress, and I was supported by colleagues and embraced by patients. The sense of inclusion was empowering, and I felt proud to be a GP.
However, things have changed since then, and last month’s Supreme Court ruling truly emphasised how my sense of safety and inclusion in my profession has eroded. I don’t feel welcome in the same way I once did and have felt increasingly sidelined due to my gender identity. The RCGP position statement in transgender care March 2024 was appalling and failed to address the needs of transgender patients. The voices of transgender individuals were completely ignored during the development of these guidelines – which also potentially deviated from GMC guidelines. To my knowledge, when the RCGP made its policy recommendations about trans healthcare, no patient engagement process took place. That in itself directly conflicts with normal processes in NHS systems – which are mandated to address healthcare inequalities through public and patient involvement. I considered it unprecedented for an organisation that, in the past, has made great changes to be a supportive ally. The college’s renewed position statement in March this year was more inclusive, but could still have done more to reduce the barriers to healthcare for trans people.
Following the Supreme Court ruling I am not sure of my rights anymore – both as a trans GP and as a trans person. What does the ruling mean for me? For other transgender GPs? Thankfully, the support of my colleagues and friends has been a lifeline. Even the children of my friends were asking about my wellbeing, showing me the value of community and solidarity.
Before the ruling, I had worked as a female GP and felt secure knowing I had protections in place under the GMC. I had never encountered any issues in performing my duties, and patients were generally supportive. I believe that there had been no complaints upheld made to the GMC regarding any doctor’s gender identity. This seemed to indicate a growing recognition that transgender people, including those in healthcare, should be able to live and work authentically without fear of discrimination or bias.
But the Supreme Court’s decision has created a tense environment where the protections I once felt were assured are now uncertain. While the statutory guidance on this has not been updated, organisations are not obligated to make changes immediately. As a result, I feel a sense of fear and anxiety, wondering whether these legal shifts will eventually restrict the rights of transgender doctors. I always believe patient choice is important, but so too is the right of a trans GP to practice in their preferred gender. It is a nuanced issue, but I believe that generally patients are more supportive and GPs always offer chaperones when examining patients.
Another issue that has been raised in light of last month’s ruling is whether GP practices are required to list the gender of their staff on their websites. This is not yet a legal obligation, but transgender GPs like me face the uncomfortable reality of having our gender identity publicly acknowledged – or worse, misrepresented – without our consent. This could lead to more risks of discrimination and exclusion in the workplace. My employers have made a strong commitment to support and protect both transgender staff and patients, and for that, I am grateful.
Despite my concerns following the Supreme Court ruling, I do continue to feel supported by my colleagues and patients. Many are genuinely empathetic, and I think this strengthens the doctor-patient relationship. But the ongoing discussions around ‘single-sex spaces’ and safety in public spaces still persist, and these discussions often focus on the wrong issues.
The vast majority of assaults on women are perpetrated by cisgender men. Hate crimes against transgender people increased by 10% in 2023, and research has shown that between 62% and 73% of transgender people have experienced harassment and violence because of their gender identity. There is no legal issue with transgender women using public toilets, and no significant problem with transgender individuals in women’s hospital wards. An investigation that sent Freedom of Information requests to 102 NHS trusts asking: ‘How many natal female inpatients complained that a transgender woman inpatient was being cared for in the same ward?’ revealed that there had been zero complaints. There is room for all of us.
The Good Law Project is currently challenging the Supreme Court ruling, arguing that it places the UK in breach of its obligations under the Human Rights Act. Like you, I was raised in an institution of justice and fairness. I truly believe that one day, we can work together toward a more inclusive society where we respect each other’s gender, religion, sexual orientation, colour and race. I am privileged that I am still working as a trans GP, and am immensely grateful for the support from family, friends, colleagues and patients.
If the NHS forced me to be admitted to a ward based on my biological sex, I would refuse. The thought of being treated in a way that violates my dignity is something I simply cannot accept. My dignity is a fundamental part of my existence, and I would rather die than allow any policy to deny my existence. I say this not out of anger, but as a statement of truth about the importance of dignity in our lives.
Dr Kamilla Kamaruddin is a GP in transgender healthcare and the clinical lead for the East of England Gender Service in Cambridge
