From the 1990s onwards, things started to change: worldwide, trans people and progressive medics have pioneered affirmative models, in which the patient’s informed agreement to specific treatments – rather than their psychiatric diagnosis – is the key criterion. Worldwide, that is, except for Britain, where, sadly, large parts of the system remain unreformed, anachronistic and unfit for purpose. The model of trans healthcare in Britain is still built around specialist gender identity clinics, which have long since been phased out in Canada, New Zealand, the US and many European countries and
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