Schedule 1 - Gender Recognition Panels
Gender Recognition Bill [Lords]
11:00 am
Mr David Lammy (Parliamentary Under-Secretary, Department for Constitutional Affairs; Tottenham, Labour)
The hon. Gentleman makes a good point, and that may well be the case. What justification is there for requiring a person or couple who acquired their new gender many years ago to seek an additional medical report presumably at their own expense? What justification is there for requiring the specialist practitioner or the consultant psychiatrist to spend their time providing a piece of formal evidence rather than doing other work?
I say to the hon. Member for South-West Bedfordshire that it is important to understand the distinction between a psychiatrist and a psychologist and to understand its bearing on the condition of gender dysphoria. Psychiatrists are concerned with the study, treatment and prevention of medical disorders and many will be involved; psychologists are focused on the behaviour of mental processes and how they affect the physical and mental state and the external environment of the individual. Social factors play an important part in the appropriate standard of care that is generally established in the area under discussion. That is why psychologists play an important role.
So we need to be clear about a person who has one piece of medical evidence containing a diagnosis. The panel will have a list of people who work in the area of gender dysphoria. It will no doubt get to know the work of the people on that list pretty well, because we are discussing a small group. In that context we believe that a diagnosis from one specialist is sufficient, especially as that diagnosis is to be buttressed by evidence of living for two years in the acquired gender and proof of the intention to continue to do so permanently.
Amendments Nos. 36 and 37 address the evidence requirements for those transsexual people who are applying under the fast-track provisions on the basis of having lived in the acquired gender for at least six years. Once again, the amendments would require two diagnoses of gender dysphoria: one from a registered medical practitioner practising in gender dysphoria, and one from a consultant psychiatrist. The amendment goes further by specifying that a registered medical practitioner must currently be working in gender dysphoria.
We need to be clear about the effect of the amendments. They would force a number of elderly, transsexual people who apply for legal recognition under the fast- track provisions to get a new diagnosis of gender dysphoria because the medical practitioner who made their original diagnosis is not currently working in gender dysphoria in the UK. That medical practitioner may well now be deceased or have retired. The transsexual person, who may have lived in the acquired gender for decades, will therefore be forced to
incur additional expense and will once again have to expose his or her private life to the scrutiny of the medical profession.
We should also remember that the medical diagnosis is not by any means the only piece of evidence required. The person must prove that he or she has lived in the acquired gender for at least six years in the case of the fast-track provisions, and he or she must also prove the intention to continue living in that gender permanently.
The Government's view is that the amendments would not add substantially to the rigour of the process, and in practice they would simply impose additional costs and burdens on the applicants, the psychiatric profession and the few specialist medical practitioners who work in the area.
Amendments Nos. 40 and 41 relate to the composition of the gender recognition panels. The amendments would ensure that two medical members were on the panel that decide applications, one of whom is recognised as currently practising in the field of gender dysphoria, the other a consultant psychiatrist. The Government are of the view that the amendments are misguided in principle and probably unworkable in practice, and I shall clarify why. First, the medical member is not there to make a diagnosis of the person. The diagnosis is to be provided by the person practising in the field of gender dysphoria who has had direct contact with the applicant.
The medical member is on the panel to ensure that the medical evidence is properly understood and that its implications are properly taken into account when the panel seeks to satisfy itself on the criteria set out in the Bill. I suggest to the hon. Member for South-West Bedfordshire that medical professionals are able to do that. Indeed, this Committee includes a medical member who might be able to make that assessment should he so wish. The panel will also be working with a list of medical practitioners and chartered psychologists who practise in gender dysphoria. That list will be drawn up with the assistance of the professional bodies. In that way, we shall ensure that the evidence comes from reputable sources—practitioners who are respected within their disciplines.
There is also a practical problem with what the hon. Member for South-West Bedfordshire suggests. The transsexual population is small. I have listed the institutions that deal with their condition. If we were to go down the road that the hon. Gentleman suggested regarding the panel, a small group of peers would be judging each other's work. I am not sure that that is desirable or necessary. In light of that, the Government's aim has been to create a robust and credible process, but not to place unnecessary burdens on the applicants that go through the process. It is on that basis that I am unable to accept the hon. Gentleman's amendment.