Transsexuals in Britain face considerable social and legal obstacles to a successful gender role change. Widespread social prejudice means that transsexuals are often harassed, ostracised or even assaulted if their condition becomes known. Many transsexuals find themselves forced to abandon their previous life, job and social circle altogether and to start a new life 'from scratch' in a new area where their gender history is not known. Many transsexuals lose friends or family due to prejudice and lack of understanding. All this makes for considerable additional difficulty for the transsexual during what is inevitably a stressful and traumatic part of her life.
The economic situation also makes life difficult for the transsexual. Many transsexuals, prior to reassignment, are unable to function effectively as productive citizens because their Gender Dysphoria is so debilitating. After successful gender reassignment, the vast majority of transsexual people become fully functional members of society and contribute to the economy in full. The biggest difficulty arises at the 'in-between' stage: today it is almost impossible to obtain gender reassignment with NHS funding, leaving private treatment as the only available option for many people. But a person who is unable to function effectively in their natal sex role will probably find it extremely difficult to save enough money for treatment, and the problem is compounded by the requirement for the 'real-life test' --- it can be very difficult to hold down a job while 'in transition'; it is a difficult time for the transsexual herself, she may require considerable time off work for treatment, and if her transsexual status is discovered (and it can be very hard to conceal, especially prior to surgery) she is likely to lose her job. In the circumstances, it is not surprising that many transsexuals become suicidal when treatment is unobtainable, or that some resort to prostitution as the only way to pay for the treatment. Privately, gender reassignment costs a minimum of £10,000 for surgery, psychiatrists' fees and electrolysis; the cost can easily rise by thousands of pounds if the patient requires more than a minimal amount of electrolysis, or if she requires any cosmetic surgery in order to 'pass' as a woman.
An untreated transsexual may well be a burden on the state if she cannot keep a job, she may have persistent psychological problems such as depression, and she may well eventually commit suicide, costing the state a great deal to 'clear up'. After successful treatment, she would most likely be a fully productive member of society, and would repay in taxation many times the cost to the NHS of providing the reassignment; recent figures show a 97 % long-term success rate. Denial of NHS treatment to transsexual people is not only a false economy for the state, it is an iniquitous denial of basic rights to a group of citizens with a genuine and debilitating medical condition.
If the social and economic difficulties are bad, the legal situation is in many ways worse, and acts to compound the other difficulties. Under present UK law, a post-treatment transsexual exists in a kind of legal 'limbo': It is not difficult to obtain a legal change of name, and after gender reassignment it is possible to have much civil documentation re-issued in the new name and gender --- for example, passport, driving licence and medical records. The single biggest problem, however, is that owing to a 25-year-old court ruling based on reasoning that is now known to be invalid in the light of new medical knowledge, transsexuals are not allowed to change their Birth Certificates , even after surgery. As a consequence, for many legal purposes the original natal sex is considered still to apply. This means, for example, that a transsexual woman may not marry a man, and if convicted of a criminal offence may be sent to a male prison, with dreadful consequences.
Prior to that Court ruling, transsexuals in Britain were allowed to change the gender recorded on their Birth Certificates after surgery. Today, the UK and Eire are the only countries in the EU that deny this fundamental right to their transsexual citizens, with far-reaching consequences for those citizens.
Since the Birth Certificate is the primary form of identification document in Britain, a post-treatment transsexual may have to reveal her history to a prospective employer, which may well lead to discrimination. Furthermore, the DSS and Inland Revenue will not recognise the new gender, so a transsexual woman will not receive her pension until 65 rather than 60 and will be treated as male for taxation purposes. This, and similar anomalies, can all too easily lead to the person's history being revealed.
(Some people object to the idea of changing the Birth Certificate, on the grounds that it 'should' record the genital sex into which the person was born --- the problem arises because the Birth Certificate is used as an identification document rather than merely as a historical record. This objection can be addressed by the method adopted by some states in the USA: a new certificate, with the new name and gender, is issued, but the original certificate is sealed and kept on file, where it can be accessed only on the order of a Court.)
Furthermore, existing case law in Britain holds that the Sex Discrimination Act does not apply to transsexuals, and that an employer may fire an employee at will merely for being transsexual. In April 1996, the European Court of Human Rights ruled, in a test case, that this was unlawful and thus that the coverage of the Act should be extended to include transsexuals; however the present UK government is still resisting this ruling and the relevant statute law has not yet been formally amended.
All of this leads to a significant denial, to the transsexual, of basic rights and civil liberties that all other citizens take for granted. Britain lags significantly behind most other developed countries in this respect, and change is long overdue.
Modernising the law to allow post-treatment transsexuals the same rights and responsibilities as other members of their gender would not only offer a significant direct improvement in quality of life for transsexuals, but would also send a clear signal to society at large that transsexual people are to be treated the same as anybody else. Over a few years, this could significantly ease the problems of social discrimination --- at the moment, the fact that transsexuals are marginalised and oppressed by the law signals to the public that it is acceptable to mistreat and discriminate against transsexuals.