In recent months, the campaign of anti-trans backlash under which UK trans people have been living for the last several years has accelerated. Following the April 2025 decision of the UK Supreme Court in For Women Scotland v The Scottish Ministers, the UK Government, the Equality and Human Rights Commission, and many other bodies have mendaciously leveraged the ruling to licence broad exclusion of trans people from participation in public life. At the same time, a trans healthcare crisis years in the making has also intensified, with the government and the NHS using the April 2024 Cass Review to deny young people access to any transition care that is not aversion therapy. Adult gender services, and measures of legal recognition such as updating gender markers on passports and NHS records, seem likely to be in the crosshairs next. National media ignore news of the tens of thousands of trans people and our allies who have turned out in recent months to attend demonstrations and lobby Parliament, preferring instead to platform those few voices who argue that universal human rights protections do not apply to us.
What use history in these times? While trans history matters for its own sake—and the academic field is flourishing—in the current moment the trans past is also often leveraged as a lobbying tool. Both academic historians and members of the public frequently make political appeals to the trans past: whether on protest placards emblazoned with slogans like ‘trans people have always been here’, or in highly specialised interventions such as the historians’ amicus brief in the 2025 US Supreme Court case US v Skrmetti. For we who trade in footnotes, such invocations of the historical record can be tempting. But the organised anti-trans movement, like other branches of right-wing extremism today, has little interest in evidence or expertise.
Faced with this, in recent months I’ve turned instead to telling stories about trans history by and for trans people: stories that draw on my specialist expertise, but that depart from the ways, and the reasons, that I might teach trans history in a university classroom, speaking to connections between the past and trans experience today. And I’ve been exploring the uses of trans history as a tool of political education: one that moves beyond questions of visibility, validity, or ‘always being here’ instead to support trans people in organising and building power together. I’ve found that when trans people come together to learn and talk about our history, it can become a basis for thinking beyond lobbying the state for rights. Instead, the trans past can be a tool for imagining how we might build liveable trans lives in community, outside of and without reference to the state and other institutions— and perhaps even in the face of, and in active resistance to, state violence and repression.
To offer an example of how this might work in practice: one story I have been telling recently is that of the history of medical transition in the UK. To be sure, people ‘transed gender’ (as the historian Jen Manion has put it) for millennia before the invention of synthetic hormones and modern plastic surgery techniques. Even today, many trans people do not seek medical interventions. But in the last century, the technologies of medical transition have done much to shape public perceptions of what it means to be trans, and have been a key space in which trans people have had to negotiate coercive institutional power. In a UK context, much of this conversation has been had through the prism of NHS specialist gender services. Today, long and intractable waiting lists, and a lack of political will to address them, mean that NHS gender services are functionally inaccessible to most people who wish to begin medically transitioning. But historically, too, many more trans people accessed medical transition outside of NHS gender clinics than is typically recognised. The reasons for this have changed over time, but they speak both to a longer history of the clinic as a site of coercion and violence and to a longer history of how trans people have exercised agency and ingenuity in navigating these hostile systems.
Trans people in the UK have pursued hormones and surgeries since the technologies were developed in the early twentieth century. The wealthy and well-connected went to a small number of private specialists, including abroad. Others found ways of telling stories about their bodies that provided access to hormones and surgery, including after the establishment of the NHS in 1948. But in 1966, a psychiatrist, John Randell, established the first gender clinic at Charing Cross Hospital in London, formally bringing medical transition within the purview of the NHS. Drawing on ideas then more common in American sexology that regarded being trans as a mental health condition rather than a congenital physical variation, he made medical treatment conditional on whether he judged that his patients conformed sufficiently to gender norms to be able to ‘pass’ as their lived gender. As the historian Zoë Playdon has evocatively put it,
NHS treatment was not a right but a privilege, to be won through an endurance test that lasted as long as Randell wished it to…. He saw his job as to give patients a sharp shock of reality, to be icily implacable in making them face life’s harshness by making their care pathway an assault course that only the fittest survived.
In 1980, the entire country saw Randell’s bullying firsthand when he featured (albeit anonymously) in the BBC documentary A Change of Sex. The programme follows 25-year-old London hospital catering manager Julia Grant as she begins living as a woman and pursues medical transition. Though it shows us many sides of Julia’s life—her challenges to keep employment and housing as she transitions; her relationships with family, friends, colleagues, and romantic partners—it concentrates on her struggle to access surgery through the Charing Cross clinic, sitting in on her sessions with Randell. Randell repeatedly condescends to and berates Grant, exercising his power to withhold surgery from her when she doesn’t do as he wishes. Grant subsequently recalled that, when the cameras weren’t rolling, Randell was even more domineering.
One way of telling this story—and an important one—is to emphasise the long history of violence undergirding the UK’s gender clinics. Randell was not just one bad apple. Although he died in 1982, clinicians he trained worked in the NHS for decades after, and the system is still premised on the notion that non-trans psychologists are better able to judge than trans people ourselves whether we are deserving of access to essential medical care. Moreover, Randell was one part of a larger historical moment in which sex differentiation was central to the organisation of social life, and conformity with racialised binary gender norms an important metric of social integration. His regime sits alongside the history of conversion therapy practised on lesbian and gay people, ‘virginity tests’ and forced sterilisation practised on migrant women and women of colour, and the incarceration in asylums of the disabled and the mentally ill.
But another way of telling this story is to emphasise the agency and community power that trans people have exercised in teaching one another how to navigate these hostile systems. Grant, faced with Randell’s stonewalling, sought surgery privately, following the recommendations of friends—although she received a poor standard of care and experienced significant complications. The writer and activist Roz Kaveney has recalled that in the 1970s her ‘very hip, very trendy’ GP prescribed her HRT himself rather than force her to endure Randell’s bullying. Then as now, trans people gave each other recommendations for surgeons, shared their hormones with each other, and taught each other what the right words were to say to the GP or the psychologist. Like thousands of other trans people in the UK today, I am unlikely ever to be seen by the NHS gender clinic on whose waitlist I sit. While my ability to medically transition has been cushioned by financial privilege, it was primarily my friends in trans community who guided me through patching together healthcare by other means.
I told this story recently to an audience of 45 people, most of them trans, in the context of an informal discussion in a local community space. I saw some of the attendees realise in real time that there were alternatives to languishing indefinitely on a gender clinic waitlist. What is more, I saw conversations start, as other people in the room began to explain to the people next to them how they had managed to access healthcare. Here, a discussion about trans history became a springboard from which to imagine trans futures—futures that located epistemic authority and political power not in the clinic, but in community.
For those of us who were trained as academic historians and who still work in universities, using history as a tool for building community power can necessitate letting go of legible metrics of ‘impact’. To be sure, we are in desperate need of an expanded academic secondary literature in twentieth-century UK trans history that can support the numerous undergraduate and master’s students who every year write dissertations in this field. But if we want to tell stories about the past that not only make historiographical contributions but also help people get healthcare (among other things), we must start by ensuring that we are in community ourselves and are responsive to community pressures and needs, including highly specific local ones. We must be willing to do work for which we can’t take credit, because to draw attention to it in the present political climate would be to jeopardise its effectiveness. We may have to cultivate humility about what our expertise can offer.
Being a trans person, and a trans historian, in the UK in 2025 can at times be a challenging experience. But I have also found it to be a profoundly radicalising experience, and one that among other things has transformed my understanding of the value of my work as a historian. ‘Joining a collective project of resistance to eliminationist state violence’ is not something I can put on a promotion application. But it has helped me to imagine futures to live into and to fight for.
I am grateful to Jack Doyle and Ruth Pearce, conversations with whom have shaped my thinking both about the history of UK trans healthcare and about how to be an academic in trans community.