Around three years ago I set up GenderGP, an advice service for gender-questioning patients. It seemed that there were many people thirsty for knowledge, and interest quickly snowballed, with requests for care quick to follow. Patients came to me with desperate tales of their situation and their struggles to get any information, let alone medical treatment.

They spoke about their situation in terms of “life and death”: many were desperately in need of help. So I researched information from any source I could get my hands on. I then combined the best practice approach of the international centres of excellence with everything I had learned in my 25 years as a GP working with male and female hormones in order to put together a package of care.

My approach was seemingly not the norm in the UK. In fact, in 2016, a Women and Equalities Committee report on Transgender Equality concluded that “trans people encounter significant problems in using general NHS services, due to the attitude of some clinicians and other staff who lack knowledge and understanding – and in some cases are prejudiced. The NHS is failing to ensure zero tolerance of transphobic behaviour.”

My work was initially with transgender adults but, in their deep desire to help their gender-questioning children, families were quick to follow. By operating within this somewhat controversial area of medicine, I quickly gained a reputation. Media attention soon followed, along with an investigation by the GMC instigated by colleagues working within the NHS.

I have been very open about my individualised approach to the treatment of transgender patients, irrespective of age, and my firm belief that they should be able to access the support and medication they need in a timely and supportive manner, and where possible via their GP. In line with self-identification of gender, I firmly advocate informed consent and individualised care.

This has attracted a certain amount of media interest. So I was not surprised to receive an invitation to appear on Genderquake, part of Channel 4’s series of programmes which are described as an opportunity “to encourage and to enlighten public discussion about sexuality and gender identity”.

My initial response was entirely positive. There is an overwhelming need for informed debate round the topic of society’s approach to transgender people and how we can better support this marginalised group. As a medical professional who has had firsthand experience of meeting and treating more members of the transgender community than most in my position, I was keen to add my voice to the mix.

Transgender Day of Visibility: Trans people share their stories

This changed rather abruptly after I dug a little deeper. I spoke to a GP registrar and LGBT+ advocate (Dr Adrian Harrop) who had also been contacted by Channel 4, as well as a number of friends, fellow trans advocates and members of the trans community. The overwhelming opinion was that this had the potential to be yet another orchestrated engineered battle between trans people and those who essentially deny their very existence.

The time for debate around the existence and validity of trans people is over. Society and our collective understanding has moved on. Trans people exist. Those continuing to deny this fundamental truth are, for the most part, members of an extremist and fanatical fringe who seem to seek out a platform to express their hatred and exclusionary views of trans people.

The conversation must now move on to address how we can better serve the needs and interests of trans people as a society. For the medical profession, the big question must be how we can best support and help these people – who can be among the most marginalised and disenfranchised individuals living in this country – in their social and medical transitions.

We need a debate based on fact, involving expert comment from well-informed medical professionals, parents, voluntary groups, transgender individuals; those whose focus is on a better outcome for members of the transgender community – rather than a debate in which people have to fight to justify their existence.

The narrative needs to change and this can only happen through informed debate which promotes education and understanding. We need to shut down the hysteria and sensationalism in which there are accusations of schoolyard sex changes, and where parents supporting their gender-questioning children are accused of child abuse.

We need to change the fact that doctors can feel this is an area of medicine so specialised that they cannot even assist their patient under the direct supervision of a gender specialist.