Questions & Issues for NHS/United Kingdom Members

[GypsyKaren]

This thread is for members who have to deal with the NHS for their transition and surgeries, UK members can post their questions and discussions here and get feedback from those who have experience or knowledge regarding the NHS.

I'm making this separate because we get too many "I don't know, but this is how we do it here" type answers to NHS questions, the intentions are good but are of no help. If you can't answer the question, do not reply, it will be deleted. UK members are still free to use any part of the forum to discuss this if they choose.

Karen

A big thanks to Elizabeth 66 for suggesting this, it's member participation that makes this place work..

[Elizabeth 66]

Here is a useful link which the department of health issued for guidance for our GP's, it is a good place to start.

Guidance for GPs, other clinicians and health professionals on the care of gender variant people

Thanks for including this thread Karen I'm sure it will soon become very popular.

[Rianna Humble]

Great link Elizabeth. Here's another that might be helpful:

A guide to hormone therapy for trans people

I have just started to take my first steps towards getting help under the NHS. It helps that my diabetes nurse, Hazel, is a friend, so I wore nail varnish when "he" went to see her for a regular clinic appointment.

Hazel complimented him on my nail varnish and he asked about the best doctor to approach for a gender consultation.

I have made an appointment with the recommended doctor in 10 days time. Hopefully, that will be my first full step towards being able to transition. I will be happy to share how it goes.

At the moment, I am planning to go as "him" but perhaps with a blouse instead of a shirt, since the doctor won't definitely know why I am going to see her. Does that sound like the right thing to do?

[Maryanne_sa]

Hi Rianna,

For my first appointment to see the doctor, I went totally dressed as I am very comfortable with how I look, and therefore confident in public.

I guess whether you go dressed or not, depends how you feel in yourself, but make the decision on how you feel about it, not what you think the Doctor might feel or think. It is his or her job to help you and set you on the right path, to a psychiatrist, and then a gender clinic. Just decide how you will feel more comfortable at the appointment. I saw a male doctor.

Good luck and I hope it all goes well, whatever you decide.

Take care,

Maryanne

[Carole Cross]

Rianna, you don't have to see your GP dressed, the first time I spoke to my doctor about it I was dressed as male. I was then advised to see a counsellor and I was not dressed for the first few visits with her, I was only dressed for the last 2 visits, then when I saw my GP again, I went dressed. You don't need to go dressed, just dress in what makes you feel comfortable until you are ready to go dressed. I don't even think it is necessary to go dressed for your first GIC appointment, although most people do.

[Sheila]

Rianna, when we first approached our GP re Debs he was dressed as him, when we were referred to the psychiatrist for further help, Debs saw her twice and neither times was dressed as Debs, we did take some pictures of Debs on her phone that we showed her, on our second visit we did take some printed pictures of her dressed, both indoors and out and about.After the second session, she was referred to Charing Cross GIC, and we are now awaiting our first appointment

Debs had previously been to see a clinical psychologist some years previously for different issues, her gender identity was touched on in those sessions, but no further action was deemed required at that time ..........


Hope this helps

Elizabeth great idea for the thread

[Rianna Humble]

I have made an appointment with the recommended doctor in 10 days time. Hopefully, that will be my first full step towards being able to transition. I will be happy to share how it goes.

In the end, I wore men's trousers & jacket over my clothes with my new heels, so a sort of compromise on the dress aspect.

I wasn't quite sure how to begin, so I gave her a very abridged overview but stressed that this is a situation that has now become intolerable for me.

I mentioned that, thanks to colleagues, I am now able to dress at work on three days of the week, but that every time I have to switch back, I get this gut-wrenching feeling. I also told her that I feel that I am living a sham whenever I have to put on male clothing.

Dr Hill listened very sympathetically to what I told her then admitted that she hasn't much experience with Gender Dysphoria but said she was willing to undertake the journey with me. She also said that she realised it "took a lot of guts to talk to someone you don't know about this".

She asked what I wanted to get out of my visit to her today. I told her that I probably needed to start with counselling but my aim was referral to a Gender Identity Clinic such as Charing Cross and ultimately to become the woman that I know I really am.

Dr Hill is going to contact someone in Brighton (which happens to be where I work) who has more specialist knowledge of the sort of counselling I might need than the local mental health hospital a few miles from my home. The
colleague is also specialised in PsychoSexual problems, so I took the opportunity to stress that this is not a sexual thing in my case.

She will call me when she hears back from the colleague in Brighton and we will meet up again in about 3 weeks to discuss the next steps. I am more sure than ever that I am doing the right thing and that Dr Hill is the right person to help me.

Thank you all for your advice, I'm sure I will need more in the coming weeks and months.

[Rianna Humble]

I've just received an appointment at the outpatients of my local NHS Mental Health trust and don't know what to expect. I'm excited and apprehensive at the same time.

Can anyone enlighten me?

[Kieron Andrew]

I've just received an appointment at the outpatients of my local NHS Mental Health trust and don't know what to expect. I'm excited and apprehensive at the same time.

Can anyone enlighten me?

you'll just get asked very basic family history, also things like when did you realise you were different?, what clues made you realise you were different....it will be fine, just questions to see if you need more counselling or whether they feel they can refer you directly to a GIC, i had one appt with the local NHS psych and was referred straight away by him to charing cross, best of luck..when is your appointment?

[Kittie]

A few months ago a took the first step to try and get on the transition bus. I went to my GP and explained that I believe I am TS and want to be put on hormones, which resulted in me being referred to a consultant at an outpatient clinic. Here I tried to explain my feelings in more depth and I was diagnosed with gender dysphoria. I was then told she will apply for funding for me to have an assessment at Charing Cross. I recieved a letter this morning and I now have another appointment at the same outpatient clinic, can anyone give me any ideas what this will be for? I didn't think I would need to go back. Because I'm so insecure I'm worried that there is going to be bad news or something...

[Shelly Preston]

NHS Scotland

There are basically 4 main consultants in Scotland, who handle anyone with Gender Dysphoria.

The clinics are based in :-
( NHS Highlands), (NHS Grampian), (NHS Lothian) and (NHS Greater Glasgow & Clyde (Sandyford Clinic))



Only the Sandyford Clinic will take self referrals, whilst the others work through the General Practitioners.

This is not ideal for some who only need advice. but have no wish to alert their G.P.’s, however that is the current system. Should anyone be taken into any programme under the control of the above,

Then they will advise the person’s G.P. as the G.P. is the person responsible for the patients welfare. Hormones are issued by the G.P. under approval from the consultant, so at some point the person needs their G.P.’s assistance.

There are currently new Gender Reassignment protocols being compiled by the NHS / Scottish Government, and self referral to all clinics is part of the review.

Anyone in Scotland can refer to the Sandyford clinic, and distance is no longer a barrier.
I believe Sandyford are now allowed to take self referrals from some areas in Northern England, which is a recent policy change

If any one needs the name of a particular consultant for an area, please send me a pm.

[Carole Cross]

Unfortunately it seems that most PCTs are still referring patients to Charing Cross and not using clinics that are nearer to them. I think the only way to change this is for patients to ask the PCT themselves although there is no guarantee that the PCT will agree to this.

[Nigella]

For those UK girls who are unsure of the way forward, here is my experience of the route I followed to get to the [size="2"]LEEDS GENDER IDENTITY CLINIC [/size] and their requirements:

Please note that a specific time frame has not been included as they will differ for each person

Visit my GP to discuss my transgenderism

GP refers me to a psychiatrist at the local Mental Health Unit, this is to ascertain there are no other issues affecting the way I was feeling.

Return to GP to discuss the results of the visit to psychiatrist.

GP applies to Primary Care Trust for funding. Funding may come from other sources due to changes to NHS funding going on within the NHS at present.

PCT approve funding and offer choice of 3 GICs LEEDS, Sheffield and Nottingham.

Appointment at LEEDS GIC for assessment.

Requirement by GIC - Initial meeting with Gender Specialist and Clinical Nurse Specialist to discuss GIC requirements and my expectations. Up to 5 further meetings with Clinical Nurse Specialist, with a minimum of 3 meetings. Final meeting with Gender Specialist and Clinical Nurse Specialist to discuss diagnosis.
PLEASE NOTE it is only at this point that an official diagnosis of GID is made. Up to this point LEEDS GIC are only assessing you.

After diagnosis the care pathway you will follow will depend upon your own circumstances.

My own experience, provided evidence of living in "role" and further meetings with Clinical Nurse Specialist while waiting for appointment with Endocrinologist. This was a quick route because I had been living as Nigella for 5 years before seeking any "medical" assistance.



Other UK based members, please add your understanding of the process for the GIC you have used. It is hopefull to build a picture of the basic requirements for each PCT/GIC within the UK. If there are sufficient replies, it may be possible to create a sticky with all the information to help those who come after us.

[Rianna Humble]

All of a sudden, 48 weeks has come down to just over 3 and the time for my first appointment at Charing Cross GIC is nearly upon me. At the moment, I'm swinging between elation at the thought that the waiting is nearly over and dread of what is going to happen.

Although I am now 10 month into my RLE, I still haven't made any real progress with my voice.

I really don't know what to expect from this first appointment, can anyone put my mind at rest or at least give me some pointers for what to expect?

What sort of preparation shoud I do for this first appointment?

[Carole Cross]

You don't need any preparation for the appointment, just arrive there on time and have any paperwork you may need such as deed poll, NHS number and letter from your employer as to when you went full time at work as a female employee. Don't worry about your voice or any mannerisms, they are not there to judge you on those just be honest to any questions they ask. You will be fine.

[susiepaul]

Here is a useful link which the department of health issued for guidance for our GP's, it is a good place to start.

Guidance for GPs, other clinicians and health professionals on the care of gender variant people

Thanks for including this thread Karen I'm sure it will soon become very popular.

Hi Elizabeth i dont know what i am doing wrong but i cannot view the file in any way for me there is no link to the actual file (i think i must be a bit thick) it sounds like something i could do with reading.

regards Paulie

[Rianna Humble]

Here is a useful link which the department of health issued for guidance for our GP's, it is a good place to start.

Guidance for GPs, other clinicians and health professionals on the care of gender variant people

Hi Elizabeth i dont know what i am doing wrong but i cannot view the file in any way for me there is no link to the actual file (i think i must be a bit thick) it sounds like something i could do with reading.

Hi Paulie,

No you're not thick and you're not doing anything wrong. The government removed the file ostensibly to review it and has not put it back.

Fortunately, the report was co-authored by the Gender Identity Research and Education Society who have included the original version with a number of other NHS booklets on this page of their website

[johanna.kitten]

After now completing my two years RLE...

Deborah, just out of curiosity. How is the RLE decumented and proven? I've now lived as Johanna since some 8 months and I'm on HRT since +6. I do my
best to document it all by all methods I can find. Problem is that I move counties at times...

I hope it all goes your way, two years is a long time if you ask me.

Hugs
/Johanna

[Serana]

Deborah, just out of curiosity. How is the RLE decumented and proven?

It's pretty much as Deborah said, for me as uni student I took in things like acceptance letters, ways to prove that your RLE is in a profession and such to show that you're full-time.
Things like HRT are documented by clinics themselves from what I'm aware of, as it has to be prescribed only from my GIC, and I think most GICs want to be controlling the hormones to say you've started through them.

It's mainly just a matter of paperwork, and pulling as much as you can from places.
Documents that can help can be deedpoll, bank letter/utilities bills in the new name, employer papers for proof of name change, or school/college/uni letters in cases of students who aren't working.

I realise this is a rather late reply, but I'm sure something like this may come in handy for anyone flicking through the forum with similar questions ^^;

Seri-chan~

[Carole Cross]

I have reached the stage of where I should be able to get a surgery refferal after my next appointment in July. I started living full time 12th April 2010 but officially it didnt start until May 3rd, the date from whem my employer changed my records to female. I haven't seen a question like that on Roses so may ask them myself in due course.

Sunderland gender clinic is a joke as been on waiting list for nearly 11 months and still waiting. It's only people's live there playing with. I hope when do get in living as female for year will help speed things along.

If you don't have an appointment date it may be worth giving them a ring to check that you are still on their system. I would urge all who are going through the NHS route to be proactive and chase things up yourself if you need to, don't rely on the NHS to do everthing for you.

[Nigella]

This may not be the right thread for this, but as it is only relevant to the UK, I think it is the best place.

A new UK law will come into effect in October 2010 which makes a lot of major changes for TRANSEXUALS, please note this does not affect TRANSVESTITES.

This link from ACAS, gives a breakdown of the major changes.

The biggest change that I have seen is that there is no longer a requirement for a person who is living in the gender that is opposite to their birth gender, to be under medical supervision to be classed as Transgender by definintion.

Anyway have a look, hope it helps some of you

[Kieron Andrew]

please note this does not affect TRANSVESTITES.

Actually in a way it does, i sat in on the talk Stephen Whittle gave about the new law at Sparkle, and it protects TS, TV and partners from harrassment, because the new law says that for TRANSGENDER people (covering ALL) if someone verbally says they INTEND to transition in the FUTURE (whether they actually do or not)...they are instantly covered by the law both at home or at work...they don't even have to follow through with that transition straightway...it is the INTENT to transition that covers ALL Transgender people in this law as long as they say it to someone that they INTEND to transition....also partners and family members of trans people are also covered by the harrassment laws for home, work, goods and services by 'association' of being a partner/friend of a trans person

*note i have bolded words because this is to show the wording of the law as it is now*

Stephen did state that Press For Change is working on changing the law even more so that words Gender Ressignment and Transsexual are scrapped completely to cover all Trans People transitioning or not regardless, but im sure this is some time away, but for now it is a huge step for all trans people in the UK

[Nigella]

Unfortunately Kieron, the UK law does not specifically cover transvestites. Some aspects of the new laws can cover transvestites, but only in the same way it would cover a number of other groups.

Our politicians consider transvestism to be a lifestyle choice, which means they will not legislate specifically for them.

The link I put up was from the ACAS site which advises employers. As a last point, until the new law is challenged in the courts it is nothing more than a piece of legislation. The courts make rulings on individual cases which can and sometimes do change the specific wording/meaning of the original legislation, this is called case law.

[Rianna Humble]

HM Government has published guidance that helps to interpret the intent of the act, in there we can read:

Section 7: Gender reassignment
Effect
41. This section defines the protected characteristic of gender reassignment for the purposes of the Act as where a person has proposed, started or completed a process to change his or her sex. A transsexual person has the protected characteristic of gender reassignment.

42. The section also explains that a reference to people who have or share the common characteristic of gender reassignment is a reference to all transsexual people. A woman making the transition to being a man and a man making the transition to being a woman both share the characteristic of gender reassignment, as does a person who has only just started out on the process of changing his or her sex and a person who has completed the process.

The examples imply that a person has to have started to live their life in the opposite gender to come under the protection of this Act, but no longer needs to have sought medical help.

From this guidance, I think it is clear that a Cross-dresser or Transvestite does not have (in the words of the Act) "the protected characteristic of gender reassignment" since they have not begun living their life in a new gender.

[Sarah Ellis]

I've not posted here in a while. But some of you may know my story in full. But basically to summarize, that after years of depression and courses of counseling by a psychologist, I eventually told my GP of my gender issues. She then referred me to another psychologist whom I told exactly what I had told my GP. I was then referred to the Cherry Knowles Hospital where I still await a reply from them for a date to see someone. Although they did confirm earlier this year that I am on their list.

They did say it could take around 4-6 months though. But the likelihood is that it may well be longer. I will be trying to chase it up though by the end of next month if I still hear nothing.