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Thread: Questions & Issues for NHS/United Kingdom Members

  1. #101
    What is normal anyway? Rianna Humble's Avatar
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    Quote Originally Posted by susiepaul View Post
    Quote Originally Posted by Elizabeth 66 View Post
    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
    Last edited by Rianna Humble; 05-21-2012 at 12:36 AM. Reason: mistake about version & new link
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  2. #102
    Member johanna.kitten's Avatar
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    Quote Originally Posted by Deborah_UK View Post
    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.

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  3. #103
    Just an average girl Carole Cross's Avatar
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    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.

    Quote Originally Posted by Playboy Zoe View Post
    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.
    Last edited by Nigella; 06-22-2012 at 12:09 PM. Reason: merged posts
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  4. #104
    "Oh god it's her." Serana's Avatar
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    Quote Originally Posted by johanna.kitten View Post
    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~

  5. #105
    Member johanna.kitten's Avatar
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    Ah, good thing I signed up with this gym today using my female name then - it all adds up I guess. Also Boots and Nectar cards are already sorted. Saturday I dealt with Centurion and the people at Lloyds TSB Offshore with less luck. There must be a way to deal with all of them in one go?!

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  6. #106
    "Oh god it's her." Serana's Avatar
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    Well, I've got a question so I'll put it up here after all.
    My plan is to get surgery after I've been on 12 months prescribed hormones with my GIC (which will be next July), and I noted in their leaflet, riiiight at the top (http://www.leedspft.nhs.uk/_document...zbOphZOEVmy5x3 the leaflet in question) it says they won't do surgery until after 18 months of continued use through them.

    However, I'm planning to go and have my operation elsewhere, and under the SOC it states 12 months, not 18. Does anybody have any experience or issues with GICs that are saying you must be 18 months before getting referrals from them? From what I'm aware I moved down the pathway pretty quickly and without many issues, but I'm a bit in wonder as to whether or not they'll make me wait those extra 6 months or not.

    As a uni student, I'll be on my holidays before starting my third year at the planned time I'd like for surgery, so right before my dissertation, which I know that I need to concentrate on and not be running around with surgeries and stuff, so the preference is to do it before the start, next July or August. I was wondering if anyone had any experience about this and perhaps might be able to lend some advice about this issue, and if the NHS/GIC should respect the SOC if in such case I want surgery abroad and not by their own system?

    Thanks,
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  7. #107
    What is normal anyway? Rianna Humble's Avatar
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    The WPATH Standards are guidelines and are not binding upon the NHS which has its own set of best practice guidelines.

    It is stated in many places that should you choose to go private with part of your treatment the NHS will not oppose it, but neither will they fund it.
    Check out this link if you are wondering about joining Safe Haven.

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  8. #108
    "Oh god it's her." Serana's Avatar
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    Quote Originally Posted by Rianna Humble View Post
    The WPATH Standards are guidelines and are not binding upon the NHS which has its own set of best practice guidelines.

    It is stated in many places that should you choose to go private with part of your treatment the NHS will not oppose it, but neither will they fund it.

    Apparently, this isn't true anymore. I was at my GIC today, and I mentioned my intentions for surgery abroad, and how I want to do it just as my HRT hits one year monitoring and prescribed. Apparently, Leeds GIC now follows WPATH standards and they aren't sure if they can get the letters of opinion until 2 years RLE and 18 months HRT! That's like, The January of my third year, when I'm doing my dissertation.

    I've spoken with them and said if we can look at it on a case by case basis, but it left me perhaps with more questions.

    I suppose I wonder now, is there any reasons why, if I'm getting SRS in another country, that I should have to follow the GICs guidelines for surgery, or if they should adopt the guidelines that specific surgeon is using? I mean, personally, I feel the latter would make sense, as their 'case path' stops before then, meaning that they're guidelines are no longer a legitimate basis on which to make decisions?

    Anybody have any ideas? I really do NOT want to be getting SRS while I'm in the middle of doing my dissertation, I'm not sure which is more important in some ways.

    Perhaps is there someone who has experienced this same issue before? It's really frustrating to think they would go and follow WPATH when it seems more an obstacle to the transcommunity than an aid. Just my personal thoughts anyway.

  9. #109
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    As Rianna has said WPATH is a set of minimum standards that all those dealing with the TG community are expected to follow. I attend the Leeds GIC, have been on their care pathway for a couple of years now.

    Each individual case is based on its own merits. There is no one size fits all, the only thing I can say is you need to discuss this with your clinical specialist at Leeds, let them know your intentions. I do know that surgery is 99/100 with a UK based surgeon.

    One point to remember is that the funding for your "treatment" does not come from Leeds GIC, it comes from your own Primary Care Trust, if you have taken the NHS route. The PCT are the ones who decide what will/will not be paid for. Usually this is anything that is considered to be working towards the mental and physical well being of the patient.

    I don't know where you get your information from regarding guidelines for surgery, but the surgeon does not come into it until you have been referred to one. The GIC care pathway does not end until after surgery, I was told that there is further appointments available after surgery if the need arises. As for having surgery in the middle of your dissertation, you do have a choice of when to take it, once you have your referral, discuss the timing with the surgeon.

    I think wires may have been crossed somewhere.
    Last edited by Nigella; 08-14-2012 at 02:20 PM.
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  10. #110
    "Oh god it's her." Serana's Avatar
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    Let me add to this.

    I'm planning on not asking the NHS for the operation here, as I have plans to go Thailand. The surgeon there on the website says 12 months HRT and 12 months RLE. I mentioned this to the specialist I'm saying and was told that they followed WPATH and that it could be complicated. I've een continuously mentioning my plans to go elsewhere for surgery since the day I walked in there, so I don't think it's a lack of them knowing.

    However, for some reason, they seem to feel the need to keep telling me that a lot of people end up going by the NHS, even if they plan otherwise. Now I don't know if it's ignorance or trying to keep me forewarned, but I have also been bounced over from one specialist, to another, and now to another. Annoying. I'm wondering if this is why there is a problem perhaps. I just feel like I'm not persuading them to see it from my side just yet.

    As opposed to what you've said, and as to my guidelines, I've been mainly reading from Harry Benjamin 'guidelines'. What my issue here is they're saying I have to follow their route when I'm going to a surgeon with different procedure. As in, different times requested for HRT and RLE. I don't need a referral in the since of getting the surgeon involved, I'm trying to bridge the gap between NHS and my surgeon of choice.

    I also find it funny how you say I have a choice for timing, when there's a yes and no behind that. One of Dr. Suporn's papers that he wrote on teh matter says two years on hormones is about he best time, so I'm trying to work it a closely as possible to two years. If I end up having to wait until getting a pair of referrals during my time doing my dissertation, then I'll have to wait even longer, and it'll end up being about 2 years and 8/9 months on HRT. Besides it being inconvenient, it also means I'll not be very happy, and the disappointment in the way the NHS will have been may even effect my academic standing. But this is besides the point.

    What I'm asking for is advice that may perhaps persuade them, not to be told things that I already know. I don't mean to be rude, but if I didn't know -that- stuff, then I wouldn't even feel I deserved to see anyone about it. I try to keep clued up the things that involve me and my life, after all. Common sense~.

    Seri-chan~

    P.S. yes wires were crossed, mainly because I failed to add info I'd said in a different thread and totally forgot to add it.
    P.P.S I see Harry Benjamin's SOC is WPATH, because WPATH is the old SOC, just made worse. Not sure I'm happy that they're fiddling about and making it longer. Seems odd to me they'd do that. Actually, that's bloody frustrating. :/
    P.P.P.S I've just read the WPATH gudelines, and it seems it's still 12 months as far as WPATH are converned. SO why is my GIC saying 18 months? And claiming to be following WPATH. Thoughts ideas anyone?
    Last edited by Serana; 08-17-2012 at 05:04 PM. Reason: For the love of...

  11. #111
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    Why the Hoo Haa then? It is irrelevant on what you are told by Leeds GIC if you intend to have surgery privately, the surgeon, in your own words, the surgeon there on the website says 12 months HRT and 12 months RLE.
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  12. #112
    "Oh god it's her." Serana's Avatar
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    Well the "Hoo Haa" stems from the fact that I'm seeing a publicly funded GIC that are meant to be doing my referrals and have different protocols.

    I think perhaps what's not being thought about is how communication with a 'middle man' can get pretty difficult, and I'm acting exactly as that by talking between surgeon and GIC.

    Beside that bit, I'm asking if anybody has come up against the GIC with this same issue and ever been able to tailor their needs to fir to the doctor's timelines and not theirs? THAT is what I'm asking.

    I feel Deborah may have a point, that the private route may be the only immediate option, but then it would quite possibly end up taking even longer at this stage, so that is something I'd not be prepared to do (nor my bank account would be prepared to do it! XD) so I have no choice but to try and find a way to see if the GIC in Leeds will work around what I'm asking. I'm merely stating that simple fact, but I can't go by the surgeon's needs because I need letters of referral. And letters of referral come from said GIC.

    GIC = Letters
    Surgeon needs said letters.
    GIC = 18 months HRT and 24 RLE
    Surgeon = 12 months HRT and 12 RLE
    Sera = Can't afford private doctor/GIC, needs to persuade NHS GIC

    ^ That is my problem.

    Seri-chan~
    Last edited by Serana; 08-19-2012 at 03:51 PM. Reason: 'tard moment.

  13. #113
    Member johanna.kitten's Avatar
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    Quote Originally Posted by Deborah_UK View Post
    I'm not one to start a thread about my surgery date, I'm not fussed with all the congratulatory words so thought I'd hide it away on here cos wanted to share a bit! Yes I've got my date for surgery!

    4th Feb next year at CXH --- scared but happy!!!!!
    Sooo envious - I recently moved houses and now struggle with getting my HRT from the NHS with new GP and all...

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  14. #114
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    Congrats Debs bet you have a chuff chart now
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  15. #115
    Member johanna.kitten's Avatar
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    Now it was my hopes that the NHS would take me more seriously now when I changed my name to my female name - but I still run into people there doing their best to deny me service. Well at least I got my name sorted and they are copied in.

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    /Giovanna - (now legally) Principessa Giovanna Del Nord
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  16. #116
    ADMINISTRATOR Sandra's Avatar
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    Maybe with such a grand name they don't think that you are serious.
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  17. #117
    Member johanna.kitten's Avatar
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    Quote Originally Posted by Sandra View Post
    Maybe with such a grand name they don't think that you are serious.
    Well, I am in the UK not all people here know Italian. I opted out from using Donatella as surname as I knew the one of the countries I have to change my name in won't let me have it. I still have to change my name in 4 countries and they all have different rules (pref. I need to change my name in 9 countries but I just can't be bothered).

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  18. #118
    Member johanna.kitten's Avatar
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    Hiya! 1) So at what stange in my transition can I go and sort out what I am (gender recognition panel)? Currently I'm (M2F TS) on HRT since +10 months and full-time since +4 months, changed my name to my female name about a month ago, and now only got to change my driver's license and passport.

    2) Perhaps not so much to do with the NHS but I'm looking for advice on my FFS, I've seen some roadmaps but none of them seem to be very good. Would the book "Facial Feminization Surgery" by Douglas Outserhout be of any help? I just lik to do things in the correct order to save time, like set it all up in some project management software.

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  19. #119
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    Hiya, I'd like to get started towards HRT but I'm not really sure what to do.
    Am i right in thinking that first I need to see my GP, who will then send me to a psychiatrist, who will then refer me to a GIC where I can start HRT?
    What do I say to the GP, do I just go in and tell them I'm trans and let them handle the rest or what?

  20. #120
    What is normal anyway? Rianna Humble's Avatar
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    Hi Samantha,

    In it's baldest sense that is exactly what you need to do. It can be a bit of a hurdle knowing how to start, but I found once I got going I couldn't stop.

    May I make a suggestion? In order to give yourself time to discuss this fully with your GP, it might be an idea to book a double appointment - that's what I did and I was glad of the extra time. You might also want to take some information with you about NHS options for transition - you can find some stuff on NHS Choices

    Your GP will refer you to your local Mental Health team so that hey can screen you for other undiagnosed conditions which might need to be taken into account or which might mimic Gender Dysphoria. This is not a "gatekeeper" situation, but a positive step to ensure that you get the most appropriate care.

    You will need at least two visits to the Gender Identity Clinic before they start prescribing Hormones - the 2nd visit is with a different doctor to ensure that the diagnosis is correct and the proposed treatment regime is the best one for you.
    Check out this link if you are wondering about joining Safe Haven.

    This above all: To thine own self be true, And it must follow, as the night the day, Thou canst not then be false to any

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  21. #121
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    Quote Originally Posted by Rianna Humble View Post
    Hi Samantha,

    You will need at least two visits to the Gender Identity Clinic before they start prescribing Hormones - the 2nd visit is with a different doctor to ensure that the diagnosis is correct and the proposed treatment regime is the best one for you.
    I agree with Rianna on most of her thread, however, this part will very much depend upon the Gender Identity Clinic you use. Leeds required up to 6 sessions before referral to an Endo for hormone therapy.
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  22. #122
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    Your GP will refer you to your local Mental Health team so that hey can screen you for other undiagnosed conditions which might need to be taken into account or which might mimic Gender Dysphoria. This is not a "gatekeeper" situation, but a positive step to ensure that you get the most appropriate care.
    Interesting... I might try this on my (understanding) GP - she passed on to me a letter from the psychiatrist in charge of said mental health team, saying they won't even talk to me unless I've already made my mind up to go full-time. I thought of putting it up in a frame actually.
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  23. #123
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    Unfortunately that maybe as a result of financial pressures being placed on the PCT, they who hold the purse strings
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  24. #124
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    Thanks Rianna.
    This might sound like a silly question, but what exactly do I discuss with the GP? Should I just go in, tell them I'm trans and that I'd like referral to the GIC and see where it goes from there? Basically, what should I expect the first appointment to be like?

  25. #125
    What is normal anyway? Rianna Humble's Avatar
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    I tell my customers that the only "silly question" is whether their question is too silly to ask, because if it concerns them then it is not too silly to ask.

    I told the GP a little about the feelings of discomfort with my gender and that I needed help to transition. I also told her in so many words "I would rather end my life as an ugly woman than spend 1 more day as a man"

    I let her refer me to the local Mental Health trust for screening, then took her some info on the Charing Cross Gender Identity Clinic
    Check out this link if you are wondering about joining Safe Haven.

    This above all: To thine own self be true, And it must follow, as the night the day, Thou canst not then be false to any

    Galileo said "You cannot teach a man anything" and they accuse ME of being sexist

    Never ascribe to malice that which can be easily explained by sheer stupidity

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