Questions & Issues for NHS/United Kingdom Members

[Serana]

Well today I just found out that my PCT are apparently not prepared to pay for the costs of laser hair removal. After finding out this decision was made months ago and I wasn't informed, I am a little frustrated and worried.

Is there a way to appeal this, and is there any point appealing this decision? Being a student, saving up for my own op -AND- paying for LHR is pretty much impossible. I'm a bit worried, though I have my clinic appointment, was just looking for some advice that might help me.

Thanks all.

[Nigella]

PCTs consider hair removal to be a cosmetic procedure and they will not pay for cosmetics. Having said that, depending on your GIC, they could put a case forward, if they consider it is essential to your "treatment". Try discussing it at your next appointment.

[Rianna Humble]

The other problem you might face even if you do appeal is that PCTs are being wound up and replaced by local commissioning groups who will have much smaller budgets because they cover a smaller area than the PCT, so your appeal could get lost in the changeover. On the other hand, you might get lucky with the new body, who knows?

[Serana]

Thanks. I didn't know about these local commissioning groups before. I'm wondering if that might indeed pose a problem.

Would perhaps be then the best route to just appeal, but expect a worst case scenario and look into paying for it from my own pocket perhaps? It's not that I can't, it's more that it would possibly hinder other things like paying for the SRS Op and such. It might slow it down at worst, but having to shave every day still after this long is still one of those rather sobering reminders of what I'm having to go through and what lies ahead. Not having to would make life easier. And the stress is enough to drive me insane, lol.

Again, thanks for the advice. If perhaps you could provide some more, that would be helpful

[Rianna Humble]

I'm unclear why you want to pay to go private for the surgery - that much is provided on the NHS by top rated surgeons

[Serana]

Because the NHS are terrible as it is. They cant seem to get even this much "right" when its very important to someone that it's ona proper process. I also don't like the idea of being bound by someone else's agenda, especially when they cant make promises.

I've also heard enough stories about the NHS and enough experiences of lack of ability myself to feel that something -this- important, namely the operation isn't safe in their hands.

I want to choosemny own times too, as being in uni tightens time that I have for something so important.

I don't trust the healthcare they offer, and I feel them denying paying for LHR just serves to make me feel even more estranged from them as a helpful service, and more a service based on their own ideals and their own decisions, not what is best for the people who use their service, their patients who jump through a million hoops just to slap those same patients after.

[Babeba]

Why aren't you willing to skip a semester at uni? Why the tight timeline? Is it to do with a scholarship?

[Serana]

Why aren't you willing to skip a semester at uni? Why the tight timeline? Is it to do with a scholarship?

It's to do with the fact that I'll be more than likely entering my final year of university at the time, and so I'll be writing up a rather hefty dissertation that culd make or break the degree that I get, and affect my eligibility to go to Portugal the following year to do a Master's Degree in Lisbon. So really it's more a matter of trying to get everything timed right.

Funnily enough, my specialist said they wouldn't do the First Opinion until next July, when I'm a full year into the hormones. But in fact she was wrong. My first opinion appointment has already been booked for February and hopefully will be able to push to get my second opinion done by June/July.

I suppose I'm not sure which comes first to me sometimes; my academia or my physical gender. I am trying to in some way create a little 'perfect world' where everything works out for me . And you never know, it's certainly possible.

So the tight timeline would be because of my dissertation, and one does not simple skip a dissertation and expect to come out with a 2:1 or better. You'd be lucky for a Third. There's no scholarships though, which is such a shame, lol as I very nearly qualified for one. XD Would have made financing my life that little bit easier.

[Babeba]

Without a dissertation in the UK you get a degree that isn't an Honours, so is automatically a wonky form of Third, if I recall correctly.

I also recall, though, that a friend of mine who did her master's at the same time as me (at Leics.) had to put off her dissertation due to stress/life/someone trying to burn down her family farm. She completed it for the next round of grading, and got a Distinction. There were others whose first language was not English who took extra time as well. Have you talked to your department about it at all? Telling them that there is a chance you may be scheduled for surgery by the NHS around that time, to see what they would say about it?

Also, TRUST me: the world will not end if you take a year or half a year break between degrees, especially if you do something with your time between like volunteer, Intern, get relevant work experience, or spend time as a research assistant to a prof.

I don't know what program you are looking at in Lisbon, and it may be perfect - but I can guarantee it won't be the only one of its type in the world. There will be others as well, so don't give up hope on applying if life doesn't end up fitting in a tidy little box.

If I were in your boots, I would think about letting the chips with the NHS fall where they may. Surgery is expensive, you're not the only person on their lists, and paying privately doesn't necessarily guarantee that you will have absolutely perfect timing, either.

[Serana]

Right, well, I did type a reply, but then my session timed out. SO here's the new, not-so-awesome one:

I agree with what you're saying on some things, Babeba, but I don't agree with you saying to see where the chips fall with the NHS, because I believe that's a rather... lax way to be about this. In the last 2+ years I have been researching into these things, I feel I have been able to make a very well informed decision to look abroad. There are things I'm willing to negotiate on, but there are some things, like where I should get my operation, that I am not prepared to.

I personally believe that if it's in my power to pay for the operation, then I should do so, and let someone else have that spot that can't afford to. Yes it's a lot of money, but if I can do that, I feel I'm helping two people that way instead. Call it a feeling of public service. Though I have never really been a big fan of the NHS for a long time, for a lot of reasons. Things from when I was younger, and things in the family etc. The NHS has shown on many times it only cares about being able to look after its funding, than its patients.

As to Portugal, I have a rather close friend there I want to spend more time with, and having recently visited him in June, and visiting again in December, I feel that it's a country I prefer over the UK. I even have plans to move there properly after my Master's degree. Another reason I won't go with the NHS? I won't take so much of their funding from them if I wish to leave that country. It just seems morally wrong. I've been constantly battled by the NHS on issues they should be helping me with. Their recent idea to not support Laser Hair Removal for me has frustrated me, as people can see if there's something on my face. But they can't see what's inside my clothes. It's a rather frustrating feeling for me when I have to battle with the people that are meant to be helping me. 600~800£ IMO, having contributed to NI and such, would be ok to take from them. But the cost of a full surgery and a bed for X nights just seems morally selfish.

As to academia, it's important to me to get a good degree, and I have worked hard to stay a good student, and a smart one, not having so far had any issues with the university, or any extenuating circumstances, means if I really have to take time out for my operation, I -will- have that possibility. Besides, my dissertation is on computer networks probably, so it's something I could do even if bed ridden. So that is little concern for me.
I do however feel that ending up with a wonky third would make things in the Job Market difficult. I want that Honours to increase chances in the job market and in it also helps really well for getting into Master Degree courses. I suppose in some ways most are right that I don't think about myself as much as I should and can be a little obsessive over my operation and my degree, but they are rather important to me.

I do agree with the idea of maybe taking a break between degrees though, as that might give me a chance to prepare my life for moving to a new country etc. But I would not wait that long for my surgery unless I fewlt my dissertation really had to.

I know medical reasons can be a rather power phrase for a lot of things, so I can also understand getting some time out in the first couple weeks or so in my final year would easily be possible.

Anyway, the most important part is the NHS bit. I'm -not- prepared to go with the NHS for surgery, private surgery gives enough convenience of things like timing, and not having to wait on someone else's time. It's a convenience I am -more- than prepared to pay for. It has also been a really good way to truly appreciate the value of money in the real world these days, with the economical climate being so rickety. I don't trust the NHS as far as I could throw them, and I think it's life experience that helped me to come to feel that.

However, Babeba, I do appreciate your advice, and am thankful for it. I suppose you could say you've given me some food for thought in some areas, and that's useful for me. So thank you very much, and I'm glad you gave me thoughts i can consider for when dealing with timing in certain things.

[Babeba]

It's refreshing to see someone who doesn't feel entitled to milk the system and get out of the country. :-) I definitely see where you are coming from. On the other hand, if it were surgery for a cleft palate or some other expensive - to- fix condition you were born with, would you be as concerned about taking money from the system?

Also - please don't underestimate the stress and research involved with writing a dissertation! You'll want your full wits about you at the time. You may even want to (gasp) take out a heavy book or two from the library to read and add in as sources, such as the work Marshall McLuhan did on how the medium is the message and how that affects the use of computer networks. Computer science profs seem to love that one!

At any rate, having a tired, healing body and being at your academic peak may be a bit difficult together.

[Rianna Humble]

Best to get the end of year festivities out of the way. Good luck!

I won't be jealous, I won't I won't!

[johanna.kitten]

Setting off to CXH in the next hour for my pre-op assessment - it would normally be six weeks before the op but a little thing called Christmas gets in the way.

Nervous but excited!!

Fantastic news, keep us posted please.

Hugs
/Giovanna - (31st of Dec 2012)

[waasup008]

So am I right in saying you speak to your GP? (Do GP's generally know anything about this or do I need to take some literature from the NHS website with me)?
GP's are bound by what you tell them being in confidence?

I've heard there is a ruling or something along the lines of you must present in the transition gender before they will prescribe hormones... is this the case? what if you don't feel you can present in public until you are on hormones.... Confused.com!

Also taking hormones, does this mean they expect you to make a full transition or do people take them just to be more feminine?

Apologies for my naivety!

[Rianna Humble]

Yes, to get the ball rolling, you need to talk to a GP. It can't hurt to have some stuff printed off from NHS web sites, but it is not mandatory. Patient confidentiality applies in all of your dealings with your GP so yes a visit to discuss Gender Dysphoria is equally protected.

Your GP will then refer you to a local Mental Health practitioner (still in confidence) who will screen you for mental health issues that may need to be taken into consideration whilst treating your Gender Dysphoria.

After that, your GP will be able to refer you to the nearest Gender Identity Clinic (in your case Charing Cross) but be prepared to wait quite a while for your first appointment.

In the Charing Cross Gender Identity Clinic FAQ, you can see

Do I have to dress/act a certain way?

No. Everyone is different. Dress and act as you feel most comfortable. This is a safe space and anything that people generally wear in public is fine.

I may have misunderstood your last question, but normally HRT will be prescribed by the GIC only if they feel it will help you to manage your Gender Dysphoria. In many cases this will be through transition.

[waasup008]

Yes, to get the ball rolling, you need to talk to a GP. It can't hurt to have some stuff printed off from NHS web sites, but it is not mandatory. Patient confidentiality applies in all of your dealings with your GP so yes a visit to discuss Gender Dysphoria is equally protected.

Your GP will then refer you to a local Mental Health practitioner (still in confidence) who will screen you for mental health issues that may need to be taken into consideration whilst treating your Gender Dysphoria.

After that, your GP will be able to refer you to the nearest Gender Identity Clinic (in your case Charing Cross) but be prepared to wait quite a while for your first appointment.

In the Charing Cross Gender Identity Clinic FAQ, you can see


I may have misunderstood your last question, but normally HRT will be prescribed by the GIC only if they feel it will help you to manage your Gender Dysphoria. In many cases this will be through transition.

Thanks, that really clarifies things, and that is a really good site ty

[Samantha171]

Yay! I went to see the GP the other week and now he has sent a letter for my referral to the local mental health team!
Thank you Rianna for your help, I'm really feeling optimistic about all of this now I've finally started!

My GP did say he didn't know how long it would take for me to get my first appointment with the mental health team though. Does anyone have any ideas on how long this should take?

[Rianna Humble]

Hi Samantha, I'm glad that I was able to be helpful. Congratulations on getting that first step under your belt.

I can only speak for my own experience, I think my mental health appointment was about 5 weeks after the initial referral, but your mileage may vary.

The wheels of the NHS grind exceedingly slow sometimes, but they do get there in the end.

I hope you will keep us informed of how you get on.

[SweetNikki]

Hi Everyone

Well today's the day I have my first doctors appointment this afternoon. Managed to be seeing a gender specialist who has dealt with Transsexual & Transgender people so i feel real good today. Will be fully dressed as i have bin full time now for 8 weeks & i couldnt go back anyway i would feel ill not what i want to go to the doctor's for.

I will put up how it goes later but my journey will begin today & it feels good ..

[Rianna Humble]

I'm sure it went well. Hang in there!

[SweetNikki]

Thanks Rianna

Yes everything went great after telling all & answering questions i have been referred to Mental Health clinic in Swansea . I was warned though that the NHS wheels turn slow due to cut backs but will be in hope of not to long.

I did have one Laugh though my wife came with me ( She is so fantastic & supportive i feel very luck after what i have been reading lately) When my name came up on the screen & we both walked into the doctors room together the Dr looked at both of us & said " Which one is the patient then" Wow did it make me feel relaxed & feel great lol..

[Katelyn B]

I asked my Dr for a referral on the 19th November last year and had the appointment on the 4th December. AFAIK it depends on the mental health trust and how busy they are, but the Psych told me that their are targets for seeing people which is why it was rather quick. Subsequently, I know CX have received her referral for me and that they have now in turn applied for funding to my PCT, so just waiting for that to go through before the 6+ month wait for the first appointment arrives. If I hadn't started going private last year the timings would have driven me mad by now.

[johanna.kitten]

Finally got my GP to refer me to a psychiatrist that now referred me to Nottingham Gender Clinic. No date set yet. Too bad I missed out on attending CHX last summer. I'd prefer CHX as I am only temporarily based in Leicester and heading back to London asap.

Hugs
/Giovanna

[Serana]

Oh, forgot to ask about this;

Are there any places that do private second opinions in the UK? I don't think I'll be able to get it from teh NHS in time for when I want to have the OP, so I'm thinking of paying for it.

Anybody know of any and what prices are associated with that?

[Rianna Humble]

There are a number of private Gender Identity Practices in the UK, but I don't know how many would want to give a second opinion to an NHS doctor's first opinion.

I don't recall the names, but you can find them via Google or possibly via the Gender Trust web site. Any further information would in any case be off topic for this thread.