How long does it take for an appointment at UK Gender Clinics

[Melanie Moxon]

Oddly enough I wasn't asked either.

Is the waiting time really that long from getting a GP referral (assuming the GP is not qualified to deal with gender related issues) over here in the UK? I mean if I go to my GP in the not so distant future am I going to have to sit and wait for years before I get an appointment to see the appropriate medical practitioner? If so that worries me a tad because I want to move on with my life as soon as I can get out of home (I can start making plans as soon as my Mustang is sold and I have replaced it with something that will take my monthly fuel bills from £250 to circa £100), starting with getting rid of everything I can get away with that is male clothing.

[pamela7]

Hi Twisted Thunderbird,

While delays vary enormously by region here in the UK, I can tell you my own delays. There are no qualified GP's as such, and very few psychiatrists who sign off, and they are almost 100% inside the NHS or too busy to even reply. So, on going to see my GP for referral in Feb 2016, I waited until August 2017 for a first appointment at the SW gender clinic, and was then put into a "12 month" queue to meet the Dr to begin then a process of getting to sign-off, to then start the queue to wait for GRS. Luckily my GP started prescribing me hormones as of the first meeting in August.

Having said this, I think we are at "peak delay" due to 2015-16 being the time it became safer to come out in the UK, so a flood of closeted TS people came out of the woodwork as it were.

[Helen_Highwater]

One of the safety checks if you like built into the system is the time it takes. Having those who express a desire to trans live as females for extended periods helps identify those who are less determined and certain as to the course they wish to take. Those if you will who express their desire more as a passing whim than a real need to trans.

For me, and I appreciate for those desperate to trans the frustration encountered, having this wait gives time for real reflection. This is such a momentous move anyone undetaking it needs to be sure.

This is why I was surprised by one of those portrayed in the series who wouldn't go out dressed without first having facial feminisation surgery. If the goal is to trans, if you feel you're born the wrong gender, then I would think the desire to show the true you to the world would overcome those fears. I did wonder if that individual trod a line between fetish/CD'er and true gender dysphoria? But if someone's willing to pay then as we saw, a private clinic will oblige.

[pamela7]

Hi Helen,

I feel this depends on one's point of view. Really, the NHS has to do due diligence that an elective surgery is required for the psycho-emotional wellbeing of a patient. What I do not think they have to do, which is part of the bigger patriarchal problem, is to express excessive concerns over the risk of a person making a mistake and wanting to undo their transition. Frankly, an adult is to be held responsible for their actions.

The provision of quality therapeutic service is laughable, and if people do not have access to good process for themselves, the time is just wasted, and super-frustrating for those of us who are clear and just want to get on with it.

I feel the private clinic ought to have proposed the person does go out and face their fears first - yet another example of poor therapeutic service.

[Melanie Moxon]

I fully understand the safety aspects of the system and why the checks need to be in place, but 18 months for the appointment from referral is insane

[HelenR2]

There are a few things you can do to speed the process a little. Whenever you are asking for or being considered for an appointment you MUST stress that you are available, at short notice, to take advantage of any cancelled appointments. When you are waiting for blood test results or referrals, even from your own GP, you MUST chase these up yourself or you might find yourself waiting six months or longer for a letter that you were promised would be with you in a week! From my own personal experience I would say the most important thing you can do is show your commitment by going full-time as soon as you can, especially at work. Change your name on everything like your driving licence, credit cards etc. Showing the GIC that you are living as a woman 24/7 can, on it's own, knock a year off the delay in being prescribed hormones. Hair removal takes forever so start now.

[Melanie Moxon]

Thanks Helen, it is going to be a while yet as I need to move out of home first; though that time in between does give me more time to prepare and more time to make sure that what I feel I have to do is indeed the right thing to do, I'm done with suppressing 'me' but if I come out now as TS I will end up living in my car, or in a friends spare room until I can sell the car to pay for a deposit on a house. It also gives me time to grow my hair so I can ditch the wig!

I will be going full time as soon as I can after moving out; I have already begun reviewing the company policy on transgender issues and though its a laborious process (defence industry so the paperwork is considerable), thankfully there is a process in place and a 'diversity team' to offer guidance and support. The other thing I have to consider is my private pilot licence, this makes the name change is a little more complex for me as I need to make sure I get things done in the right order. Thankfully the CAA are supportive of transgender pilots so as long as I follow due process (and rightly so as flying even a light aircraft is not to be taken lightly) I will be fine in that regard.

[Shelly Preston]

To answer your question it kind on depends on where you live.

As far as I know there is only one clinic in the UK which allows you to refer yourself

This may quicken the process a little but they still have long waiting times.

[Teresa]

TwistedT.,

NHS or private they don't want to get it wrong , sadly the NHS is being stretched in so many directions GD issues may not be top of their list, you only have to look at the budgets for litigation and interpreters alone to get some idea .
I can't comment on the tie up between NHS and private but I don't believe a private clinic will take your money without some rigid guide lines , I believe the NHS has it right if only they had the budget to implement it .
I didn't have to wait very long to wait for a gender counsellor but then the budget was withdrawn and so was my full course .

I can't fault my GP he fully understood and did his part to the best of his ability taking into account of the NHS restrictions . If the private sector gets it wrong the NHS will have to pick up the pieces.

[Janice Ashton]

The NHS is presently under severe pressure coping with the volume of people wanting and awaiting access to Gender Identity Clinics (GIC) in the UK.
The amount of media and LGBTQ coverage on television and in the press over the last few years has highlighted the Gender subject of what it's like being 'Trans' Male to Female or Female to Male highlighting a lot of genuine and not so genuine cases of people wishing to gain access to the services of the NHS or Private Gender Clinics.
A recent television programme on the ITV Channel (Transformation Street) gave some sympathetic and empathetic coverage of what transpires if you decide to take the Private Clinic route, as for the process of taking the NHS route? You will find this is far more conservative because the NHS are not only under pressure from the volume of people wishing help, they also want to ensure you are making the appropriate decision regarding this life changing procedure.
Helen has provided some good advice and Pamela makes some valid points but I can tell you for definite that for me, from my first visit to my GP to final surgery which I had in September 2017 at the Nuffield Hospital Brighton, the process was five and a half years in waiting and lots of hoops to jump through along the way.
If you go private the medical process I am informed will be much quicker, but slower if you await the NHS. Who is the best option is your choice? All I can say personally, is I am glad I took my time with the NHS clinic and I am 100% sure I made the right decision in making my life changes.
So you have a choice yes, but for me the NHS is the best route by far, for however long it takes.
The waiting frustration is difficult to deal with I agree and the journey is long, but the NHS would be my recommendation.
You have a choice? Subject to finances? So take your time before you make your decision.
Best I can say on this subject hope it helps?

[pamela7]

wow, thankyou Janice, and that 5 1/2 years was before the big surge of demand hit - we could be talking 8 or more years now if the queue lengths have gone up as much as i've experienced here. Those surgeons in Brighton only have so much capacity.

[Kaitlyn Michele]

Hi Helen,

I feel this depends on one's point of view. Really, the NHS has to do due diligence that an elective surgery is required for the psycho-emotional wellbeing of a patient. What I do not think they have to do, which is part of the bigger patriarchal problem, is to express excessive concerns over the risk of a person making a mistake and wanting to undo their transition. Frankly, an adult is to be held responsible for their actions.

The provision of quality therapeutic service is laughable, and if people do not have access to good process for themselves, the time is just wasted, and super-frustrating for those of us who are clear and just want to get on with it.

I feel the private clinic ought to have proposed the person does go out and face their fears first - yet another example of poor therapeutic service.

this is an excellent rebuttal to the knee jerk response of people that do not understand what trans people go through. The base case should not be that a person presenting as trans or gender needs to go through a long process to prove it so that the very very few people that are not trans might be screwing up their lives.... personal responsibility ...and ive said this before gender dysphoria takes all forms...including "facial" and i personally know multiple people that well planned their transition and did FFS and came out of it "full time"....very good outcomes in all cases... for what its worth...i went full time three months before my FFS.... i actually did take the point of view that i needed to test myself one more time, but i really understand and relate to those that feel differently.... i also have a friend that got FFS then decided to not transition.....they decided they were gender queer, they LOVED their feminine face, their gender dysphoria went away totally and they are very very happy and successful....

[Janice Ashton]

As for Pamela's comments about the long waiting times I endured? I should just mention;

I know that the NHS are now shortening all their times for appointments (New policies from Oct 2017) and its lengthy procedures toward eventual surgery. I guess I was one of the old school so say? So don't take my time as todays norm.
But it should be realised that if you are accepted by the NHS you will still have to live the required 2 year Real Life Experience (RLE) as the gender you are choosing to change to and you will need to confirm change of name before surgery. So it may not be as long as I waited but still a considerable length of time. Whereas the private clinic route I believe is shorter.
A very good point again raised by Pamela and reiterated by Kaitlyn, these are good points to ponder as both have wide gender experience and knowledge providing valued comments.

[~Emma D~]

Hopefully the NHS will fund and resource things better in the coming years.
it can only help the mental health well being of so many people.

I've been thinking of speaking to my GP again but, I'm not comfortable with him.
That said, I have an appointment with a NHS Psychologist (non-Gender), later this year.
My GID has been discussed previously with the option of referral put to me.
I'll see how it goes in the coming months.

if I've learnt one thing in recent years, it's to never give up on the NHS.
It might not always seem to make sense, but Doctors, Surgeons, Counsellors etc, tend to have our best interests as their main focus.

[Teresa]

Emma,
I don't want to make this a total UK member NHS debate but I can't help thinking your wishful thinking is over optimistic . If things don't change I believe we will be more in private hands and having to pay for more services . The proposed changes to the 2021 national census concerning our community is intended to find what extra resources are required for us , there are no guarantees the money will be available .

As for GP response , I can't fault mine , sadly the Relate budget was blown and services cut back . I had to accept that but felt for younger couples who may have been in a greater need .

Janice,
So grateful for your story it really brings the whole situation into perspective , we do need that time to consider , I do feel the NHS has pitched it right even with the restraint of their budgets . We do have to accept we aren't priority cases when people are faced with life threatening illnesses .

One question , do the private sector still enforce a timescale , we do hear of cases where the NHS has had to pick up the tab to put things right .

[Janice Ashton]

Teresa,

Thank you for your comments, I understand that the NHS budget is very small in comparison with the many services the NHS provides in the UK and although Gender issues are now being given more priority this still remains under the constraints of budgetary restrictions.
The long waiting times may well reflect this and to the best of my knowledge the NHS does not have that many surgeons in the UK authorised to carry out Gender Realignment Surgery. Again I think this adds to waiting time.
The private medical sector will most obviously perform surgery at a cost? However, the medical ethics, rules and regulations pertaining to any surgery in the private medical sector may not follow the same path the NHS presently takes to ensure a person is approved for surgery or treatment for any other Gender issues.
Then finally of course there is the path to having medical realignment in the Far East or other countries? I do know people who have chosen this route and have been very happy with the results, But, I have also seen some the after surgery results and body mutilation that some of these clinics provide. This has been commented on before whereby UK residents who have chosen this path have returned to the NHS to help rectify medical problems or incompetence's. I am not saying all private clinics are the same but again as an adult individual you have a choice. I would always recommend to think hard and long in choosing the route you wish to take for your gender issues, the options are many the results are not all the same.

[Melanie Moxon]

Thank you Janice for such a frank and honest reply, I realise that on such a major change to one’s life that the NHS do not want to get it wrong, after all as Teresa said, no matter who does the treatment if it ends up pete tong, the NHS will be picking up the pieces. I think that the private clinics are still bound by the same timescales in terms of life experience before they will prescribe hormone treatment and then the same again before they will perform GRS. I realise the NHS doesn't have an infinite budget, sadly an organisation like the NHS needs to be overfunded and over staffed but it also needs to be managed in the correct way, at the moment it seems to have neither. Thanks to everybody else that has contributed thus far as well, all highly informative

As far as jumping through hoops and hurdles is concerned I am very much used to it, my entire adult life working in the defence industry on fast jet software has been filled with procedures, counter checks, counter signatures and reviews, for similar reasons to NHS treatment, it has to be right as the consequences of it being wrong are horrific. In case anybody is wondering why jets cost so much, its because "when the paperwork weighs as much as the aircraft you can fly it". I also have a PPL so I am well versed with checks, balances and the never ending tirade of bureaucracy that is maintaining my privilege to fly light aircraft. I have over a year before I can even start considering (that is how long it is going to take me to get everything in place so that I can move out) any form of transition and if by that point I still want to go ahead.

I do feel a little odd with it though; as I am not particularly dysphoric (well aside from by beard; I and pardon my French, ****ing loath it) about my body. I don’t feel the need to be kicking the hospital doors in to get GRS done but at the same time I don’t feel right as a male, I won’t say “man” because I have never particularly tried to be a “mans man” I have never wanted to be “a man”. I have tried in the past to pass it off as a shoe fetish (because I do have one) and it being an urge to cross dress. Unfortunately occasional cross dressing just doesn’t placate the feelings I have, I’d rather get home from work and remove a bra than get home from work and put one on if that makes sense and I don't feel comfortable with the idea of just being a man in a dress. The feelings are not as strong as those that have sadly driven many to attempt and in some cases commit suicide. I guess its a sliding scale and it does lead me to question whether transitioning is sensible or not, but I guess questioning myself (with the assistance of supportive friends whom I can discuss it at length with and who would support me no matter what the end decision is) is healthy.

The only time I don’t feel anything relevant to gender and gender identity is when I am airborne, slipping the bonds of earth, me and the machine, beholden to nobody and nothing but the immutable laws of physics. Three thousand feet below the issues and problems of the daily grind are left behind, I may talk to the local lower airspace radar service, I might not, but when I do my gender and its identity are irrelevant I am a voice on the radio and a four digit number I appear as a blip on a radar screen. I am just me; I am comfortable, I’m happy. That is how I want to feel every day, I don’t (and sorry for details) want to sit on the toilet at work and look down at my shoes and think; I hate those. Not because they are bad quality, uncomfortable or anything, I just don’t feel like I have any connection with them, they just look wrong.