Questions & Issues for NHS/United Kingdom Members

[johanna.kitten]

Sandra, the person that gave me the information was a NHS employee that was invited to speak at the trans group I am a member of at the local lgbt centre to inform us regarding the NHS pathway to transition. It never struck my mind to question her information. Can't remember her name but I could prolly find out, as she also spoke at another local ts/cd group I sometimes frequent.

Anyway, I think it should not matter where you happen to live, you should be treated the same all over the country. If that is so, all good.

Hugs
/Gio

[Serana]

Amy, as said, and from personal experience, I went full time about 2/3 months before actually being seen by the Leeds GIC, and they took it into account because I provided the original name change documentation, my attendance at university (maybe in you case a job slip with the new name would work, or something to that affect (changing your name and such with HMRC is actually easier than before because you can do it from their website, and it changes the name for all government documentation, which is helpful.)) Once you provide the evidences of WHEN you changed your name and when all the other documents were changed to the new name, they'll set a date from there and work from there.

Also, the Leeds GIC seems to be one of the most popular GICs, and so they get a lot of people. I'm at least glad to know they're informing their new referrals with information on how long it might take them, as I certainly didn't get that information before and was waiting about 14 months before the initial assessment. My best advice would be to be full time by that point, and to try and push through the initial asessment phase as quickly as possible. They can shorten assessments to 4 or so before they'll give hormones. Not much, but it's at least a little compensation.

Johanna, from what I'm aware of, there are only two surgeons who actually do the SRS surgeries in the UK, Bellringer and Thomas (slight chance I'm outdated on info here though), and I do believe one of those surgeons does advertise his services privately also. It's quicker to go private just because of the NHS beds are the things with waiting times, not the surgeons themselves (silly really, why can't you bring your own bed? :P)

Also, I have some questions, this may be more relevant to post-ops who might have some info.

So, I just got back from my surgery in Thailand, and I'm trying to deal with the NHS (oh how I didn't miss them) to get important things like KY Jelly for dilation, Betadine Solution (now Videne Solution) for douching, and to get more hormones. Namely, I want to move from patches to pills again, as I don't like the idea of, if I become sexually active, I wouldn't want the patches to be seen as I find them a bit of a turn-off for myself, and I'm not sure if the other half would also.

My GP is apparently "not confident" to prescribe me any hormones at all, not even the recommended amounts, until I can speak with the GIC or a local endocronologist, and he was not prepared to prescribe enough KY Jelly until he has spoken with the GIC also. Besides the fact that I'd be worried about a GP who isn't confident in prescribing something, I also wonder what's the deal with the KY. I find myself wondering, if perhaps I would now be considered a female who suffers from vaginismus, or something like so, as it's commonly known as a "tightening of the vaginal walls/entrance" and so I should be able to get it under that sort of medical condition?

The amount of KY I go through it pretty stupid though. More than you'd normally expect to go through anyway.

So, would it be worth maybe going to a different GP? As a student and after having dropped the amount I did on the surgery, I can't really even afford to eat properly again right now, let alone buy 75G packs of KY Jelly at 4£ a pop. I also -really- urgently need hormones as I've nearly ran out.

Thoughts, peeps? Thanks.

[Sandra]

Johanna, from what I'm aware of, there are only two surgeons who actually do the SRS surgeries in the UK, Bellringer and Thomas (slight chance I'm outdated on info here though

There is a 3rd Mr Oliver Fenton Leeds GIC refer to him, that is who did Nigella's surgery.

[Eryn]

As a student and after having dropped the amount I did on the surgery, I can't really even afford to eat properly again right now, let alone buy 75G packs of KY Jelly at 4£ a pop.

If you can find a supplier for carboxymethylcellulose powder it can be mixed with distilled water and you have the same thing as KY minus the preservatives.

[Samantha171]

Hi, I have a quick question hopefully someone can clear up for me.
When I get my NHS records changed to reflect my new name and gender, do I also get a new NHS number?
I'm super confused at the moment because my GP says it stays the same and my psychiatrist says they need my new NHS number to update their records for me. :/

[Nigella]

Hi Samantha

Your NHS number will stay the same, the only change that will take place is the updating of your name and gender

[Samantha171]

Ok. Thanks.
I was just confused because I had phoned up my GP and asked for my NHS number, and then gave that to the psychiatry, and only after realized that it was the same as my old number... Not sure what's going on but I hope I've done everything right.
I guess they'll tell me when I next go in if they needed a different NHS number.
Thanks Nigella!

[Windy]

Sighhhhhh, has anyone had any particular experiences with private care?

I'm in a VERY frustrating position right now. I sent off the C1 consent forms about a month ago to Charring Cross, but today I found out that they've been returned to me and marked as "not called for"...because I put a first class stamp on the letter and didn't pay a 9p (!!!) postage charge. I've spent 3 months trying to get a psychologist's opinion, and then another 6 months waiting for the clinic to even send me my consent forms. I know that the clinic also runs a 14 day service where if they don't hear back from you then they assume you're not going with them and wasting their time but...blagghhh, I really don't want to have to go back through ANOTHER 9 month wait, just because I forgot to pay a 9p charge.

[emma5410]

My NHS number changed when I changed my name. I did not change anything else doctor, address etc.
The new rules that are supposed to have been adopted means that your GP can now refer you direct. Whether Charing Cross will abide by them is another question.
I have used Gendercare and they were excellent. The staff actually work at Charing Cross. Obviously they are expensive, as is all private care. I am waiting to hear from Charing Cross. I sent back my forms in early July but have heard nothing yet. I put two first class stamps on but now I am worrying that they may not have received them and I will be back at the start again. By the way it took the psychiatrist/doctor nearly six months to send the referral. I was constantly assured it had been done but it only happened when I sat down in front of my doctor and watched him do it.

[Nigella]

From the NHS website

If you have an old medical card, it will have an old-style NHS Number made up of both letters and numbers. This has now been replaced, for all patients, by a new NHS Number made up entirely of numbers

This could be one reason why some people seem to get a new NHS number, simply because they have never been issued a new 10 digit number to replace their old number

and their PDF FAQs

1.6 I have changed my name: does this affect my NHS number? No, moving or changing your name does not affect or change your NHS Number, which stays with you throughout your life. You will need to arrange for your new name to be updated on your medical records. To do this, contact your GP Practice and let them know about your name change. They may ask to see some identification or proof of the name change. Your GP Practice will make sure your medical records are updated.

and what to do if you have 2 NHS numbers

1.13 I seem to have more than one NHS Number, which one is correct? Your NHS Number is made up of a 10-digit numbers. If one of your NHS Numbers has both letters and numbers it is an old NHS Number which you can no longer use. If you have more than one 10-digit number you should contact your primary care trust (PCT) to find out which is one is the right number. To find out the phone number for your nearest PCT visit the NHS Choices website at the following address and enter your postcode.
http://www.nhs.uk/ServiceDirectories...onal.aspx?Sear chType=PCT&ServiceType=Trust When you phone your local PCT, ask for the department which deals with enquiries about NHS Number. A member of staff will take your name, date of birth and address and then send you a medical card with your NHS Number on it, usually within two days. We also recommend that you tell the organisations that have two different numbers so that they can find out which is the right NHS Number and change their records.
Healthcare providers use other numbers and ways of identifying you and these may also be in your documents. In an emergency, if a provider can’t identify who you are they won’t have your NHS Number and will use another way of identifying you instead. As soon as healthcare staff can identify you they will find your NHS Number and add it to your records.

[emma5410]

In my case both of my numbers are 10 digit.

[Windy]

My NHS number changed when I changed my name. I did not change anything else doctor, address etc.
The new rules that are supposed to have been adopted means that your GP can now refer you direct. Whether Charing Cross will abide by them is another question.
I have used Gendercare and they were excellent. The staff actually work at Charing Cross. Obviously they are expensive, as is all private care. I am waiting to hear from Charing Cross. I sent back my forms in early July but have heard nothing yet. I put two first class stamps on but now I am worrying that they may not have received them and I will be back at the start again. By the way it took the psychiatrist/doctor nearly six months to send the referral. I was constantly assured it had been done but it only happened when I sat down in front of my doctor and watched him do it.

Lol, we're in the same boat then. I know exactly how it feels to be pushed around and given false assurances. I'm sorry that it's taken so long for you >:

[emma5410]

I am still hopeful that my forms are working their way through Charing Cross but who knows. The positive is that I have been full time since January so I feel I am making progress.
I can recommend GenderCare but if you abandon the NHS it means that you will have to pay for hormones/surgery.
I hope it works out for you. Have you contacted Charing Cross to find out the situation? If you do have to reapply then it would be worth taking a copy of the new protocols with you to show your GP. If he is anything like mine he is clueless about TS issues. I can probably find you a link if you need it.

[emma5410]

I do not know if this is of interest to anyone but I rang CHX on Friday and was told they are currently processing the forms they received in March.

[Amy A]

I'm gearing up to changing my name at the end of the month, but I'm not sure what the deal is with what gender I should say I am. Say, with an insurance company, I'd be putting my title as Miss, but I'm not legally recognised as female (eg no certificate because I'm starting full time next month), so do I say I'm male or female? And would a bank or insurance company allow me to change gender without a certificate?

Is there any definitive source of information about this on the interweb anywhere?

Thanks!

[Nigella]

Most will not require your gender, they will accept the name and title change, providing you give them the original document you used to change your name/title i.e. deed poll. The only issue I have had is with my marital status as, at least on line applications for insurance, will not accept Mrs and Ms as being married. Most companies accept that if you are a Mrs, Miss or Ms then you are female, good old computer planning.

I always list myself as female even though "officially male", that is until I get a GRC. Never had an issue with it and my name/title has been changed for 6.5 years. If in doubt ask

[Amy A]

Thanks Nigella. Some of my concern is about my motorbike insurance; I'm not sure if they would let me change my gender on an existing policy or not.

EDIT: Just found this on the FAQs of a deed poll site:

'However if you do change your title to ‘Miss’, ‘Ms’ or ‘Mrs’, you will need to make it clear when completing any application forms (for example for credit, loans, insurance, etc) that your sex at birth was male.

This is particularly important with insurance because the insurer might give you a cheaper rate if they believe you were born female. Then, if you ever came to make a claim, you might find that your insurance is invalid if they discover your sex at birth was male. Furthermore, it is a criminal offence to obtain a financial advantage if you deceive someone.'

[Carla Stevens]

I have a question that I hope someone may be able to answer for me.
I know the NHS pathway can be painfully slow.
3 months ago I first spoke to my GP about my Gender issues, 2 months ago I got to see a Psychiatrist & 1.5 months ago the Psychiatrists report got sent to my GP.
I've since found out from my GP that they haven't yet referred me to Leeds GIC yet. It seems as though all the GP's in the practice are having to get together to discuss my case before writing a report. I therefore assume that none of them have ever had to deal with GD before.

In the meantime I'm having an emotional meltdown & I'm really struggling to function on a daily basis. I'm in a very dark place at the moment.
My question is: does the NHS provide any interim Gender support such as being able to speak to a Gender Psychologist before actually getting to Leeds?
If I can go to my GP prepared with the correct information as to what options are available, I think this may speed up the process. It can take around 2 weeks just to get to speak to a GP at my surgery & I need to go prepared to prevent any un-necessary delays.

[Janice Ashton]

Hi Carla,

One thing I have found having gone through what you are experiencing at present is patience; This may not be the answer you are looking for but it is fact, nothing will move quickly regarding your journey with the NHS. The NHS are really very good but it takes time, the reason why you have to wait in the circustance you are presently in is because the NHS has to find 'Funding from your local health authority for you to commence at the Leed GIC clinic. I had to wait for similar as in my case my Doctor confirmed by GD and then had to apply for funding because I attend the Devon NHS health authority where my clinic is in Exeter and I live in Gloucestershire. In my case it took nine months from my intial request to my GP to my first GIC appointment and I have now been registered with the clinic for over a year and been on HRT for 4 months.
It will happen for you if you definately tick all the boxes but it will take time and this is the frustrating part of the journey. I know this is not what you want to hear but I am sure it is how it will be.
Good luck Carla and I hope all goes well and you will get there.....

[Amy A]

Hi Carla. Short answer is you are basically on your own until that first appointment with Leeds. I was referred in June last year, and have been told that in April they will send out a letter telling me which month my first appointment will be in. The only options you have in front of you to speed things up are 1. go full time ahead of your first appointment. They won't prescribe hormones until you've been full time for six months, but if you can prove you've got a chunk of time under your belt (say 3-6 months) they will consider reducing the assessment period to three months. I know this would be difficult for you but it's worth considering. 2. Go private for hormones, which is waht I did. Costly but facing another 6-7 months minimum without treatment was too much for me. 3. Find a gender therapist so you can at least talk things through. Also would help your case when you get to Leeds if you had supporting letters.

Like Louise says it's a long game, and that feeling of putting your life on hold until you can get started is pretty hard to cope with. If it's any help I will happily meet you any time you want in Manchester for a chat.

[Carla Stevens]

I know the referral process is slow, but what is frustrating me is the fact you are left to fend for yourself until you actually get to your first GIC appointment.
I really am emotionally screwed up at the moment & I'm struggling to make sense of what's going on in my head.
I'm finding my GP surgery frustrating with the difficulty of getting an appointment for any medical conditions & they just seem to be giving me the run-around. It took me 2 weeks to get an appointment to speak to a GP about the problem I have with my sudden onset of male pattern baldness that's hit me hard. It's like a switch has been flicked & my hair is falling out in handfuls & I've lost a considerable amount in the past 3 months. The GP was very dismissive of this & basically told me that I'd just have to live with it, despite the fact that I'd told them about my Gender issues & it was causing me great distress. I already know that any medication to try to halt male pattern baldness can take up to 3 months to have an effect & in the meantime my hair is rapidly disappearing, never to return. I need to try to get another appointment & will need to see if I can speak to a different GP this time.

Ideally I'd go private to get to speak to a Gender specialist sooner, but I'm still out of work & cash strapped.

Amy, I will take you up on your offer to meet up in Manchester for a chat sometime. I'll give you a shout soon. Thanks.

[johanna.kitten]

Carla,

You might find that your local lgbt centre/org. can advice you on how to handle some of the nhs hurdles, at least I have had some support that way as there is always someone that is ahead of you and/or have had similar worries. Perhaps you have already gone down that route. I don't even know how many times I changes GPs the last 18 months not to mention it took me a whole 888 days from when I informed the nhs until I actually held my hrt in my hand down the local Boots not even four weeks ago. So it can be quite frustrating at times to say the least.

Hugs and best of luck!
/Giovanna

[Carla Stevens]

Thanks Giovanna, I might just try to contact a LGBT centre in the Manchester area. I am a member of Manchester Concord, but to be honest, most of the social meetings I've been to seem to be geared more towards the TV / CD side of the Trans scene, which really doesn't offer me much support.
I may have to start pushing my GP to get some progress as I seem to be stuck in a downward spiral of depression at the moment.
I've gone through many emotions from simply accepting the fact that I'm Trans & deciding to embrace this, to the state I'm in at the moment of considering the whole thing to be a curse & wishing I didn't have GD.
Recently I've found myself lying in bed at night just wishing I'd go to sleep & never wake up again.

[johanna.kitten]

Carla, depression is common in TS people. It is not great at all, but I do keep hearing that lots of people get better with proceeding with treatment (be it more of
HRT and the lot rather than treatment of depression). Just hang in there and do not give up. I'm currently/temporarily in Leicester and the "Butterflies" here are
more political than focused on the social bit so hence quite a lot of good advice on dealing with the nhs and more.

You might want to not disclose too much of the signs on depression to your GIC as it might trigger delaying investigations into that, just try to wait
with that until you're on hrt (if that is what you're aiming for at the mo).

Hugs
/Gio

[emma5410]

Recently I've found myself lying in bed at night just wishing I'd go to sleep & never wake up again.

I know that feeling but it is heart breaking to hear someone else say it. Amy is spot on in her recommendations. Some therapists will offer a reduced rate for the unemployed. My therapist does it on a limited basis. I am not sure if she has any slots but I can give you a link or I can ask her when I see her on Thursday. She is in Chorlton. Not sure how far away you are.
I am waiting for my first appointment with Charing Cross. I sent my forms back in July 2013 and they are currently not doing any after 1st April until they clear the backlog. The difference is that I am full time and on hormones. I cannot imagine what state I would be in if I was not.
If there is anything I can do to help please let me know.