I was sent a link by GIRES this morning to the new draft GIC draft guide on transgender pathways and consultation. You can access it at:

http://gires.org.uk/tranzwiki/index.php/Main_Page#Draft_Guide_on_Transgender_Pathways_in_England

 

I had a quick look at it this lunchtime and the main idea seems to be harmonising best practice across the NHS. In tune with the changes that are coming with NHS reforms a much bigger role for GPs is proposed with what looked to me like a proposal that they be allowed to prescribe hormones before attendance at a GIC. To me that all sounds great and has the potential to speed things up but I am also aware that some GPs are as trans aware as an old copy of the Daily Mail. There is a process by which we can make helpful suggestions for the draft but I'd ask everyone to not raise any personal experiences but instead be constructive in any criticism. If anyone wants me to collect and collate suggestions for a general response I'd be happy to do this.

 

Thanks

Well I think my gender clinic (CX) pretty much adhered to all that when I was there several years ago.
I couldn't see any suggestion that GP's should be allowed to prescribe hormones before being seen by the GIC though, Nell. It says:
"AFTER assessment at the Gender service, the GP is responsible for the initiation and on-going prescribing of endocrine therapy and organising blood and other diagnostic tests as recommended by the specialist gender service clinician..."
And also:
"It is important for the Gender service to review results of blood tests (preferably with the assistance of a specialist Endocrinologist) before endorsing hormones..."
So they're clearly saying that the GIC needs to see the patient first, and review initial blood tests before allowing hormone prescription. Aren't they?
I don't think anyone should worry too much about their GP not being trans aware; most GP's in the country won't have come across the likes of us (!) before, but the GIC will instruct them on hormone dosage etc.
Once you're fully transitioned it's just a case of a yearly blood test (liver function etc), which a GP should have no problem interpreting.
xx

Thanks for the post Lucy. It's the 3rd para on hormones in the draft that led me to the conclusion that the GP could prescribe,'If ... has already socially transitioned .... then it may be recommended that the GP prescribe....'. I took that as the GP being allowed to prescribe hormones but having read it again it is most probably still that in all circumstances that you've got to go to the GIC first. So possibly needs a clarification there in the final version.

I also think there is a need for the awareness of GPs to be increased. I had to change GPs because when I spoke to my previous one about a referral I ended up with a prescription for iron tablets and him saying I must be 'feeling a bit off it to say things like that.'

Here are the documents that the GICRG (Gender Identity Clinical Reference Group) have published for consideration when the NHS is re-organised next year

 

1. http://www.crazy-girl.webspace.virginmedia.com/GICRG/2012-07-24/Collated_feedback_NHS_South_of_England_held_a_Round_table_event_on_17th_July_2012.pdf

2. http://www.crazy-girl.webspace.virginmedia.com/GICRG/2012-07-24/Confirmed_GICRG_Associates_(Organisation_list_at_24-07-12)_(2).pdf

3. http://www.crazy-girl.webspace.virginmedia.com/GICRG/2012-07-24/Gender_dysphoria_(adult)_(EM)_Nov-2009.pdf

4. http://www.crazy-girl.webspace.virginmedia.com/GICRG/2012-07-24/Gender_identity_Risk_Log_East_Mids_policy_final_draft_June_12_submission.pdf

5. http://www.crazy-girl.webspace.virginmedia.com/GICRG/2012-07-24/Sch_E_Sec_19_Equity_Equality_&_No_Discrimination_2012_13_NHS_Std_Contract.pdf

6. http://www.crazy-girl.webspace.virginmedia.com/GICRG/2012-07-24/Service_Specific_Template_GIC_Draft_v3_05.07.12.doc

7. http://www.crazy-girl.webspace.virginmedia.com/GICRG/2012-07-24/Service_Specific_Template_SRS_Draft_v2_05.07.12.doc

All feedback is gratefully received - remember that these draft protocols will affect how funding will be arranged for all treatments of transgender people - so it is important that your voice is heard

This post was edited by Former Member at July 31, 2012 7:42 AM BST

In the Netherlands , Post Op. It is normal to have blood tests and mammograms (Regardless of age) every two years and bone scans (For Osteoporosis) every five years, this is also the situation in France. Perhaps Nell could suggest these addition checks for all post op. TS's in the Uk too. (The Doctors here think they're important!)

Mammograms are offered to every woman (regardless of whether TS or no) from the age of about 50 until the age of 70 (but this can be extended if requested)
http://www.cancerscreening.nhs.uk/breastscreen/publications/nhsbsp.pdf

My bloods are done regularly too by my GP - even after almost 40 years of commencing hormone treatments,

That's right Carol, breast screening is offered to every woman here, one of my TS friends who is only 48 has recently had her first, but it's usually from age 50 I believe. All TS's on hormones will get regular blood tests, mine are done once a year.
Bone scans to detect osteoporosis may be a good idea, pretty sure we don't get that here. Long-term lack of testosterone can cause osteoporosis, so it's important that we take sufficient oestrogen post-op to compensate.
xx

Thanks for posting the GICRG documents Carol. Just got mine today but you beat me to it with posting them! Osteoporis bone scans do sound like a good idea for all women given the disability and pain caused as a result of fractures. Thanks for the suggestions. x

Hi again, I was in discussions today with a colleague and she sent me an email from Bernard at GIRES which she received back at the end of May. In it, under the section 'Local Care', he seems to say what I thought was inferred in the report. See what you think: Dear Colleagues, You may find it helpful to have this update. The Department of Health conducted a consultation event in London yesterday, which a number of you attended. National Commissioning Much of yesterday's discussion focused on the new arrangements for commissioning the specialist services currently provided by the gender identity clinics. In April 2013, their contracts with the local Primary Care Trusts and regional Specialised Commissioning Groups will be transferred to the National Commissioning Board (NCB). This should eliminate the post-code lottery, under which access to care depends on where a trans person lives. The NCB will not increase the current total amount of money paid to the clinics. GIRES estimates that the number of gender variant people seeking medical care is continuing to grow at 11% per annum. Hence, unless the clinics change their approach to treatment, this will inevitably lead to ever lengthening waiting times. The NCB has established a Clinical Reference Group (CRG) that is currently preparing the specification of the services to be provided by the clinics. There will be 4 representatives from the trans community on the CRG, in addition to 2 NHS officials and 13 clinicians, of whom 3 work at the London clinic and 2 at Nottingham. If the CRG attempts to improve the quality and range of services to be purchased from the clinics, it appears that this would have to be achieved with no increase in cost. The CRG intends to invite a number of trans organisations to comment on the specifications and also attend a consultation event on 17 July. Human rights and equality law, as well as the new Standards of Care published by the World Professional Association for Transgender Health are relevant to the CRG's work. Under the above arrangements, the individual community representatives and the trans organisations will have an opportunity to ensure that they are properly considered. Although many trans people receive good care in the NHS, the community may also need reassurance about the way the NCB will monitor the quality of care actually provided by some of the clinics when an individual is finally able to attend for gender identity treatment. The Trans Community Statement of Need, to which the GEO's representative referred during her presentation, raises a number of concerns, which included: equality and human rights issues; the misuse of the Real Life Experience (which no longer features in the WPATH Standards); inappropriate name change requirements; and negative attitudes. Local Care The provision of other gender identity treatments, including counselling, hormones and hair removal would be the responsibility of the GPs within the local Clinical Commissioning Groups (CCGs). Here the post code lottery will persist. At present, at least one GP offers a package, that includes counselling, specialist endocrinology and prescription of hormones, in accordance with the WPATH Standards. However, others refuse to treat (6%) or do not wish to do so (21%). Among doctors generally, 84% think that NHS money should not be spent on a treating gender dysphoria, which they consider to be a "lifestyle choice". It would save the NHS money if more GPs offered the above care package. Referrals to a gender identity clinic would only be necessary if the GP needed a second opinion before prescribing hormones or the service user was considering surgery. Then, the GP should be able to refer directly to the clinic, without having first to obtain an opinion from a local non-specialised psychiatrist. British Standards of Care The Intercollegiate Committee, which the Royal College of Psychiatrists established 9 years ago to prepare British Standards of Care for treating gender dysphoria in adults, met again on 29 May 2012. It considered the latest draft (version 12.4) of the proposed British Standards. Representatives from GIRES and Press for Change attended the meeting. In the afternoon, a number of additional clinicians joined the meeting. There is continuing resistance among some of the clinicians to accept the implications of the law or the new WPATH Standards. The meeting was again inconclusive and the Committee will reconvene on 2 and 3 October 2012. Guidance for GPs The London clinicians, to whom the Department of Health (DH) has assigned the task of writing the guidance, have already drafted the document without engaging the trans community. The DH intends to conduct a consultation about the document by means of an online survey. However, the authors would then be in a position to accept or reject the community's responses. This is not a proper engagement process, which should commence in the formative stage of any initiative. Warmest regards, Bernard

This post was edited by Nell S at August 2, 2012 12:20 AM BST

I was astounded by some of the facts revealed there - 84% of the GP's consulted consider being trans a lifestyle choice - when around 50% of us have considered or attempted suicide on one or more occasions.  Absolutely staggering that so many GP's appear to be completely unsympathetic or even antagonistic.

It was also noted that there is predicted to be a 10% increase in the number of trans people accessing the NHS for treatments year on year, but that the overall funding will remain the same i.e. quality of care will be reduced, appointment times will become longer and it will become increasingly difficult to obtain surgery after the 2 year RLE test.  We will soon be back to the waiting times/RLE times will be the same as they were back in the 1980's when the RLE was a minimum of 3 years and then a minimum of 1 year after being referred to the surgeon waiting for the operation.

This post was edited by Former Member at August 8, 2012 12:37 PM BST

http://gendersociety.com/forums/topic/8248/transsexualism-the-current-uk

Crown Copywrite 2007
Product Code 06 LD044440/o

Licence to reproduce all or in part copy
C.J Shye 14/05/2010 -CRB/3184312


Foreword


This research project was undertaken for the Equalities Review between the
period of July 14th and September 1st 2006. During this 6 week period, the
researchers undertook a mixed quantitative/qualitative approach to collecting and
analysing information on transgender and transsexual people’s experiences
of inequality and discrimination in the UK.


This report is an analysis and summary of the results obtained, and it outlines the
levels of inequality and discrimination that trans people face.
The work undertaken is certainly the largest data collection ever analysed and the
largest survey response ever received when doing research on trans people’s lives.
One can never claim that research data is entirely representative of a community,
even less so when the community being studied consists of many small subcommunities
as is the case with trans people. However, as will be alluded to in the
introduction, the reality of the estimated number of transsexual people in the UK
means that this piece of work reflects the experiences of a substantial section of
the trans community. As such, we are proud of this research, and would claim
that it is as near a reflection of the reality of trans people’s lives as is possible
through data collection.


Acknowledgements
Our contributors, Em Rundall of the Department of International Relations, Politics
and Sociology at Oxford Brookes University for her extensive contribution to our
understanding of contemporary issues in Employment for trans people. Also Ben
Thom, Barrister at Law, who helped again extensively, with our outline of the
current position of trans people within the law.
Christine Burns from Plain Sense1 for providing a significant amount of the
qualitative data analysed, and for other key ‘memory moments’. Angela Clayton
from Press for Change, Emma Cole and Rosie Seymour from the Equalities
Review, and Catherine Little and Melanie Latham from Manchester Metropolitan
University for their guidance and advice.
The Equalities Review for commissioning this work.

Take time to click the link and read on

http://www.pfc.org.uk/fil[...]ies.pdf

BASICALLY

Transsexual people are those who establish a permanent identity with the gender opposite to that which they were assigned at birth. As most legal jurisdictions have at least some recognition of the two traditional genders at the exclusion of other categories, this raises many legal issues and aspects of transsexualism. Most of these issues tend to be located in what is generally considered family law, especially the issue of marriage, but also things such as the ability of a transgendered person to benefit from a partner's insurance or social security.

The degree of legal recognition provided to transsexualism varies widely throughout the world. Many countries now extend legal recognition to sex reassignment by permitting a change of gender on the birth certificate. Many transsexual people have their bodies permanently changed by surgical means or semi-permanently changed by hormonal means. In many countries, some of these modifications are required for legal recognition. In a few, the legal aspects are directly tied to health care; i.e. the same bodies or doctors decide whether a person can go ahead, and the subsequent processes automatically incorporate both matters.

The amount to which non-transsexual transgender people can benefit from the legal recognition given to transsexual people varies. In some countries, an explicit medical diagnosis of transsexualism is (at least formally) necessary. In others, a diagnosis of gender identity disorder, or simply the fact that one has established a different gender role, can be sufficient for some or all of the legal recognition available.

Europe
Several countries in Europe give transsexual people the right to at least change their first name. Most also provide a way of changing birth certificates. Several European countries recognize the right of transsexuals to marry in their post-operative sex. France, Germany, Italy, the Netherlands, Portugal, Romania, Denmark, Finland, Sweden and the United Kingdom all recognize this right.

The situation is different in some eastern European countries. For instance, countries like the Czech Republic have laws governing sex change or, at least, give people the right to change their name and legal documents (Latvia). Other countries like Lithuania do not have any working legislation governing sex change.

United Kingdom
Historically in the United Kingdom, transsexual people had succeeded in getting their birth certificates changed and marriages conducted. However, this was not legally tested until the case of Corbett v Corbett in 1970, where Arthur Corbett attempted to annul his marriage to April Ashley on the grounds that transsexuals were not recognised in English law. It was decided that, for the purposes of marriage, a post-operative transsexual was considered to be of the sex they had at birth.

This set the precedent for the coming decades. People who thought they had existing valid marriages turned out not to - and the previous unofficial changing of birth certificates was stopped.

Transsexual people were able to change their names freely; to get passports and driving licences altered; to have their National Insurance details changed; and so forth. A piece of legislation was also introduced to ban discrimination against transsexual people for employment.

In the 1980s and 1990s the pressure group, Press for Change, helped people take several cases to the European Court of Human Rights about this. In Rees vs. United Kingdom, 1986, it was decided that the UK was not violating any human rights; but, that they should keep the situation under review. The UK government did nothing to look at the situation - and in 2002 in the case Goodwin vs. United Kingdom, it was decided that the rights to privacy and family life were being infringed.

In response to its obligation, Parliament passed the Gender Recognition Act 2004, which effectively granted full legal recognition for transsexual people.

In contrast to systems elsewhere in the world, the Gender Recognition process will not require applicants to be post-operative. They need only demonstrate that they have suffered gender dysphoria, have lived in the 'acquired gender' for two years, and intend to continue doing so until death.

Medical treatment
It has been established by the courts that no National Health Service Health Authority has the right to deny treatment for gender dysphoria as a matter of policy. However, effective access to treatment varies wildly depending upon the policies of the individual Gender Identity Clinics - with some taking a more relaxed approach than others. Transsexual people frequently characterise some centres as arrogant and controlling. A minimum requirement of 24 months real life experience, before a surgical referral is permitted, is not uncommon; and many GICs will force patients to transition before they are allowed access to hormone replacement therapy.

A common alternative for the more well off is to seek private treatment; though most private health insurance plans specifically exclude it. Often, people will seek hormone therapy privately and then later seek surgery on the NHS; which, may prove troublesome because the NHS likes to be involved at all stages of the process.

However, that position has now seemingly been overridden by a subsequent decision, Goodwin v. United Kingdom (11 July 2002) in which the right to marry (Article 12 of the ECHR) and the right to a private and family life (Article 8 ECHR) were infringed by the UK's refusal to allow a post-operative transsexual person to change the gender on their birth certificate (the only conclusive documentary proof of gender in most cases including marriage). One of the factors considered by the Court was the acceptance of gender identity disorder by the UK's National Health Service and the provision of treatment including surgery. Another factor was the fact that the government had effectively done nothing to keep the law under review. The UK must therefore take steps to provide such recognition. In 2004 Parliament implemented its obligation with the Gender Recognition Act 2004.

Its my understanding, that once you have been diagnosed as gender dysphoric/suffer a gender identity disorder and prescribed treatment by way of referal, then you should be entitled to the following care needed, eventually resulting in SRS if so desired. But its obvious that after reading so many reports of people being denied surgery or continually being deffered for surgery, without any real medical reasons in the way of health, its down to a few individuals to allocate treatment and their personal opinions on wether funding should be available. Unfortunately in so many cases, delays cause frustration and depression, the referal teams pick up on this and delay referals, which snowball, and people wonder why the suicide rate for pre-op transexuals in expectation of speedy surgery after completing RLE is the highest per capita of population and the highest in any minority group.

http://gendersociety.com/forums/topic/8942/department-of-health-gic-new-dra

So far as I can make out, there has not yet been a ruling under the terms of the EHRC over the delay or lack of funding, Only where treatment has been refused.

http://gendersociety.com/forums/topic/7662/nhs-expectations-views-and-laws

http://www.gires.org.uk/medpros.php

http://www.gires.org.uk/assets/DOH-Assets/pdf/doh-guidelines-for-clinicians.pdf

Thanks for all the posts on this. My recent experience shows (see my recent thread 'I get a nasty shock') bears out what is actually happening. What I can't understand is this: if we don't get the treatment we should be then it isn't just a case that we shrug our shoulders and say OK I'll have to just grin and bear this. For many there are consequences in terms of breakdowns and subsequent medication, hospitalisation, follow -  up counselling, etc, suicide and attempted suicide (what is the cost of a coroner's court and all the police investigation), consequences for employers, the need for local authority mental health teams to support people - the list is endless. All of this costs money and lots of it usually. And it changes nothing - the trans person involved will still be wanting treatment - unless of course they have been successful in their suicide. Well I've got the name and phone number of the person who makes the commissioning decisions for the NHS and we will be having a 'full and frank discussion' on Monday morning. I'll keep you posted.

x 

This post was edited by Nell S at August 4, 2012 8:00 AM BST

I'm posting again in response to your comment Carol about 'lifestyle choice', perhaps because my wife used the term 'choice' with me this morning about transitioning. To me a 'lifestyle choice' is something you do when you have a viable alternative. Choices I can think of are: gambling, eating until one becomes obese, binge drinking, spending beyond one's means to repay, and starting to take drugs. All of these have an alternative. Being trans on the other hand does not have an alternative choice but repression and anguish - day in, day out, week in, week out - until we crack up or attempt suicide. If my experience is typical the need to transition to another gender never eases. It is there constantly - a pain with nothing to give comfort or ease it; an itch that can never be scratched. So choice - what choice? Nell xxx

This post was edited by Nell S at August 5, 2012 12:33 AM BST

'Choice' was not my wording Nell, it was what was stated in the document. I know it is never a choice (unless you say that death is the alternative 'choice'). This is what 84% of the GP's who were surveyed believed.

You all just refuse to accept that the NHS has to follow the ECHR verdicts and case-law that says genuine TSism has to be treated in a timely fashion.
Any genuine Ts will want to change name, appearance etc and has the full protection of the laws to allow this.
If some idiot local PCT says otherwise just get a lawyer to remind them.
Obviously 84% of GPs will be a little sceptical and think 'its a lifestyle choice' when some person comes in claiming to be genderqueer etc and has no obvious TSism.

Carol I hope you can accept my apologies. You are quite correct in pointing out that you were only quoting what was in the report. Although I was feeling raw from a verbal tongue lashing I should have exercised more care in wording my reply. Again I must emphasise sorry for any hurt caused.

And yes Rose I do know that the NHS should follow the law. That doesn't make it any easier to deal with a monolithic system where the person concerned is still on leave. I will keep you all posted.

Another thought Rose - why should 'some person' come 'in claiming to be genderqueer etc' and with 'no TSism'? Most transgender folk who are gender queer, androgynous, etc aren't likely to be going to see their GP to request a referral to a GIC for transition I would have thought. To me if 84% of GPs think transgender is a 'lifestyle choice' then that is down to their prejudice. I prefer to think that all gender variance is a spectrum of expression trying to fit into a binary world of black and white and if we can't even be inclusive to all gender variant folk then there's not much hope of expecting the rest of society to do so either.

I think that 84% figure really must be from a very small data sampling number which has been distorted, but since the early 1970's what with 5 location moves and 6 changes of GP I have yet to meet one who has been unsympathetic (and yes, I interview them before I go onto their books to make sure they have no religious or other hang ups about treatments etc).

Not a single one of them had any problems and all were willing to help me wherever the could. Surely I cannot have been that lucky. If 84% were against treatment less than one doctor in those six would would have been happy to have me on their books.

"There are lies, damn lies and statistics". I find it hard to believe that 84% of UK doctors could be so ignorant.
If we analyse the data correlated from the experiences of Carol, myself, and the 4 other TS's that I am good friends with in my own town, we get a result of:
0% of GP's are in any way reluctant to help transsexuals on their path.
And:
100% of GP's are happy to provide lifelong prescriptions for hormones.
Clearly, there are some TS's who have it in for the medical establishment, but most of us get on ok with no problems.
If you want to know how many GP's believe gender dysphoria is a lifestyle choice, then just think of a number that suits you.
My GP is really nice, and very helpful. And for that matter, the various psychiatrists that have interviewed me were polite and courteous and in no way obstructive. I don't believe any of them had any mental problems, or felt it was their job to insult me, or had some ulterior motive to deny me treatment.
It's outrageous for someone to tar the entire medical profession with the same brush just because they themselves have had a bad experience. I've met a couple of girls like that on my travels, in my opinion they really needed to look inwards.

DH INFORMATION
Document Purpose For Information
ROCR ref: Gateway ref: 9507

Title Guidance for GPs and other clinicians on the
treatment of gender variant people

Author GIRES

Publication date 10 March 2008
Target audience Allied Health Professionals,
GPs Circulation list

Description This booklet is for information only, no
feedback is being sought.
Cross reference We have produced several documents on the
treatment of gender variant people aimed at
the general public
Superseded documents N/A
Action required N/A
Timing N/A

Contact details Monique Akosa
Equality and Human Rights group
693D Skipton House
80 London Road, Elephant and Castle,
London SE1 6LH
0207 972 5936

For recipient’s use
Policy Estates
HR/Workforce Performance
Management IM & T
Planning Finance
Clinical Social Care/Partnership Working
© Crown copyright 2008
First published January 2008
Produced by COI for the Department of Health
The text of this document may be reproduced without formal permission
or charge for personal or in-house use.
www.dh.gov.uk/publications

 

This is a sample of similar documents that have  been sent out to clinicians and General Practitioners by various organisations PFC, GIRES, DOH. Other Gov departments, in various form since the ratification of the GRA in 2005.

To say such a large proportion of GP's are in total ignorance of Transgender matters is being rather obtuse.

The only problem I ever had with the medical proffession was trying to convince the first shrink I was refered to that my condition was not related to other issues I had at the time, who was reluctant to refer me on to a specialist in gender related issues.

Hi Cristine, Lucy and Carol, Thanks for your posts. The points you make are all highly valid. This was never better illustrated than what happened to me today. I related last week how I was told that the Porterbrook's waiting times had grown to the point where they were indefinite. Well I think I'd read so many negative pieces of information that I was getting to the point where I was feeling quite down about it all. Anyway this morning I emailed a colleague who is also trans and who works in a different department. My email was about the support group I'm trying to set up in Chesterfield but I mentioned the problems I was having at the Porterbrook. Her response was that she'd had a similar experience and after going back to her GP her referral was switched from the Porterbrook to Nottingham where she was seen inside a couple of months. She gave me the number and so I phoned up. I spoke to a receptionist but learned that the secretarial staff were all on holiday. I gave my contact details for them to get in touch tomorrow. Within an hour I took a phone call from a doctor at the GIC who told me that their waiting time was 8 - 10 weeks and they had been urging Porterbrook to send down patients if they were having to wait too long.

 

The moral of this is tale for me is to check local sources and take a balanced view. The internet is a great place to get information - both good and bad, balanced and unbalanced.

 

Best wishes,

 

Nell x

This post was edited by Nell S at August 7, 2012 11:23 PM BST

That is good news for you indeed Nell. Sometimes I think peoples attitudes is the reason why they experience these difficulties - if they approached from a slightly different angle and asked for help rather than demanding their 'rights', they would receive a far more sympathetic response from the medical profession.

I also experienced the ridiculously long queue of porterbrook and was eventually referred to nottingham.
I had the additional problem of my PCT refusing to send me anywhere other than porterbrook and that only changed once I enlisted the help of my local MP.

Oops, its me Layla but im on aprils computer, sorry about that.

The right to respect, privacy and appropriate care.

 

Whatever their medical needs, trans people (trans men, female to male/FtM; and
trans women, male to female/MtF) should be addressed and accommodated
according to the gender in which they present, unless they specify otherwise. This
applies, as far as possible, to any correspondence. If medical and administrative
staff are unsure about whether to address an individual as Mr, Miss, Ms or Mrs, it is
better to ask, discreetly.

Confidentiality is required for all service users, but this is a particularly sensitive
issue for trans people. Reception staff and practice nurses, as well as doctors, need
to be aware that unnecessary and unwanted disclosure of the transsexual status of
service users is bad practice and, in respect of those who are covered by the
privacy provisions of the Gender Recognition Act, could amount to a criminal
offence. Furthermore, this information may be irrelevant to their reasons for
attending the surgery, since people experiencing gender variance may seek medical
treatment for conditions that are totally unrelated to transsexualism.

**  People are entitled to treatment for transsexualism by law as stated in the case of
North West Lancashire Health Authority v A, D & G, Court of Appeal, 1999 (see
the forthcoming NHS publication A guide to trans service users’ rights). This is not
a condition that clinicians may decline to treat. When trans service users present
for the first time for help with their gender discomfort, it is important that they are
treated non-judgementally and sympathetically. Doctors who feel unable to do this,
should refer them to a colleague who can.  **

 

GPs may also consider that:
“Private services may be appropriate in individual circumstances and are not
necessarily more expensive than National Health services in this field. Services from
within the private sector which meet contemporaneous standards of care can also
be commissioned” (Parliamentary Forum Commissioning Guidelines).6
This is in accordance with the British Medical Association policy that states:
“Patients who are entitled to NHS funded treatment may opt into or out of NHS
care at any stage. Patients who have had private consultation for investigations and
diagnosis may transfer to the NHS for any subsequent treatment. They should be
placed directly on the waiting list at the same position as if their original
consultation had been within the NHS.” 7,8
GUIDANCE FOR GPs, OTHER CLINICIANS AND HEALTH PROFESSIONALS ON THE CARE OF GENDER VARIANT PEOPLE

This post was edited by Cristine Jennifer Shye. BL at August 8, 2012 7:33 PM BST

Hi,

Thanks for the recent posts on this. There does seem to be an issue with the Porterbrook having long waiting times. It was also frustrating when I phoned up to ask that the receptionist, when I gave her my name as 'Nell' called me 'Neil' back to me. Although she was really friendly and typical 'dee, dar' Sheffielder this really bugs and as Cristine points out is against their own codes of practice.

Best wishes,

Nell x

This is the base for the National LGB&T partnership initial response to the service spec dated 24th July 2012.  This is a very good read and may be used as a template for feedback, if you are registered to be on the panel.

The Gender Society is on the list of bodies representing trans people so you may do so I believe.

 

http://www.crazy-girl.webspace.virginmedia.com/GICRG/2012-07-24_Responses/Associate_Response_by_NLGBT.pdf

This post was edited by Former Member at August 13, 2012 6:16 PM BST

A very comprehensive response. Bernard at GIRES emailed me their September draft in which they have gone down the route of actually amending the document. However, comparing the two they both seem to have reached similar conclusions, apart from the NLGBT response including facial hair removal, which I think needs inclusion. I'm not sure if the GIRES draft is on any websites yet - I'll try and get it for comparison.

just because papers get sent out by the DoH does not mean doctors have or will find time to read them.