Hallo everyone,

 

I wondering what other people's experiences are regarding the NHS pathway.

 

My GP has referred me to the CMHT (Community Mental Health Team) because the NHS Pathway apparently requires that an assessment is undertaken before referral to CX.  The idea is to find out if there are any underlying mental health issues. In my case, I've seen a few psychiatrists over the past 25 years about my trans issues and there were no underlying issues found. I don't feel I need such an assessment.  However, since asking my GP about getting on the NHS route to CX and being referred to CMHT, I've had 3 appointments. The first was cut short (lasted 15 minutes) due to the doctor having a personal emergency, the second one the doctor didn't turn up (no reason given other than had to do some "training") and the last one (this week), the doctor cancelled at short notice (no reason given). One begins to wonder. Receptionist who phoned to tell me my appointment this week was very nice and apologetic. She said all I could do was go back to the GP and explain that CMHT is unable to field any doctors and ask for direct referral from GP to CX (if such a thing is possible)! I tried everything to get in for this assessment, even if I think it's actually unnecessary.  Apparently one cannot go "out of area" to another CMHT team. I feel I am being messed around.

 

Has anyone else had these kinds of experiences?

 

Rachael x

I didn't have any such problems, sounds like your 3 failed appointments were just bad luck. Can't you make another appointment with them?
xx

Naturally, you would think you are being messed about but it doesn't necessarily follow. Mental health doctors?? I used to work with several different psychiatrists and they are not the easiest people to get to comply with your wishes. It sounds to me like the three appointments were dererred for valid reasons, and it is too easy to look for negative excuses as to why they cancelled the appointments.

Try again, its simply not going to happen overnight anyway.

 

Your Mental Health Team are not your usual 'run of the mill' Human Service's people anyhow. This you will learn fairly quickly if you are going to transition fully over a long period of time. Afterall, there are reasons why some people work in Mental Health. lol 

 

My outlook is not to be too hasty in becoming negative about anything. If an adverse situation does arise, you will have no doubts about its presence. Until then, every situation can be taken in your stride.

 

Try again, if you still feel its necessary and good luck!

 

~*!*~   

This post was edited by Former Member at June 18, 2013 10:41 AM BST

Lucy Diamond said:
I didn't have any such problems, sounds like your 3 failed appointments were just bad luck. Can't you make another appointment with them? xx

I've tried but now they saying August. It's a bit like a unnecessary hurdle.  They said today that some doctors are holiday, one left the CMHT and this particular unreliable one only works 2 days a week. I am not being overly negative about it. I just think it was a bit off for them to make an appointment months in advance and repeatedly inconvenience me at such short notice.  I'm being told this particular doctor is the only one with experience in the subject and no others can do it.  I was thinking perhaps I should just see another one but I've been rebuffed. The lack of doctors in that particular CMHT is worrying for everyone, not just me.

Am I right in thinking that CX (or any English GIC) does not allow self-referrals but that in Scotland, they do?  Isn't this changing in the new guidelines? I'm hoping someone will know.

I doubt if you'd get into CX without seeing your local psychiatrist, so take that appointment in August, it's just weeks away now.
This is the NHS, which apparently is in a bit of a mess generally, you will have to be patient. When you do get a referral to CX you will be waiting several months probably before you even get a date for your first appointment, which will undoubtedly be another several months away. It's all par for the course.
But full transition takes years, do what you can on your own in the meantime. Hair removal, work on your voice, general deportment... CX don't wave magic wands and none of this happens overnight, it's up to you to be the best woman you can.
When I first saw my GP it seemed like nothing would ever happen, but I'm now 6 years post-op, and getting older. Time passes all too quickly.
Just be yourself, and be happy. It's your life and you're in charge of it.
xx

Thanks Lucy. 

 

CMHT seems to have taken some action now and allocated another psychiatrist, presumably because the original one may have some reliability issues. I don't know if the one I was allocated to previously is still there. 

 

There's a lot of odd behaviour by the NHS where I am (Worthing). One of the GPs in my shared practice said about six months ago, "the NHS does not fund gender reassignment in this area".  I find that a very strange thing to say as we had not got that far into the details of where I'm going with this and I was not asking for that.

 

I've got the resources to do everything without the NHS, but I do have other conditions which need to be monitored by my GP.  This is how I got into it with them.  If I didn't have any other conditions, I would have just done my own thing (I am well into the laser and electrolysis hair removal anyway).

 

I am not particularly bothered about a referral to CX, but I do value the health care monitoring and I don't want to do this chaotically. The monitoring is more really what I want from them rather than a psychiatric diagnosis (I've had years of those discussions in the past).

 

I do realise it takes years to transition. I just don't like to waste my time and being messed about!

 

Firstly, yes the NHS does fund gender reassignment in that area:
http://www.westsussex.nhs.uk/domains/westsussex.nhs.uk/local/media/publications/Health-professionals/Individual_Funding_Requests/Low_Priority_Procedures_and_other_procedures_with_restrictions_2011_version_2.1.pdf
(section 38)
GP's don't get everything right! I guess he just assumed that SRS was where you were ultimately heading.
If you really get fud up with the whole system and you can afford it - there's always the option of going private:
http://www.transhealth.co.uk/dr_curtis.php
where you will get the same monitoring/prescriptions etc as on the NHS, only you will have to pay for the privilege.
A bit of patience though and you will get there in the end on the NHS. Glad to hear you've been assigned another psychiatrist. Sounds like the last one needed an appointment for himself!
xx

Lucy,

 

Thanks for reminding me about Dr Curtis. He's well known of course but I thought he was suspended or something currently for some reason (prescribing to under-18s? don't remember).

 

For sure GPs don't know everything. I think I've been educating them sometimes.

 

Rachael

Hmmmm....so an update here now on this subject.  And I wouldn't mind some suggestions. I finally got to the CX GIC this week and had my first assessment. Talk about messing about. I was away when they finally managed to set up the appointment so I couldn't attend. Sent them a fax, then they sent me another appointment which I could attend. I arrived to find my appointment was cancelled and I had to get another appointment but luckily I was able to have it the same day, albeit a couple of hours later.  I got to look around Cafe Nero opposite for a few hours. Nice to see others in there as well.

 

Anyway, I feel the assessment was brusque, somewhat dismissive and very much oriented to categorising me in some box and moving me on some kind of fixed track. I can see there's one size fits all at the GIC.    As a self-medicator, I expected to have some care and attention over my endocrinology - as I have other endocrine conditions which are monitored but could be complicated by self-medication.  My aim/outcome of the assessment was to get monitored but I didn't get that.   Seems to me no-one wants to take on the responsibility for "shared care".  I am considering asking my GP to take it on.  She doesn't seem to feel capable.  So what's going on? Am I being fobbed off?

 

Another thing was discussions on "magic wands".  Here's the questions - it's been playing on my mind ever since. I won't say what my answer was. I might have got the wording wrong but it was something like this:

 

1.  Imagine you had a wand and it would make you appear female (without necessarily changing anything), would you use it?

 

2. Imagine you had a wand and it would make everyone else around you think you were female (without changing anything), would you use it?

 

I am sure there's no "right" answer and there is not a particularly subtle difference between them. Just interested other people's opinions on what this is supposed to diagnose.

 

Upshot from the Doc was to come back in 6 months. I really do feel fobbed off actually.

 

Rachael x

This post was edited by Rachael Jane Robinson at December 5, 2014 5:14 PM GMT

There is only one answer to the 2 questions above. Think about it.

Surely if one had a magic wand, the sensible ones would whish to be normal per se, I would have missed all the hurt and angst, but being 'normal' would I have  a contented and happy worthwhile life, now.   If one could see into the future, one could win the lottery every week.   It's a chicken and egg question there is no answer.

True Crissie but when the gender clinic are trying to get into someones head they ask what could be called silly questions but they have obvious answers.

They know what the answer should be to any question they ask , they are not a trick questions but there is only one choice out of the two and by asking questions such as above they can figure out the gender your mind thinks as.

 

I was never asked that question but was asked random questions thrown into conversation once they have you in what they consider to be a comfort zone.

Sadly there was never a question asking would you had rather had been born normal per se and that is because the answer is to obvious.

 

Julia xx

Sorry Crissie I was doing 10 jobs at the same time in my response above. You do have a worthwhie life now and I am sure you are happy and content. Yes we could do without the hurt but for some of us I believe it makes us better human beings in the end. It makes us more understanding and caring and as you well know there are not enough who do understand or care but you do , that makes you special in my eyes. You have not turned out bitter as some do and I am proud to call you my friend and you should be proud of what you have achieved.

 

Back to work now. Take care , Julia xxx

Some replies to my post of TWO years ago.  Thanks for those inputs. Obviously things have moved on considerably. The answer was of course obvious but I was confused at the time by them.  Basically they handled me incorrectly. 

 

So I am no longer seeing anyone at the GIC and doing it all privately including using a trans aware GP.  I still do not agree with the GIC methods. But I realised I do not actually need them to tell me who I am.  I have never wavered from that course.

 

I never stopped what I was doing but I, like others of the 1960s/70s, have a passivity and deference to people in authority like medics, lawyers etc.  I always thought doctors knew what they were doing and their opinions had to be right. In the face of strong opinions from people, I tend to clam up. I find it hard to think on the fly. Now I know differently about myself and I know how fallible they are!  From chats on Facebook I know others are also unhappy with their treatment by GICs.  

 

But things are changing...

 

This idea of self-declaration of gender currently doing the rounds via MP Maria Miller which to me, means the GIC is more marginalised and at least we have the nascent beginnings of acceptance of trans people.  We're more visible for sure.  I expect self-declaration will lead to the next thing, medical treatment on demand as a routine.

This post was edited by Rachael Jane Robinson at April 20, 2016 7:47 AM BST

I have my first appointment next week any tips 

Just smile and be yourself, Bea.

xx

Thank you Lucy

xx