Hiya,
This is an NHS care path question. Someone I was speaking to the other day said that they had explained to their GP about their feelings of gender dsyphoria and their GP referred them to a specialist. When the appointment came they lost the courage to attend. Understanding the feelings that we experience and making sense of it all I can imagine that this could be a very common situation. I spent most of my life in denial and the last few years accepting it and trying to ensure I choose the right path to treat it, so I understand how difficult it can be to take those first initial steps.

The individual said that recently, after about 5 years from the previous attempt, that their GP has said that they had their chance 5 years ago and now they cannot be referred to a specialist. Considering the nature of our situation I find this extremely worrying that this person might be left to suffer without professional guidance.

Could it be that the GP is just blocking a referral? and they should start by finding a new GP?

Is it NHS policy to only give people one chance? It seems really unfair if that is the case.

If I speak with this individual again, is there something I can say that might give them ideas on how to pursue NHS health care? or is it this individual's only option now to pay privately or buy health care insurance.

Much Love
Penny
x

Thanks a lot Crissie xxxx, thats fantastic. I will pass on the information. I'm also sure this will help a lot of other people in similar situations too.

Much Love
Penny
x

Hiya, Penny,

This is a very interesting situation from the point of view that out of all the different experiences that I have come across, this one is new to me.
I don’t have a legal knowledge to give advice of that nature, however I will give you my opinion and a bit of personal experience that may be helpful. –

The 1st GP that I spoke to back in 2001, gave me awful advice and did not refer me to a specialist, I explained that I felt like a woman and always have and that I was having trouble sustaining relationships as I felt that my life was a big lie. He in turn advised me to be very careful of whom I told this too and did not give me any further advice on gender dysphoria. This was a time before I had access to the Internet and social networking sites like the Gender Society. In fact the only information that I had access to was the sensationalism in the media that refers to trans people as “Gender Benders” in a smutty and derogatory way rather than what I have now come to know as a birth defect.

After around 6 years of still feeling the same way, learning more about why I may be feeling like I am a woman, I became 99.9% sure that I had gender dysphoria. I was suffering from migraine headaches (which I think were stress related) and had an appointment scheduled with my GP. This was a new GP as I now live in a different area. After a discussion on how to deal with migraine headaches, I asked him to turn to the page in my medical notes from my appointment in 2001 and asked him what entry was made. It simply said, “Patient has gender issues”. My new GP asked if I still had the same feelings? I said yes and explained that I had been out on a few occasions expressing myself in the female gender in which I feel most comfortable and that I had also made many friends from the whole transgender spectrum. My GP admitted that this was an area in which he had no expertise but had referred some one to a specialist in the past. He then asked if I would like him to refer me to a specialist. I replied “YES PLEASE!”

2 months later I got a card from the NHS stating that due to waiting lists, it could take around 2 years for me to receive an a appointment for a specialist. I felt short changed my the system that I pay my taxes to, yet slightly relived that I had some time before having to explain the whole situation to my family. Around 6 months after being told that it could take 2 years, I got an appointment to see a specialist due to the clinic taken on an extra consultant.

I was extremely nervous and also excited. Excited at the prospect of finally dealing with my issues yet nervous of the prospect of being given a different diagnosis. I was so nervous that I asked my dad to drive me there.

As I am not dressing full time at the moment, I took the decision to go to this appointment dressed in male clothing as I did not want to present the Dr with a false version of how I am living, after all I wanted an accurate diagnosis. During our discussion, she did point out the fact that I had presented as a man but did not dwell on it. Instead she focused more on my feelings at present and throughout different times and situations in my life. She concluded the session by stating that I did have gender dysphoria and after some discussion about how to progress, she told me that I was under no pressure of time to start making any changes and that she would be willing to make appointments at regular intervals whether I fully transition or not.

In conclusion, Penny, from my experience –

• GP’s are not always consistent and don’t always give the best advice as they are not specialists. Also some clinics allow patients to self refer.
• The prospect of transition can be very nerve racking so I would guess that cancelled appointments are fairly common. (Possibly you could ask this person to ask an understanding friend to accompany them next time for support)
• Specialists who understand this condition do not put undue pressure on Patients and speaking to a specialist who can empathise with your situation can be very helpful to your mental state.

I hope you get the chance to talk to this person again or at least they get the chance to read some of the comments in this forum.

Hugs
x Ace x

Cristine,
Once again, it seems that inconsistency within the NHS/NHSHA (and the GIC's) rules the day! (below)

" 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. "

<<< What I get from this, is that some GICs want a person to live as a woman (without hormones) for as much as two years before they can qualify for hormones - and some GICs don't have that requirement.
I can see the need to ensure that a person is fully prepared for the change in gender position, but the rules should be consistent for all! To allow so many deviations within the envelope of the NHS/NHSHA is "beyond stupid!"
Without a firm baseline, the system automatically creates increased costs in litigation, human resources (probably the intention), confusion, and suffering.
Someone needs to step into the situation and do an analysis of the increased costs, both in financial and human suffering.
The GIC's mandate should be to apply the regulations as supplied! Not to create their own little "kingdom" in which they can do as they damn well want!!
Cristine, with your keen interest in the "gender laws" combined with your ability to research these matters, you would be ideally suited compile a list of all the variations present within the GICs - with respect to application of the regulations.
Perhaps all that would be needed is an "interpretive guideline" of the regulations to be sent to the various GICs. An interpretive guideline is a far more efficient way to achieve consistency in the application of regulations. It not only speeds up the process, but allows the matter to be dealt with at a lower level.
The "row we hoe" is hard enough without having GIC's throwing sticks and stones in our path.

hugs!

---

"and my needs entwined, like ribbons of light...and I came through the doorway, some where... in the night"

My doctor/therapist situation over the years has probably been somewhat different than many gals. I started off with a psychiatrist which here in the U.S. can also write prescriptions. He handled gender identity along with other stuff so I don't think you could say he specialized in gender related issues. At least early on he seemed to know what he was talking about and that worked for me. I don't know what happened to him but I no longer could get in contact with him after about 6 months on hrt, so I began to self medicate. While self medicating I did a lot of research on every aspect of transitioning that I could find information on. As my body began to change with the hormones I started having issues related to my wife and family that were emotionally turning me into a wreck and I had no therapist to help me through that tough period in my life. So for those who Know how much I advocate having a doctor/psych, it is because of my personal experience that nearly destroyed me, that I do suggest others not go this alone. It was only after telling my wife what was going on with me that I found a medical doctor to monitor my hormones. I can't fully describe the burden that came off of my shoulders just by having someone I could trust help me on this journey. A year and a half ago I knew fully transitioning was a reality for me and by a stroke of luck I found a local licensed psychologist who had experience with transsexuals. By that point, it was only a matter of record keeping so I could get the necessary documentation for SRS when the time came. I now have my documentation and SRS appointment so I can probably stop seeing the therapist if I wanted. BUT! reading through this thread I think many are overrating what a doctor and therapist can do for you as far as gender identity. That is not what you need them for, but instead you need them to help you through the struggles that will come along as you transition. Medical doctors keep you healthy as your body changes and a good doctor can quickly learn what he/she needs to be keeping an eye out for. A good therapist will be someone you are comfortable talking to so you can freely share your experiences and head off any approaching struggles that will come your way.

With minimal guidance physically transitioning is relatively easy. It is living your life that you should not attempt to do alone. I think some that have yet to experience the doctors and therapists believe that these doctors are going to transform them. It doesn't work that way, you are the one doing the transforming, they only assist you.

Hugs,
Marsha

Hiya!
I started hormones as soon as I had 2 psychiatrists’ approvals, ie 2nd assessment, not forgetting I didnt start until I had given up smoking for 3 months to help reduce the risks of DVT. Someone could pay private and see 2 psychiatrists within a week and start almost straight away, so I believe. However, for UK girls, doing so, would negate access to any NHS care path in treating gender dsyphoria. Have to do it the NHS way if you want NHS treatment!

I changed my identity straight away as soon as I discovered the statuary declaration details courtesy of Lucy Diamond which allowed me to have a female driving license, bank accounts and so on, even before I went full time. It is free and immediate and I have passed on the same knowledge to a number of UK girls and I would be happy to continue, contact me

To me, it makes a lot of sense to have a two-year real life test before surgery is approved. When I first realised that it was possible for me to live in a female role I naturally wanted everything to happen in an instant. I didnt want to waste any more time spending my life in a male role and that is very common. I think two years is a good "cool down" period for people to seriously contemplate what they are entertaining.

For me, the 18 months I have been living full time so far has been just as much about my mental adjustment. After all, I spent 35 years in a male role and despite all my feminine characteristics and my gender dsyphoria feelings one doesnt pop on a dress and suddenly become a woman. I dont know how long it takes to physically become the person I see myself as. I also need to accept that I might only achieve a bad approximation.

The thing that concerns me and I have heard a number of stories are about individuals who say they are full time when they are not. They try to fool the psychiatrists in getting approved and so on. I think this is terribly silly as they arent giving themselves the opportunity to make informed and educated choices with how to treat their gender dsyphoria.

Love
Penny
x

It is working out for me that it will be 2 years RLE for me by the time I have my surgery in December. I probably would have told you last October at the one year mark that I was ready and to some extent I may have been ready enough. Now at just over 1 1/2 years I must say I am far better prepared than I was at 1 year. I believe your confidence and presentation for lack of better words really blossom as time goes on. So I have to say yes, you can do it at one year, but two years is just that much better.
Hugs,
Marsha

it's no concern of your doctors whether you had asked before or not. some fat slobs get belly bands put on and taken off almost at whim so you have a perfect right to ask again.
sexchnage is legally seen as an illness and the proper cure is whatever therapy and surgery the person feels is necessary.. go read the verdict and arguments of the 1999 NWA Case.