Susan's Place Logo

News:

According to Google Analytics 25,259,719 users made visits accounting for 140,758,117 Pageviews since December 2006

Main Menu

So, what happens next with the NHS at a GID clinic?

Started by Stella Stanhope, September 22, 2013, 08:01:43 AM

Previous topic - Next topic

0 Members and 1 Guest are viewing this topic.

Stella Stanhope

'Ey up everyone!

A quick question to ask what happens when you reach the third appointment at a GID clinic in the UK (on the NHS)?

I was referred to a psychiatrist last year - had two interviews, and then was referred to one of the NHS gender clinics.
This year I have had two interviews and will be having my third shortly. The third interviews will take place with a therapist and a medical doctor (apparently).

So, what is the usual procedure? What might be the next stage(s)?

Thank you
:-)

There are no more barriers to cross... But even after admitting this, there is no catharsis... I gain no deeper knowledge of myself. No new knowledge can be extracted from my telling. This confession has meant nothing.

When you find yourself hopelessly stuck between the floors of gender - you make yourself at home in the lift.
  •  

Kaylee

I can't answer unfortunately, as I'm still waiting for my first appointment at the GIC in Leeds.  Though I was referred after my first appointment the MHO I'm going to be waiting till possibly September next year for the GIC appointment :(

Anyway, I was wondering how long after you received confirmation of your referral did you see someone at the GIC?

(Funky name by the way, I loves me some Doug I do!)
  •  

Bunny Girl Zoe

Was on waiting list 1.5 years before my 1st gic appointment but was only two appointment's before put me on hrt. But think each clinic is different and depends where about in transition person is.
  •  

kira21 ♡♡♡

I don't know, I am not quite at that stage yet. I am just before the second.

I think it depends on the GIC, but it would probably be referal to endo, bloodwork, hormones.

Look on the GIC website. They should have published pathways. There is an NHS guidance document which has details in, that was published in July.

Let us know how it goes! :-)

Akira x

pebbles

1st appointment with Dr Barett,
I'd been self medicating for a few YEARS prior to that, I was full time name change and everything at the time I was unemployed having been laid off. He asked me 20 questions about my family history and about me... We then chatted about human Kidney function. I'd not even been given a blood test in the years of dealing with the NHS and my self medicating, he seemed alittle surprised but not very. I got the blood test done right away.

I heard nothing after that... I asked both the hospital and my GP about my blood test nothing came up they'd lost it apparently, My appointment 6 months later was cancelled and I had to wait, 11months.

2nd Appointment with Dr Lorimer.
First thing he asked was "how is the new Hormone regime treating you" I was baffled, he showed me what they had on file. My blood test results had been processed, Dr Barrett refereed them to the head endocrinologist who'd suggested a prescription (Noting a problem with my levels) and sent it to my GP... who did nothing... for 10 months... The second appointment was much like the first, I was now employed as a Lab Scientist. He gave forms and his contact details if I wanted him to write a referral for a GRC. He gave me a print out of the letter to give my GP. He also Showed me Dr Barrett's report, Saying he'd approved my diagnosis as transsexual and he was going to do the same. He gave me a copy of those. Afterwards A nurse also came along and took a peek at my genitals Dr Lorimer asked if I was possibly intersex, I denied this. The nurse confirmed there wasn't anything out of the ordinary with my "bits"

I showed my GP the letter she said she'd already seen it, ¬.¬ Grr I followed there prescribed regime but had an adverse reaction to it, I tried to get in contact with my GP but that took over 6 weeks, By which time I'd already lost it and attempted to vivisect my own genitals earning me a trip to A&E I took there regime for abit but I was only given 2months worth of hormones per prescription, It took so long to get appointments that I'd basically have to rebook immediately after getting them. I eventually gave up and using the information in my blood test adjusted my Hormone levels and self medicated again.

9 Months later


3rd Appointment With Dr Barrett
Much shorter, he asked 10 questions instead of 20 I mentioned my change in job since I'd last seen him, he was disappointed when I said that modern immunoassay's use Chemiluminescence these days and not radioactive emission, I said he was a typical man, if it doesn't glow or explode they arn't interested in it. He then nonchalantly approved me for surgery I asked him what it's like and a time frame, as I've never had surgery. He gave me a time frame so I can inform work, and suggested I order pizza after my surgery, and play lots of computer games and to stay up all night prior to my surgery, I said it sounded like a typical Friday night for me.
He also commented about my self harm scars, his line of questioning implied that he sort of got it, but he suggested advice that I would find difficult to follow. I said I'd consider it. And that was that. I spent the rest of the day goofing around London with my friend.

I gave my operation approval form to the front desk they said they would contact me in 4-6weeks, It's been 4months and still no contact, I keep ringing them even when they pick up they either can't find my referral or they can find my referral but say they handed it to someone else (Aka the surgical team administration and I have to wait for them)

I'm sick of there bungling ineptitude I have the money I'm seriously considering paying for my operation myself I have to do everything else related to my care myself, I've been post transition for nearly 5 years now... I'm tired of waiting.


NB: I'm okay with the actual medical staff its the appalling administration that I'm annoyed with.
  •  

Stella Stanhope

QuoteAnyway, I was wondering how long after you received confirmation of your referral did you see someone at the GIC?

Hi Kaylee!

From my first GP appointment where I first brought up my GID issues (Feb '12) to my first GIC appointment (June '13) was 17 months (year and a half).
From the official GIC referral from my GP (May '12) to the first actual GIC appointment (June '13) was 13 months.
(This is the standard time-frame from what I've heard, so despite the initial errors made, its' been pretty "quick" and straight-forward for the NHS system. By contrast a friend in London waited three years only to be lost on the system after waiting).

It was an arduous process to begin with. Basically the first two times I visited the GP asking for a GIC referral  - they made mistakes. The first time the GP forgot to forward the referral on to the psychiatrist, and the second time they referred me to the "wrong" psychiatrist who told me he had no idea why they forwarded me onto him. (I needed to be interviewed by the psychiatrist first, so that he could make an assessment as to my general mental health,  before forwarding me back to my GP to tell them I didn't have underlying issues. Therefore the GP would be free to refer me to the GIC if she wished, which is what she indeed, did in the end).

However, at first, the surgery I was with was adamant that I could make my own referral to an NHS GIC! Despite the fact that this is completely not the case. So, they dilly dailled some more, until I complained and threatened to contact the newspapers. They knew absolutely nothing about the standards of care or the process involved. I got a formal apology from the manager of the practice, and they seemed genuinely apologetic and keen to find out more to prevent similar instances.

(Oh, Stanhope is so hilariously bitter and caustic! Can you imagine him presenting a vlog on being transgender?!! That would be intense.)

Bunny Girl Zoe - so exactly the same time frame as I have experienced, then pretty much, just over a year or so. I'm happy to go through further interviews before HRT as I don't identity as male or female strictly, and so deciding what to do with this identity is more of a challenge. So far, these GIC sessions have been excellent and the interviewees have been very knowledgeable, warm, and un-judgemental yet also gently investigative.   

Pebbles- thanks for your account of your journey so far. And I hope you receive better care and attention in the future :-)

Akira21 - will do! Thanks for that information!
There are no more barriers to cross... But even after admitting this, there is no catharsis... I gain no deeper knowledge of myself. No new knowledge can be extracted from my telling. This confession has meant nothing.

When you find yourself hopelessly stuck between the floors of gender - you make yourself at home in the lift.
  •  

kira21 ♡♡♡

I hate how crap the NHS is in dealing with trans people. When I first went to my GP I was told to go away as the NHS don't support trans people.

I haven;t had to wait as long as you guys tho, so I suppose I am lucky there.

pebbles

Quote from: Akira21 ♡♡♡ on September 22, 2013, 11:15:23 AM
I hate how crap the NHS is in dealing with trans people. When I first went to my GP I was told to go away as the NHS don't support trans people.

Ditto that Least I'm not the only one.
  •  

FTMDiaries

Congrats on getting to your third appointment! :D

If this appointment will be with both your therapist and the doctor, then this is the stage where you should be formally diagnosed with Gender Dysphoria and offered medical treatment. The medical doctor will have reviewed the therapist's notes from your previous sessions, and will most likely go along with their recommendations. They'll probably go over some of the questions you've already answered, but that's ok: the doctor is jointly responsible for anything that goes wrong with your medical treatment so they have to be sure you're a suitable candidate. If they agree with your therapist that you have GD, the doctor will talk to you about hormones and surgical options.

This doesn't mean that you get your hormones on the same day; rather, the doctor will write to your GP recommending the type of HRT they want to put you on. It can take a while for this letter to come through (mine took a month, and a lot of chasing up) but once it's been received, your GP can write the prescription. Your GP is responsible for prescribing and monitoring your HRT usage.

There's a series of blood tests the medical doctor will probably want done before they prescribe hormones. If these aren't done before your appointment, the doctor may ask you to get your GP to run the tests and come back for another appointment before you can get your hormones. But you can speed things up by ringing the GIC now to ask them which blood tests they want done, then go to your GP and ask them to run them. It takes around a week to get the results, but as soon as they come in, ask for a printout of your results and take them with you to your GIC appointment. (Top tip: it takes a long time for paperwork to percolate through the NHS, so always take a printout of any tests etc. with you for each appointment). Once the doctor has discussed HRT with you, they'll ask you to sign a consent form. The usually prefer you to go away & think about it, but I found it enormously helpful to research in advance all the pros and cons of the HRT they were going to put me on, because it meant the doctor was happy for me to sign the consent form there & then. If you do all this, there's a chance the doctor will not make you attend another appointment before prescribing HRT.

Likewise, talking about surgery means that they'll ask you about what procedures you might be interested in, and they'll agree a timeframe with you. Then they'll write to the relevant surgeons and you'll join their waiting lists. You'll probably also discuss with your therapist what kind of therapy you need going forward.

Good luck!





  •  

stacey fisher

am in Scotland and was 12 months from first being referred by GP  then after first appointment was 6 months and then started my real life experience and normally ask you to live 12 months full time and show changes ie legal change of name and bank details that sort of thing I did that in July 2012  I was seen every 3 months there on till had proven mentally ready normally see a second psychiatrists then stating HRT and then sent for the blood test I was referred for laser hair removal on the NHS in September 2012 and still having this (this started in Scotland a long time before England ) and since this have been seen every 3 months and been on HRT 3 months   
start hrt on july 11/7/2013 been living as fem for 15 months full time and changed name legal a year ago and med recs to fem started spironolactone 7/6/2014 just laying in bed after getting my surgery done on the 11/11/2015 feel so good
  •  

Kaylee

Quote from: "I'm Stella Stanhope, and that's why I drink". on September 22, 2013, 10:45:33 AM
From my first GP appointment where I first brought up my GID issues (Feb '12) to my first GIC appointment (June '13) was 17 months (year and a half).
From the official GIC referral from my GP (May '12) to the first actual GIC appointment (June '13) was 13 months.

Coolio, I got my letter through on the 13th so hopefully I should be seeing some one this time next year (which hopefully will just flyby!)

Quote from: "I'm Stella Stanhope, and that's why I drink". on September 22, 2013, 10:45:33 AM
(Oh, Stanhope is so hilariously bitter and caustic! Can you imagine him presenting a vlog on being transgender?!! That would be intense.)

I'm quite a fan of grumpy angry people that are annoyed at pretty much everyone, some of his stand has me it stiches.  Also the speech he gave on *wipe about reproduction being bad for the environment and everyone should just do anal... gross but a valid argument!

Quote from: "I'm Stella Stanhope, and that's why I drink". on September 22, 2013, 10:45:33 AM
It was an arduous process to begin with. Basically the first two times I visited the GP asking for a GIC referral  - they made mistakes. The first time the GP forgot to forward the referral on to the psychiatrist, and the second time they referred me to the "wrong" psychiatrist who told me he had no idea why they forwarded me onto him. (I needed to be interviewed by the psychiatrist first, so that he could make an assessment as to my general mental health,  before forwarding me back to my GP to tell them I didn't have underlying issues. Therefore the GP would be free to refer me to the GIC if she wished, which is what she indeed, did in the end).

However, at first, the surgery I was with was adamant that I could make my own referral to an NHS GIC! Despite the fact that this is completely not the case. So, they dilly dailled some more, until I complained and threatened to contact the newspapers. They knew absolutely nothing about the standards of care or the process involved. I got a formal apology from the manager of the practice, and they seemed genuinely apologetic and keen to find out more to prevent similar instances.

Quote from: Akira21 ♡♡♡ on September 22, 2013, 11:15:23 AM
I hate how crap the NHS is in dealing with trans people. When I first went to my GP I was told to go away as the NHS don't support trans people.

I haven;t had to wait as long as you guys tho, so I suppose I am lucky there.

Ouch, you guys sound like you had a painful time.  My doctor was awesome.  I just went in, sat down and told her I was trans and that she needed to refer me to an MHO, was there 4 weeks later being told she'd be happy to refer me on to the GIC, quite quick and (relatively) painless


Pebbles - That sounds rough, hope things start to swing your way soon.

Quote from: stacey fisher on September 23, 2013, 10:00:18 AM
am in Scotland and was 12 months from first being referred by GP  then after first appointment was 6 months and then started my real life experience and normally ask you to live 12 months full time and show changes ie legal change of name and bank details that sort of thing I did that in July 2012  I was seen every 3 months there on till had proven mentally ready normally see a second psychiatrists then stating HRT and then sent for the blood test I was referred for laser hair removal on the NHS in September 2012 and still having this (this started in Scotland a long time before England ) and since this have been seen every 3 months and been on HRT 3 months   

Did they make you do 9 months before getting a prescription for HRT?  There's no way I would of even considered going full time if it wasn't for self medding.  Now I'm here though, there's no chance I could ever go back.
  •  

stacey fisher

Quote from: Kaylee on September 23, 2013, 02:46:04 PM
Coolio, I got my letter through on the 13th so hopefully I should be seeing some one this time next year (which hopefully will just flyby!)

I'm quite a fan of grumpy angry people that are annoyed at pretty much everyone, some of his stand has me it stiches.  Also the speech he gave on *wipe about reproduction being bad for the environment and everyone should just do anal... gross but a valid argument!

Ouch, you guys sound like you had a painful time.  My doctor was awesome.  I just went in, sat down and told her I was trans and that she needed to refer me to an MH
start hrt on july 11/7/2013 been living as fem for 15 months full time and changed name legal a year ago and med recs to fem started spironolactone 7/6/2014 just laying in bed after getting my surgery done on the 11/11/2015 feel so good
  •  

stacey fisher

12  month full  time is about the normal time in UK before starting HRT to prove u can live day to day life before getting any meds have to prove your self
start hrt on july 11/7/2013 been living as fem for 15 months full time and changed name legal a year ago and med recs to fem started spironolactone 7/6/2014 just laying in bed after getting my surgery done on the 11/11/2015 feel so good
  •  

Kaylee

Quote from: stacey fisher on September 24, 2013, 12:35:57 PM
12  month full  time is about the normal time in UK before starting HRT to prove u can live day to day life before getting any meds have to prove your self

Are you sure on that time scale?  I know that most GIC's aren't exactly following SoC v7 yet, but I was sure that the 12 month RLE thing was a thing of the past due to it being positively draconian?
  •  

stacey fisher

Quote from: Kaylee on September 24, 2013, 03:30:17 PM
Are you sure on that time scale?  I know that most GIC's aren't exactly following SoC v7 yet, but I was sure that the 12 month RLE thing was a thing of the past due to it being positively draconian?

yes am sure on this and some cases longer and have to show evidences of changes such as name change but have heard that this is all changing soon and real life going down to 3 to 6 months I heard this at LGBT but not in places as yet
start hrt on july 11/7/2013 been living as fem for 15 months full time and changed name legal a year ago and med recs to fem started spironolactone 7/6/2014 just laying in bed after getting my surgery done on the 11/11/2015 feel so good
  •  

FTMDiaries

Quote from: stacey fisher on September 24, 2013, 12:35:57 PM
12  month full  time is about the normal time in UK before starting HRT to prove u can live day to day life before getting any meds have to prove your self

With respect, the rules for Scotland and England are different, and England's rules changed for the better last month. I was given HRT after (according to my clinic) 8 months' RLE, but new patients can go on it even more quickly due to the bridging endocrine treatment provisions I've mentioned elsewhere.

So yeah, in England at least it isn't necessary to do 12 months' RLE. But it's swings and roundabouts, because in Scotland you can refer yourself to a GIC without even seeing a GP first, whereas we need to go through a GP.





  •  

big kim

It was in 1992 and has probably changed but I was given HRT on my  2nd visit after showing my deed poll,driving licence,bank details and wage slip in new name.The 3rd visit I only remember seeing 1 doctor and not sure if it was a Psychiatrist or Psychologist.Sorry it's a bit crap but I can't remember anything else
  •  

stacey fisher

Quote from: FTMDiaries on September 25, 2013, 03:37:38 AM
With respect, the rules for Scotland and England are different, and England's rules changed for the better last month. I was given HRT after (according to my clinic) 8 months' RLE, but new patients can go on it even more quickly due to the bridging endocrine treatment provisions I've mentioned elsewhere.

So yeah, in England at least it isn't necessary to do 12 months' RLE. But it's swings and roundabouts, because in Scotland you can refer yourself to a GIC without even seeing a GP first, whereas we need to go through a GP.

has it now just changed in England heard it was going to things changed with NHS IN Scotland over a year ago with what can and get like hair removal laser treatment and time lines I noticed this when move to Scotland from England that more help available in Scotland and moves faster than england
start hrt on july 11/7/2013 been living as fem for 15 months full time and changed name legal a year ago and med recs to fem started spironolactone 7/6/2014 just laying in bed after getting my surgery done on the 11/11/2015 feel so good
  •