Moving from a private clinic to NHS

[Trillium]

Hey all,

It's been awhile since I've posted on here. I've finally gotten referred to a GIC through my GP, though I wish I had been a bit more pushy. I was waiting to hear from the mental health people/CMHT for over 3 months only to find that they had sent a response to my GP, which for some reason she didn't receive, saying that I didn't need to see them and she should refer me directly.

I've been feeling pretty frustrated lately and from that I've been self medicating over the last week. I did talk to my GP before starting and asked about getting a blood test but I think she refused to acknowledge that I was adamant about it and said I couldn't get the blood tests I was wanting unless there was an emergency. Today I've decided to stop with self medicating, I really don't want to because things felt so right this past week and my minds never felt as clear, but I'm concerned that it might affect my health or impede my transitioning once I get on the official route. One big sign for me was that my muscles felt weak which I've read could be from to much potassium.

I know that it's likely I wont get an appointment with the NHS GIC until the end of this year/beginning of next. So I'm going to see if my father will lend me the money to go private. What I'm wondering is when I do get an appointment with the NHS GIC can I easily move onto them after being with the private GIC for sometime?

On the NHS website they say "If you are referred to the GIC and have had or continue to have treatment within the private sector, you will need to make a choice. After two appointments you will need to commit to treatment within the NHS or the private sector, but not both at the same time." What do they mean by after two appointments?

[Trillium]

I guess I'm asking in the wrong place...

[Beverly]

I guess I'm asking in the wrong place...

In a way - Susan's is a US site and they all think the NHS is a wet dungeon with spiders that only operates 1 day in 6 with a trainee nurse...

Anyway, to answer your question, if you go to either Dr Curtis (Transhealth) or Dr Lorimer (Gendercare) and get diagnosed with them, then you should go to your GP and see if they are willing to take over prescribing for you.

Once you get to a GIC then you will undergo at least two assessments before they offer to prescribe hormones. This is the point where you must choose. No medical organisation wants to have two different doctors prescribing the same medicines at the same time. So you either get the GIC to do it or you get it privately. You choose.

I would do it like this...

Get the private diagnosis and prescription. Take these to your GP and ask for blood tests and then to see if your GP will take over the prescription. They will almost certainly agree to the blood tests once you have been diagnosed by someone.

When the GIC asks if you are on hormones, you need to show that you are being RESPONSIBLE about it and that you are MONITORED. Those are they keys. If they think you are just popping pills with gay abandon then they will tell you to stop.

Be sensible about this and there will be no problems.

[Kaylee]

You shouldn't really have a problem moving to the NHS from everything I've read

Your GP shouldn't be denying blood tests, I've been self medding since before coming out to my GP and they agreed to blood tests fine in order to monitor me.  Have you spoke to the practice manager about this?  Mine has been absolutely fantastic with assisting me while waiting for a GIC appointment (12 months and counting so far, 1st appointment not till December).

[Trillium]

Thank you Kaylee and rkwkat, I'll book to see my GP tomorrow and just be more pushy about getting a blood test.

[Beverly]

Tell your GP you have been self-medding and that you need the following tests

Oestradiol (E2)
Hepatic profile (H1)
Prolactin (PROL)
Testosterone (TEST)

Those are the test names together with the usual codes. The hepatic profile should include Alkaline Phosphatase and another test called ALT. If this is your first then it might be a good idea to add PSA to check for Prostate issues.

If you tell them you are self medding then they have an obligation to ensure that yuo are not harming yourself. If this gets you nowhere then see the practice manager as Kaylee said.

[Trillium]

Thankies rkwkat,

Last time I asked for
•    CBC with Differential
•    Comprehensive Metabolic Panel
•    Lipid Profile
•    Testosterone -Total + Free
•    PT/PTT
•    Urinalysis

Not sure if these cover the same thing?

[Beverly]

There are some differences. PTT is a clotting test usually used if you have unexplained bleeding. None of your tests have Oestrogen or Prolactin.

The four I have given you are the standard monitoring ones my GIC has run on me every few months or so. Prolactin is important because it can affect your eyesight if too high. ALT in the hepatic panel will indicate any liver damage.

[Trillium]

The source I copied it from transgendercare.com mentioned that... "You will note the absence of serum estradiol, as its measurement offers a poor gauge in determining the effectiveness of treatment."

I guess I need to really read into each of these tests to work out what I'll need.

Thanks again x