The NHS is a bureaucratic organisation and the bureaucrats have little time for mere mortals, but if you get your facts organised then they tend to back off rather quickly.
The facial hair removal (in England, but very similar to Scotland) is in this document (see appendix 4)
http://www.england.nhs.uk/wp-content/uploads/2013/10/int-gend-proto.pdfThat has been updated slightly, but is essentially unchanged. It makes no mention about hormones, make-up or RLE other than MTF people should be given hair removal to assist with their RLE. The statement that will be of particular interest is
"It is recommended that facial hair removal should commence prior to social gender roletransition, as the beard must grow to visible lengths to be removed."These are indeed guidelines for treatment but it would be a very foolish doctor that ignores them. If they do ignore them then ask the Practice Manager to forward the guidelines to their Medical Defence Union and ask if they would defend the Practice for refusal to treat. Asking questions like that often produces results if you ask politely (do not threaten or shout).
Transitioning on the NHS is actually quite straightforward as long as you are prepared to document everything, follow up on appointments, research what medications you are
entitled to and so on. Knowledgeable patients are rarely bothered by awkward medical staff. Anyone who expects the NHS to ride in, sweep them off their feet and carry them from the start to the finish is in for a big shock. Most medical staff have never seen a trans-person and are utterly clueless.
My technique is to never leave the building without my next appointment printed out and handed to me and filed in my transition folder in front of the appointments clerk. I never go to a meeting without my transition folder and I can look up any details at any time and give them the answer without going away to find it. They soon get the idea that you
know what you are entitled to. Ask staff for direct email addresses and bypass the admin bureaucrats as much as possible. I have emails for all my clinicians in the GIC and my GP staff know I know my stuff and I get no trouble.
My transition is far, far, far too important to leave up to admin people and suchlike to whom I am just another patient in an area of practice about which they may know little. I run my transition and let them know, politely, what I want done and I usually get it. I encourage everyone I meet in transition to do the same - be your own "Transition Manager" and use the NHS as a resource pool.
