My journey begins tomorrow... I'm nervous

[Fred86]

Hi all,

The appointment I set with my GP is tomorrow and... I am getting nervous, even though it's not exactly a true milestone.

I am not sure why I am so anxious about the whole thing... First I was uncomfortable with the fact that it was a man and not my actual GP (who for the next fortnight is only going to see patients whilst medical students are present, urgh). Then I realised it wouldn't be better at all if it were a woman and it's best if no one else is going to be there anyway.

And now I am starting to question myself since I should not be so nervous about talking about it with strangers as I plan to actually walk out in the open as a man at some point, so I just don't make sense.

I guess it's because it will be the first time I tell it to a stranger in person. But I don't quite know. Sorry for rambling.

Anyway, I would love to hear about your experiences when you first told your doctor about how you feel and transitioning. I'd love to read your tips.

[Alexthecat]

I'll be doing this in 3 months, I'm curious of the replies. But in regards to medial students, you can request them to leave the room. It's your healthcare and if you don't want them there they need to respect that.

[Kara Jayde]

And now I am starting to question myself since I should not be so nervous about talking about it with strangers as I plan to actually walk out in the open as a man at some point, so I just don't make sense.

I guess it's because it will be the first time I tell it to a stranger in person. But I don't quite know. Sorry for rambling.

Anyway, I would love to hear about your experiences when you first told your doctor about how you feel and transitioning. I'd love to read your tips.

I think its very VERY normal to feel that way, and I'd say it's probably a feeling we have because of how society treats/views trans people. I was dead scared, but my GP was very nice about it and tried to help me as much as she was able to. Sure, I have to leave my house as a woman eventually, but there are steps, and we have to walk before we can run. We have to climb over a mountain of societal pressure that we've been raised with, and that's never easy. Best of luck ^^

My GP was the first person I told outside of one friend who is also somewhat trans, so I saw it as a milestone as well.

[Bombadil]

That sounds like a totally normal response to me. I'm hopefully setting up an appointment today and I am definitely going to be nervous.

Good luck on your appoinment!

[Ryan55]

good luck at your appointment, I felt nervous just making my appointment lol I think its normal and everything will be alright

[AdamMLP]

I'd never met my GP before (just moved).  I went in, he greeted me, and I said straight out, "I'm trans and I'm wondering what you can do for me."  That just got it out in the open and it was easier to talk about from there.  I knew that if I bandied about the topic I'd never manage to get it out.  It was probably easier for me to do it that way than some people because I'd known for two years before then that I was trans, it wasn't such a scary topic for me anymore.

I know of someone else who wrote a letter, went in there and warned them that they might have to read it for themselves, read the first two lines, started crying and let the GP take the letter and read it all for themselves.  So maybe that's another option if you're really nervous about it.

It's normal to be nervous about telling people.  I was scared of telling a friend who I'd witnessed stick up for trans people a couple of times before and knew would take it well.  I'm nervous telling my work even though I know they're okay with it.  I'm nervous every time someone has to find out, but it's always turned out fine.

[Adam (birkin)]

With the GPs, surgeons, psychiatrists, etc...I just tell them straight up. I assume any professional doctor just wants the up and up so they know what's going on and how to approach it. If they are weird about it, they're not professional, and I won't waste my time with them. I had a few act really weird to me and I just went and called another doctor.

[Fred86]

Thanks everybody for the replies. I must admit it was a very difficult experience, far worse than I had anticipated. Warning: it took me a whole day to calm down and I am still quite agitated so my post might be a bit over-emotional.

Firstly, he was completely emotionless, which I wouldn't have minded, but then he avoided my questions about linking NHS with private care and repeatedly said how difficult the process is here in Wales (compared to England). I was quite annoyed since he had no constructive approach to it (whilst I was doing my best to understand how to move the process a little faster so I won't lose my mind).

Then he said he'd have to force me to talk to him about my life before he would even consider making a referral to the Welsh Assembly which apparently needs to approve any referral to a psychiatrist. Now I wouldn't mind talking to a professional about my life, why I need to transition etc etc. but I feel that what I told him today should be enough to persuade anybody to make me see a psychiatrist. Especially since I have to wait for another three weeks to see him alone.

And when I said that all of that would take years and I don't fancy wasting all that times when I can have a more practical and healthier approach with the help of the private clinics, he went ahead and said that I should not concentrate on how long it would take but on the fact that I have just started the process and it's better than nothing.

At that point I was so shocked that I had tears in my eyes. I told him that in no way am I trying to make the change happen tomorrow or in the next few months as I know that it's a process and not a quick fix, but he just wouldn't listen and said that I should instead concentrate on preparing for talking about my life and history in a double session.

I wasn't even planning to go through the whole process with the NHS but wanted to find out whether they'd be willing to prescribe hormones if any of the private clinics recommend to do so. But he obviously decide to just not answer that and just said that if they would prescribe any hormones they're unfamiliar with, they will not be able to help anyway.

And he did all of that whilst treating me like a child. I don't remember the last time I was treated that way and I was far from pleased that I was reminded just how painful it can be.

I was so upset that I felt like punching a wall when I arrived home. What completely amazed me was that his first reaction to me saying that I am a man in a female body was that they have treated quite a few trans people. I would think he'd then know better how to handle it.

Sigh. Sorry about this long post, I needed to let off steam...

[Kara Jayde]

I'm sorry it was such a bad experience overall. At least he accepted your dysphoria, and it sounds like he was just making sure you understood the process. I can image there would be a few people who walk into doctors clinics and ask for a 'sex change' without understand the years of transition it takes and how it all works. None the less, his emotionless/cold approach and his hesitance to listen might mean it's a good idea to find somebody else to work with, I'm sure next time you go in, you could ask for a different GP and go through the process again. It'll be easier for your to open up about it a second time, and if you get lucky and get somebody you're more compatible with, I'm sure the whole process with be much smoother for you.

[Fred86]

I'm sorry it was such a bad experience overall. At least he accepted your dysphoria, and it sounds like he was just making sure you understood the process. I can image there would be a few people who walk into doctors clinics and ask for a 'sex change' without understand the years of transition it takes and how it all works. None the less, his emotionless/cold approach and his hesitance to listen might mean it's a good idea to find somebody else to work with, I'm sure next time you go in, you could ask for a different GP and go through the process again. It'll be easier for your to open up about it a second time, and if you get lucky and get somebody you're more compatible with, I'm sure the whole process with be much smoother for you.

Thank you, Nattie. I am not sure I will try any GP any time soon as I am planning to move back to England in a few months for work. I guess I might have better luck there but I am considering going to a private clinic. It won't exactly serve me in terms of speeding the process but at least I will get to talk to an expert about this. I need to consider a few things (including starting my RLE phase) and I feel that it's something I need to do soon to avoid depression. The NHS process is too slow and complicated to help with that at this point (especially here in Wales).

I just hope that in due time, the next GP I see will trust the assessment of the private clinic and would be willing to help, otherwise I fear I will be spending a great deal of money on hormones and blood tests. I am actually trying to find out which one of the two clinics in London is better in terms of quality of service and reputation (just so a GP will be more likely to accept their recommendations). I am just not sure where to start looking.

[Greeneyedrebel]

That sounds like a big let down for you Fred, I'm sorry.

I know nothing about the UK's health system, so I can't give advise really. But I hope you can get moving forward again soon.

[JulieBlair]

I sometimes am flabbergasted when professionals who ought to know better behave with casual cruelty.  I'm sorry that you should have to be subjected to this. I also hope that no matter how many fools get in your path that you persist.  All people deserve and have a human right to living an authentic life. 

Seems very strange to me.  In the states we have to pay for everything, but maybe that provides practitioners with an incentive to treat us with respect, and be an advocate.  What happened to you is messed up and not necessary.

Julie

[Bombadil]

I'm sorry the experience was so difficult. That really stinks. Hopefully the next step will go better. Hang in there.

And don't punch any walls. That can mess you up

[CaitlinH]

Hey Fred,

Sorry to hear about how awkward your GP is being. To my knowledge all a GP needs to do is be willing to perform blood tests and dispense the hormones. If you're not going through the Charing Cross GIC your GP shouldn't be doing any referrals, since you can self-refer to both Transhealth and GenderCare (I assume those are the two you are referring to).

It may help to go to one of the private clinics and get ask either Dr. Curtis or Dr. Lorimer to write a letter to your GP about it. From what you've wrote though I suspect that your GP will be awkward about prescribing hormone and helping you out with blood tests. I know that GenderCare have an onsite nurse who can perform phlebotomy for a relatively cheap price (£30 last I heard), but I don't know how much you'd expect to be paying for hormones if you can't get them through the NHS.

Have you considered moving to a different practice? It doesn't take much effort to move these days (at least in England) and you may find a more sympathetic and helpful doctor there.

[Beverly]

GenderCare has suspended appointments for a few weeks due to legal paperwork / registration issues with the CQC.

As for the awkward GP, you might want to refer him to this document http://www.england.nhs.uk/wp-content/uploads/2013/10/int-gend-proto.pdf and in particular page 15 which says

NHS England expects GPs to co-operate with their commissioned GICs and to prescribe hormone therapy recommended for their patients by the GIC. They are also expected to co-operate with GICs in patient safety monitoring, by providing basic physical examinations (within the competence of GPs) and blood tests recommended by the GIC.

Admittedly NHS Wales is a different organisation but since Wales has no GICs and sends it patients to England. Furthermore your GP can send you direct

See your GP if you think that you or your child may have gender dysphoria. They can refer you or your child to a Gender Dysphoria (GD) clinic.

http://www.nhsdirect.wales.nhs.uk/Encyclopaedia/g/article/genderdysphoria/#Treatment

[Fred86]

Thanks everybody for the sympathy and tips.

Thanks for the in depth points, CaitlinH and provizora3.  I've heard about the clinics and I will definitely try to go through the private route as much as my bank account will allow me to. But it seems that the best way to go about it, for now, would be to contact one of the clinics in London (still unsure as to which one is better) and see how it goes until I move to England. Then I could try to find a good GP who would be willing to help with hormones and blood tests.

What do you think? I am also not so sure as to whether I should see any psychiatrist for assessment before I even start my RLE phase. I mean, for now the main thing I need to do is cut my hair shorter, as my clothes are very boyish. I have also not told most people in my life about the fact I chose to go through with it. I sort of fear they won't take me seriously or think I am not confident about my decision.

[Beverly]

Thanks everybody for the sympathy and tips.

Thanks for the in depth points, CaitlinH and provizora3.  I've heard about the clinics and I will definitely try to go through the private route as much as my bank account will allow me to. But it seems that the best way to go about it, for now, would be to contact one of the clinics in London (still unsure as to which one is better) and see how it goes until I move to England. Then I could try to find a good GP who would be willing to help with hormones and blood tests.

You can ask your current GP for blood tests. Tell him you need baseline tests as you intend to medically transition. The tests you need are

Testosterone (*)
Estradiol (E2) (*)
Prolactin (*)
Liver function (*)
SHBG
Lutenising hormone (LH)
Follicle stimulation hormone (FSH)
Thyroid function
Cholesterol
PSA
Lipid profile

The four marked (*) are the essentials but the others will indicate the state of your health at this point in time. If you get the Cholesterol test then remember to fast for 12-14 hours beforehand so it is a good idea to arrange to have the blood drawn at 10am or so and eat nothing but water after 6pm the previous night.

What do you think? I am also not so sure as to whether I should see any psychiatrist for assessment before I even start my RLE phase.

You do not need anyone's permission to start RLE if that is what you want to do. Everyone on here seems to think that RLE means flouncing round in a frock. It does not. It means making concrete steps to commence your transition. The GICs usually take RLE to start when you change your name but any supporting evidence that you are commencing to change gender role will be given consideration.

[Alexthecat]

http://www.webmd.com/cholesterol-management/news/20121108/fasting-may-not-be-needed-before-cholesterol-test

[Beverly]

People should not really eat after 6pm anyway, and skipping breakfast the next morning is hardly difficult...