UK - Need advice on asking for GP referral ?

[Takoto]

Hello! I  really hope this is the right place to post this, I'm a little new to this forum.

Basically, I have a GP appointment this Wednesday- I've been asking to be referred to Charing Cross several times but on the tail-end of previous appointments (when I say previous, I've been doing this for two/three years. I'm a bit anxious), this is my first time dedicating a whole GP appointment to saying, please refer me, I've legally changed my name, I'm living as a man, please refer me. There shouldn't be any problems, right?

My GP has provided to be pretty not-knowledgeable about things related to this before. When I first came out to them they referred me to a service for depression and anxiety (upon my second session with them, they were like, we have no idea why your GP referred you here, as what you seem to need is dedicated gender-related support).

I'm bringing the details of Charing Cross' Gender Clinic, but I was wondering is there anything else I should bring? Anything I should say?

I legally changed my name over a year ago, and I've been trying to live as a man for the past two-three years (I am FtM), so there should be no issues with them feeling like I need to wait longer to be referred, right?

Thank you for your time!!

[Olivia P]

First of all, read up on current NHS protocol for gender referrals, also expect a wait.

The waiting lists for charring cross are quite long.

If you can afford it, i recommend using a service like gendercare.co.uk while you wait for the nhs to accept you. That is what i am currently doing.

Your GP shoudnt make you wait ever for referral, they should referr you regardless of if you have started changing or made no changes at all.

The gender clinic deals 100% in assessment and deciding on appropriate treatment.

[Takoto]

Thanks for the response!

Yeah, I've been told by friends IRL the waiting lists are very long, especially for Charing Cross. I shall look up the protocol as soon as possible and try to get familiar with it, thank you! Do you know of anywhere online I can find it?

I'm afraid I doubt I can afford it, I'm a student without work, but I will definitely read that website anyway. Thanks!

[Olivia P]

Thanks for the response!

Yeah, I've been told by friends IRL the waiting lists are very long, especially for Charing Cross. I shall look up the protocol as soon as possible and try to get familiar with it, thank you! Do you know of anywhere online I can find it?

I'm afraid I doubt I can afford it, I'm a student without work, but I will definitely read that website anyway. Thanks!

I believe this is the latest version: http://www.england.nhs.uk/wp-content/uploads/2013/10/int-gend-proto.pdf#

I will clarify for you, if you did go for the private option until nhs accepts you, you only pay for the assessments, the blood tests and the medication goes through shared care and you get NHS prescriptions via your gp, and therefore pay normal amounts.

[Seras]

First time I told my GP I got a referral to the GIC straight up. Soon as I had my local psychologist type make sure I wasn't just a mental, that is.

So yea. Grt a new GP if they won't/don't refer.

[Olivia P]

First time I told my GP I got a referral to the GIC straight up. Soon as I had my local psychologist type make sure I wasn't just a mental, that is.

So yea. Grt a new GP if they won't/don't refer.

Its even better now as you dont need to visit a local mental health specilist in england, the gender clinic deals with it all directly

[FTMDiaries]

I second what others have said about Charing Cross having ridiculous waiting times. Not only do you generally wait a long time for your first appointment, but the waits between subsequent appointments are very long too. This means it can take them years to do what should only take a couple of months.

There are 7 NHS GICs in England (London, Sheffield, Leeds, Sunderland, Nottingham, Norwich, Exeter) and they all have a lot of patients on their books already, as well as people who are waiting to see them. However, Charing Cross is the famous one that everyone knows about, so they tend to get inundated more than the others. If one of the other GICs is within reach, you might want to consider asking to be referred there instead. I see you've said you're on the south coast; I highly recommend Exeter if you can get there.

Here's another handy document you might find useful: it's the NHS's guidance to GPs telling them how they should go about referring their patients to GICs: http://www.nhs.uk/Livewell/Transhealth/Documents/gender-dysphoria-guide-for-gps-and-other-health-care-staff.pdf

And if you've not yet done so, you can ask the staff at your surgery how you should go about changing your name on their records. I had to write to my local branch of NHS England, but some surgeries will do this for you.

Good luck!

[Danniella]

And if you've not yet done so, you can ask the staff at your surgery how you should go about changing your name on their records. I had to write to my local branch of NHS England, but some surgeries will do this for you.

Good luck!

I'm in Scotland...so it's possibly a bit different. But my GP actually offered to change my gender as well on all my NHS records once they saw me full time and I had changed my name with them

It was all a bit unexpected, but they offered to do all the legwork and paperwork for me, so I should get a new national insurance number, NHS records, GP records and everything using my new name and saying that I am female...

Apparently they said that the only downside is that I will get automated letters etc to arrange the likes of smear tests etc, so i will need to inform the receptionists when I do...I don't think it would go down to well with the poor gynecologist if I tried to go through with one x'D

All of this...and I haven't even set foot in any NHS gender Identity Clinics yet! xD

So it's very dependant on your particular GP, but I have heard tales of girls even getting HRT and things prescribed before they go to their GIC...it's rare don't get me wrong, but it just goes to show that they can do allot for you...or not much.

It all just depends on luck, and how confident you are sadly :S

[FTMDiaries]

I'm in Scotland...so it's possibly a bit different. But my GP actually offered to change my gender as well on all my NHS records once they saw me full time and I had changed my name with them

Thats great! Sounds like you have an excellent GP. But yes, NHS England and NHS Scotland are very different animals.

You're also lucky that you have access to the Sandyford, which allows patients to self-refer without even going to a GP first. And of course, I daresay you won't have to pay a penny for your hormone prescriptions either, unlike us Sassenachs... at least for now.

But yes, NHS England's protocols do state that GPs can prescribe 'bridging endocrine treatment' to start patients on hormones whilst they wait for a GIC appointment. However, finding a GP who is willing to do that is not easy. As you say, it's mainly down to luck.

[Danniella]

Thats great! Sounds like you have an excellent GP. But yes, NHS England and NHS Scotland are very different animals.

I thought so...such a lovely devolved power the Scottish NHS ^^

My GP can be hit and miss, we can't book individual appointments with select doctors because "IDON'TKNOWDON'TEXPECTLOGICFROMTHENHS!" So I know when I walk in the room whether I am going to have a good day or not by what doctor I have lucked into on that particular visit...some highlights have been one doctor who was completely oblivious to everything and had no idea what to do with me, so she ran off and called a "crisis meeting"...within earshot, one super kind doctor who offered all the gender change/name change stuff, and even one who tried to have me admitted to a mental health hospital...so it's quite the lucky draw >.>

You're also lucky that you have access to the Sandyford, which allows patients to self-refer without even going to a GP first. And of course, I daresay you won't have to pay a penny for your hormone prescriptions either, unlike us Sassenachs... at least for now.

Unless you live in Tayside like me...which for some strange reason functions under it's own obtuse system or referral to Sandyford -.-;

-comforting self reassurance chanting- "only 5 months to go...only 5 months to go"

But yes, NHS England's protocols do state that GPs can prescribe 'bridging endocrine treatment' to start patients on hormones whilst they wait for a GIC appointment. However, finding a GP who is willing to do that is not easy. As you say, it's mainly down to luck.

Hm that's probably what I had heard of. ALas my GP will not go that far in helping me, but that's understandable I guess.

[Takoto]

Thanks for all the responses! I'm slowly reading through the thread, will respond to all in time.

And if you've not yet done so, you can ask the staff at your surgery how you should go about changing your name on their records. I had to write to my local branch of NHS England, but some surgeries will do this for you.

Just to clarify, I have already done this, I've changed my name records over at my GP/Surgery/on the NHS records and all my old schools and work places, so this shouldn't be a problem (I did it about a year ago)

I live in Brighton/Sussex, so Charing Cross is the very nearest GIC to me, Exeter is quite far out my reach. I'm moving to Southampton soon, but even then, I think Charing Cross is still closer, but I will look into the others!

[FTMDiaries]

I live in Brighton/Sussex, so Charing Cross is the very nearest GIC to me, Exeter is quite far out my reach. I'm moving to Southampton soon, but even then, I think Charing Cross is still closer, but I will look into the others!

Ah Brighton, how I love the place.

I'm aware of how difficult it can be to travel between Brighton and Exeter, particularly by public transport; you'd most likely have to travel to London first before heading down to the South-West, so it can seem inconvenient.

But consider this: Charing Cross may make you wait a year or more for your first appointment, and you'll wait anything from several months to a year between each subsequent appointment; whereas Exeter will most likely see you within a couple of months and your gap between subsequent appointments is measured in weeks. So it's well worth weighing up whether you'd be willing to put up with the occasional transport headache just so that you can transition at a reasonable pace.

Oh, and the good news is that if you decide to go for top surgery, you can have that done in Brighton. Bottom surgery is performed in London.

[Takoto]

Ah Brighton, how I love the place.

I'm aware of how difficult it can be to travel between Brighton and Exeter, particularly by public transport; you'd most likely have to travel to London first before heading down to the South-West, so it can seem inconvenient.

But consider this: Charing Cross may make you wait a year or more for your first appointment, and you'll wait anything from several months to a year between each subsequent appointment; whereas Exeter will most likely see you within a couple of months and your gap between subsequent appointments is measured in weeks. So it's well worth weighing up whether you'd be willing to put up with the occasional transport headache just so that you can transition at a reasonable pace.

Oh, and the good news is that if you decide to go for top surgery, you can have that done in Brighton. Bottom surgery is performed in London.

Thanks for the information!

Sorry to bother, but do you happen to know any estimate on the waiting time for Exeter? Thanks so much for everything so far! If it's only a month or so more, I don't mind waiting too  much and saving the money, but if it's pretty significant, I might see if I can find a way to get to Exeter and back sometimes.

And ah! I didn't know that! That's very helpful to learn, thanks!

[krogan]

I live in the Southwest so I was referred to the Exeter clinic. In total it took about 5-6 months for me to get an appointment with them, once I'd been referred, but they were in a bit of an administrative mess at that time. I think their situation has improved a lot since then.

As for my experience with the GP: mine had no idea what to do with me. I told him that I knew where the nearest clinic was and that he should just refer me, but instead he said he'd 'research' it. A month later I'd heard nothing, so I went and pestered him. He then sent me to a local psychologist. After talking to her, I was referred to the gender clinic. ¬_¬ (By this time I'd already been living as a man for a year+ and had legally changed my name etc.)

My experience with the Exeter team was, overall, very positive, and things went forward a lot faster than I'd anticipated. My first appointment with them was just awesome, cos I was finally talking to people who understood what I needed!

I don't attend the clinic anymore though: my choice. After I'd had my chest surgery (also performed in Exeter), I didn't feel the need to keep attending, since I have a very strong support network at home, and felt someone else could use the appointments more. 

[FTMDiaries]

Sorry to bother, but do you happen to know any estimate on the waiting time for Exeter? Thanks so much for everything so far! If it's only a month or so more, I don't mind waiting too  much and saving the money, but if it's pretty significant, I might see if I can find a way to get to Exeter and back sometimes.

You're welcome. :-)

Waiting times are long at any NHS clinic; the only way you'll be seen really quickly is if you decide to go to one of the private clinics in London.

But Exeter's waiting times are much shorter than Charing Cross's. I spoke to the staff at Exeter recently and they said they currently have double their normal amount of people on their waiting list but that's still a fraction of the number of people waiting for Charing Cross. Their usual wait for an initial appointment is about 3-4 months, so if they have double the usual number waiting at the moment I would estimate the wait would be something like 6 months... but compared to Charing Cross, where new referrals generally take more than a year, that's a massive difference.

Bottom line is this: if you go to Exeter you're likely to be seen this year. If you go to Charing Cross, you'll be lucky to be seen before next summer.

Also, there's the matter of subsequent appointments. Exeter will have no problem with seeing you as frequently as every six weeks if you wish; but Charing Cross has been known to make people wait several months, and sometimes up to a year, between each appointment.

You might be lucky. But the smart money is on you transitioning faster if you go with Exeter. Even if it's a bit of a faff to get there.

[Kaylee]

But yes, NHS England's protocols do state that GPs can prescribe 'bridging endocrine treatment' to start patients on hormones whilst they wait for a GIC appointment. However, finding a GP who is willing to do that is not easy. As you say, it's mainly down to luck.

I've had a hell of a time trying to get bridging treatment from my GP/St James hospital.  Yesterday I finally managed to find an endo I can see on the NHS that is willing to provide it to me!

Bloody good job as well, I've recently found out my 1st GIC appointment won't be until December, after requesting an appointment back in May last year...20 months wait in Leeds!

[FTMDiaries]

I've had a hell of a time trying to get bridging treatment from my GP/St James hospital.  Yesterday I finally managed to find an endo I can see on the NHS that is willing to provide it to me!

Bloody good job as well, I've recently found out my 1st GIC appointment won't be until December, after requesting an appointment back in May last year...20 months wait in Leeds!

Congrats on finding a willing endo!

But bloody hell... 20 months to wait for your first appointment. 

So much for the NHS target of 18 weeks. 

[Kaylee]

Congrats on finding a willing endo!

But bloody hell... 20 months to wait for your first appointment. 

So much for the NHS target of 18 weeks. 

Thankies

I very nearly ended up going private just to cut the unnecessary stress of trying to find someone to help in the meantime, and quite likely would've already been seeing someone if all the trans people in the UK apart from me didn't live down in London (you know, where ALL of the private doctors are)

And they wonder why so many people in the UK self med...

[Danniella]

12-14 Month wait to get in the door at Sandyford -.-;

The waiting lists are never short anywhere.

[Takoto]

Thank you for the responses on waiting times!

I have about 24 hours to decide what clinic to ask to be refereed to... this is gonna be fun. xD

I would love to go private because I've heard nothing but good things about some of the private clinics in London, but I'm just about to enter University (I'm about to turn 20) and I can barely afford rent, so it's not an option unless I manage to luck out and get a great job over the summer/great part time job, but I've been looking for four years every Summer and Winter with no luck yet.

This is assuming things with my GP actually go smoothly... xD;;