GIC clinix referral... What should I expect?

[Oneal]

As title, I have recently been refered to a GIC clinic in London which I am very excited about but what should I expect? I'm assuming initially there will be constellations where they will make a mental assesment?  I'm nervous and excited but a little daunted by the lack of insight as to what will happen and the order of events.

Can anyone shed some light please

Thank you

[Rejennyrated]

Rule one with the NHS is that if you aren't actually imminently dying then things do tend to happen a quite a leisurely pace.

So what can you expect? Well initially a lot of talking and getting to know who you are, what brought you to the clinic? What medical history you have? How do you see yourself? What is your motivation? How realistic are your aims? How well informed are you about the process? What do you want to achieve? How deeply ahve you thought about it and any possible complications or obstacles involved? etc etc etc.

For the first several appointments a lot of nothing will seem to be happening, because sadly you only get to come in once every few months and so it takes some considerable time to build a picture and a rapport. Ultimately, if you have reasonable expectations, have taken the trouble to inform yourself of the process, have realistic expectations and appear stable, things will eventually progress and you may be offered various treatments including HRT and surgery.

Thats about it really, there is nothing to be affraid of, there are no trick questions, and the doctors you see will try to do their best for you. I know some of them quite well because they are among my lecturers at medical school, so I can assure you they will do their best, but do be warned that it isn't going to happen overnight. There are ocassional exceptions but in general think in terms of a process happening over a couple of years or more and not months.

[Squircle]

I am at Leeds gic so things could work differently to Charing x. My first appointment was a talk about my background and gender, including questions about support networks (friends and family etc), followed by a risk assessment, which was a series of questions about substance abuse, self harm etc. they are basically trying to make sure there aren't any issues that need resolving first. Depression arising from gender dysphoria is not a problem, but issues arising from childhood trauma or alcoholism/drug addiction would be.

How quickly you progress will depend on where you are up to in your transition. When I went I had already been full time for seven months, so my second appointment was with the psychiatrist to get a second opinion and final diagnosis, but with many people that assessment period can be three to six sessions long.

Take with you any documentation that would show you've been living full time if you have, or anything else such as letters from past therapists etc.

Above all don't worry about it and relax, they aren't the evil gatekeepers of legend.

[CB]

The first appointment is essentially a psychiatric assessment. As Squiicle above said if you are already progressed a bit in your transition and done name changes etc bring along documentation and you might be on hormones quicker than you expect. On the name change they are a bit negotiable on that but it's not talked about shall we say. All in all nothing to get stressed about, they are actually quite nice!
The biggest problem is the delay in getting appointments!

[Oneal]

Thank you for te reply's. It's seems that I shouldn't expect anything to happen at any great pace at all with this...

I won't hold anyone to their answer but as a guideline, how long am I looking at before I can actaually expect he ball to start rolling as such? A few of my closest friends and family know as well as my fiancé but my life predominantly is still lived as my current gender. Will this slow things down even further? I've known something hasn't been right for years. It's only recently that I've plucked up the courage and decided enough is enough and I want to feel comfortable with myself.

[alexis.j]

If you really want to speed things up, go private.
A few sessions at a shrink to help you figure out exactly what you want, if you are not sure yet.
Then even faster progress if you know exactly where you are going and what you want, go the informed consent route. Sure this costs you money out of your pocket, but sure beats putting your life on hold until someone decided to help you...

Where I stay, state SRS results are pathetic, and there are HUGE waiting lists... once you have jumped through all the hoops...

So, my only option is to fund my own SRS, and money is extremely tight, if not impossible to achieve.
But I stay positive, and know exactly what I want.

Good luck in your journey.

:-)

[Oneal]

I am certain as to what I want and what I would like to achieve. Like you say I'm just struggling to come to terms with the possibility of a 12 month wait just before and initial assessment. I have found a place in Daventry which looks well established. I shall speak to my GP and see about the possibility of getting a referral for there. The wait according to their website is an average of 12 weeks for the initial meeting.

I think I shall see how this place in Daventry pans out first but yes, I have also been looking into private care. The cost seems more than worth the price of happiness

[CB]

I'm not exactly sure of what the status of the place in Daventry, it's not far from me but I do wonder if after initial assessment you still get moved on to CX or one of the other clinics? I don't know.

Anyway under the NHS while you can pretty much present how you wish you won't make much progress until you start presenting in your target gender. Going private will speed things up some but you will still need initial assessment just like NHS. After that things can move a lot quicker although they will still adhere to the WPATH guidelines, just not above and beyond like CX. If you decide to go via the private clinic you may be able to get a shared care agreement set up. I pay the consult fees and then my GP picks up all the rest on the NHS. It works well. 

[Oneal]

Really! That seems almost unfair. The sole purpose of seeking medical help is because I'm not comfortable with my body. I don't want to look like a bloke in a dress. I can see that only making things worse that is the sole reason I don't publicly present myself. I don't feel like I can 'pass'. If I did I wouldn't be going down the route I am!

I'm more than happy to go private if that is what it comes to. Have you got any information on this part-part payment scheme? Please

Thank you

[Squircle]

I went private to bridge the wait between my referral and actually getting to the GIC. I went to see Dr Richard Curtis in London. However I was already full time so he prescribed hormones quite quickly. I do think that he will prescribe before you are full time though, as long as he's sure you are trans. Once you have a letter from him saying that he's recommending HRT (he sends them to your GP if you allow him to) you can usually get your doctor to prescribe which brings the cost down. Private consultations are very expensive though!

If you are going to wait for hormones to make you completely passable before going full time then be prepared for your NHS transition to be long and slow. The first year of my RLE was to be honest, a bit grim, but I'm glad I did it now as I have come a long way in about a year and a half and it's looking hopeful that I'll be through the NHS pathway (ie post op) within a year. I'm just waiting for an appointment for my second opinion now.

Also the NHS are quite cautious, and if you go along and tell them that you haven't fully come out, and haven't made any plans to go full time, then don't expect them to accept you straight onto the care pathway. The NHS is slow, underfunded and sometimes outdated in the way it does things, but it's free.

[CB]

I went private to bridge the wait between my referral and actually getting to the GIC. I went to see Dr Richard Curtis in London. However I was already full time so he prescribed hormones quite quickly. I do think that he will prescribe before you are full time though, as long as he's sure you are trans.

Correct, me too.  Also he will refer you for another psych consult if needed. I was prescribed on my second appointment with him.

[mfox]

I went private to bridge the wait between my referral and actually getting to the GIC. I went to see Dr Richard Curtis in London. However I was already full time so he prescribed hormones quite quickly. I do think that he will prescribe before you are full time though, as long as he's sure you are trans.

My GIC psychiatrist also recommended HRT at the second appointment.  At the first appointment I was already full time with my name and documents changed, and almost done with laser/electrolsys hair removal too.  It might have helped that I had been on HRT on my own before that.  So I agree, if you have solid evidence you're already trans when you go to your first GIC appointment, it should really shorten the long diagnosis/assessment wait to start HRT (and hopefully shorten the wait for surgery too).

[Rejennyrated]

Oneal - I really wouldnt rush. This is a marathon not a sprint, and while I completely understand that you don't want to spend decades waiting, you probably have nothing to lose by going to the first couple of NHS sessions and seeing how things are panning out. The private option is always there.

I'm not in any position to hand out criticism or advice, because back in my day 30 years ago there were virtually no guidelines, and even then I drove a coach and horses thorugh the middle of them, and ended up doing things my way with very little regard to due process. So I do completely understand the feeling of wanting action.

I suppose what I think with the benefit of three decades of hindsight is that it does no harm to try both routes and see which seems to be most helpful for YOU. Some people find the NHS does wonders for them. So I wouldnt prejudge it, and more than that, use your own first hand experience, rather than relying on what any of us say. The NHS may be slightly slower, but they are thorough in their investigations and they do genuinely work hard to make sure you get the best outcome.

Read some of the stories on here and you'll soon realise that while a few of us (me for example) are disgustingly lucky, some people do have a pretty tough time postoperatively, and through absolutely no fault of their own. If you are unlucky then if you have gone through the NHS route you do at least know that no stone was left un-turned and that your decision was rigorously tested.

If, like me, you take matters into your own hands its fine if you are as lucky as I was, but I do wonder how I might have fared if I had come up against some of the bad luck and obstacles that some people have. At that point its just possible I might have been less well prepared, as I completely avoided any sort of testing before leaping into instant surgery with no RLE or anything. I know that's not what a private clinic does these days, but all I'm trying to illustrate is that this is a big life changing decision with consequences.

To be clear I have no regrets, but I would still say take all the time you need and don't rush...

[Oneal]

Thank you all the reply'a, it's nice to hear from people with personal experience. More often than not I feel a little lost.

I spoke to my GP today and mentioned about the waiting times for London. He is going to contact both London and Daventry and see what they are saying with regards to waiting times. I'm sure once he has contacted them both he will be willing and supportive writing out a second referral for Daventry.

I understand and appreciate that this is no overnight fix, I'm just keen to speak with someone. Someone that will personally be able to guide me and help work out exactly what is going on in my head