Britain has reached a 'point of crisis' over transgender services, support group

[stephaniec]

Britain has reached a 'point of crisis' over transgender services, support group says

http://www.itv.com/news/2015-10-29/transgender/

ITV News/By Rachel Younger   10/29/2015

"An ITV News investigation has found transgender people are waiting months - and sometimes years - for the earliest stages of gender reassignment.

ITV News spoke to the eight NHS gender clinics that cover England and Wales and found there are now almost 4,000 adults still waiting for their first appointment."

[T90]

I was referred to a therapist to discuss my possible Gender Dysphoria back in June and I'm still waiting on my first appointment (I'm in Scotland). Getting a bit to the end of my tether now to be honest, so much so that for the first time I've started lying awake at night thinking about GD.

[Peep]

I was referred to a therapist to discuss my possible Gender Dysphoria back in June and I'm still waiting on my first appointment (I'm in Scotland). Getting a bit to the end of my tether now to be honest, so much so that for the first time I've started lying awake at night thinking about GD.

Sorry to say this but the stats for wait times for clinics in Scotland seem to be a year to 14 months. Just in case you weren't already aware.

[JenniRP70]

This is not good news for somebody who hasn't even spoken to a GP and got the ball rolling (if you excuse the distant pun there!).  I am thinking of going private to avoid the lengthy waiting lists and to try and get HRT without needing to do the RLT.

[kelly_aus]

This is not good news for somebody who hasn't even spoken to a GP and got the ball rolling (if you excuse the distant pun there!).  I am thinking of going private to avoid the lengthy waiting lists and to try and get HRT without needing to do the RLT.

Not one of the dozen or so Brits I know from another site has had to do any kind of RLT before hormones - iirc, they cover 5 of the GIC's.. It's also against NHS clinical guidelines..

[T90]

Sorry to say this but the stats for wait times for clinics in Scotland seem to be a year to 14 months. Just in case you weren't already aware.

It's not even a Gender Identity Clinic I'm waiting on yet, just an ordinary NHS therapist. A GIC appointment would be even further away, if the therapist decides to refer me to one. I really don't know exactly what I want at this point in time, so I'm considering attending a Non Binary group in Newcastle if I don't see the therapist soon. At least that way I'd be able to talk to people about it.

[kira21 ♡♡♡]

Not one of the dozen or so Brits I know from another site has had to do any kind of RLT before hormones - iirc, they cover 5 of the GIC's.. It's also against NHS clinical guidelines..

Well, the guidelines are taken very loosely and there is a great variation in how they are taken. Also, the NHS often don't meet their guidelines. For example there is a requirement of the NHS to see everyone 18 weeks from referral, and they don't meet that. I would not count on them following their own rules. This is also what Healthwatch (our NHS watchdog found when they appraised transgender services).

Regardless of how you take the guidelines, if your friends had transitioned in recent history, they will have had several waits before HRT, even without the RLE...

1. GP to local Psych (this is optional at the local health cares discretion - they required it in my area for example. The wait was 16 weeks for that from referral)

2. Referral to GIC
This varies according to GIC. 52% of people go through Charring cross. The wait time there is 52 weeks. Other places the wait can be up to 89 Weeks.

3. Time until diagnosis as transgender
This, according to my GIC, typically required 3 visits or more (they can keep you waiting wile they decide and each visit is 3-4 months apart). Mine took a year. I had already changed all documents and had been full time and blah blah blah before I met them. No mental or physical health complications or other consideration, just standard process.

4. Wait to see endocrinologist following approval
3-4 months.

Sure. You can do all that before transitioning, but if you want to wait nearly two years before starting your transition. There is no quick route to hormones in the NHS or any kind of treatment. You have to be 'diagnosed' before they will start treatment so you need to get in the GIC out with approval and into the endo. That's why every single trans person I have met in the UK has done one of two things, probably in about 50-50 split; waited about 2 years to get hormones, transitioning anyway; self medicated. I do know one person who could afford to go private, though their script is for spironolactone and the NHS ones are for goserelin (which is better but much more expensive). Also, if you go private, you can have a harder time accessing services such as surgery and gender recognition.

A good option if you have money is to go private and initiate the GIC route at the same time. That way you can take private scripts until the GIC process is complete and still have the GICs support when it comes to surgery and other things.

[T90]

1. GP to local Psych (this is optional at the local health cares discretion - they required it in my area for example. The wait was 16 weeks for that from referral)

It's now been 20 weeks and counting for me for this stage. Everyday when the postman arrives I'm hoping that a letter with my initial appointment date will arrive, but nothing as of yet. 

[kira21 ♡♡♡]

It's now been 20 weeks and counting for me for this stage. Everyday when the postman arrives I'm hoping that a letter with my initial appointment date will arrive, but nothing as of yet. 

I would recommend checking out the wait times here:

http://uktrans.info/attachments/article/341/patientpopulation-july15.pdf

So that you know who you want them to refer you to ahead of time and ask specifically for that one, providing them with the address, as well as your GP.

[kira21 ♡♡♡]

2. Referral to GIC
This varies according to GIC. 52% of people go through Charring cross. The wait time there is 52 weeks. Other places the wait can be up to 89 Weeks.

The figures I used were based on current people in the system. The estimated wait time for someone joining the back of the queue now is up to 3.5 years for Leeds GIC! That should put you about 5 years from NHS hormones in that queue.  All of them in England are a year or over.

It's all about knowing the system.

[T90]

The figures I used were based on current people in the system. The estimated wait time for someone joining the back of the queue now is up to 3.5 years for Leeds GIC! That should put you about 5 years from NHS hormones in that queue.  All of them in England are a year or over.

It's all about knowing the system.

That's just an insane wait.  I'm not 100% sure hormones would be right for me yet (though as my GD seems to get stronger each time I get it, it's looking increasingly likely) but what if I was someone who was suicidal about their gender (i'm not, just to be clear)? This wait list is surely killing trans people in this country. That definitely sounds like a "crisis point" to me.

[Nicolette]

I envisage the waiting times only getting worse. Whereas awareness of conditions such as diabetes ultimately leads to the desperately needed easing of pressure upon limited NHS resources, awareness of transgender issues can only increase the strain upon said system. I don't see a way out.

[Alison-Rose]

As someone who falls under the Leeds catchment area for gender therapy (which I have yet to even see a GP about - never mind anything further!), my heart goes out to all those struggling with the unnecessarily long wait they'll endure. I've thankfully never experienced suicidal thoughts relating to my personal situation, but I can definitely see how being faced with literally years of potentially being trapped in what they perceive as the wrong body may push others to seeking private treatment, self-medicating or even ultimately taking their own life sooner rather than later. Despite the promising signs I see in the media as LGBT issues become more commonplace, the flip side of this is how upsetting it is to realise we have a government that by its very nature is extremely conservative about funding the NHS and providing adequate resources within this for something now clearly past the "point of crisis," now a genuine problem here in the UK. Of course, I can't imagine the current administration regards this a priority, and I wouldn't be at all surprised if these alarming figures end up shaming the whole country into positive action being forced through... Perhaps one of the other political parties may even try gaining favour with the transgender community especially by promising reform or at least improvements to the present flawed system as part of their manifesto for the next general election?

[kira21 ♡♡♡]

i would ask for nottingham if i were you

[Hyperduck_23]

I'm in Nottingham and have, finally, got onto the NHS programme; this is about 2.5 years since my first appointment with them

When I went to my doctor I asked to be referred to the GIC. My first appointment was 3 months after I got referred, which was so much faster than I'd anticipated. I have a couple of friends who have been referred in the last month and the waiting is now around 11 month for the first appointment.

Nottingham insist on the RLT/RLE, which includes an official name change, before they'll give anyone HRT, which is terrible in my opinion, especially considering a low dose of Estrodial (in my case, I can't speak for the F2M crew) can be taken for a few months with no irreversible effects and, in my experience, a few days after starting HRT my brain felt right for the first time that I can remember; this has been echoed by friends of mine and on various forums I frequent. Giving people a bit of the hormones they think may be right for them initially would really help them make good decisions about their future instead of ploughing ahead with all the RLE stuff whilst they're feeling incomplete and vulnerable. I can't think of any other condition where the NHS asks you to prove that you're feeling like that before they'll give treatment.

Anyway, it's a sad state of affairs to say the least. It looks like more people are accessing the services (or trying to!) as there is more trans exposure around the world and people either feel more confident in coming out or are finally able to figure out what's going on in their heads, which is all good, but the NHS are really behind on keeping up with demand and it's not something that looks like it's going to change, unfortunately.

Which is why a lot of people are either going private or self medicating. It would be better if there was some sort of protocol in place to cover GP's doing blood tests if someone has decided the wait is too long and to self medicate, but that's currently extremely hit & miss; I asked several GP's at 2 different surgeries and none of them were willing to just take the bloods & give me the results so I could monitor things myself. Total pain in the bum and it leaves a lot of people, myself included, going unmonitored whilst waiting for the GIC to catch up

[kira21 ♡♡♡]

I completely agree with everything you said. I was also at Nottingham. They ignored guidance on things and had stupid protocols that protracted the process needlessly. Its ridiculous. They should just move to informed consent with counselling. It would add counselling into the mix which it isn't now and its sorely needed, be cheaper and cut waiting lists down in an instant.

Still.

One thing you can try, if all your GPs say no to dishing out hormones to stop self medicating, is try asking them with the bridging endocrine treatment statement from the guidance session and if that fails get them to refer you to an endocrinologist. Its logical that you should see one anyway and they may well be more comfortable prescribing hormones as they have probably got trans patients as that's who you will end up with after the GIC.

[Hyperduck_23]

One thing you can try, if all your GPs say no to dishing out hormones to stop self medicating, is try asking them with the bridging endocrine treatment statement from the guidance session and if that fails get them to refer you to an endocrinologist. Its logical that you should see one anyway and they may well be more comfortable prescribing hormones as they have probably got trans patients as that's who you will end up with after the GIC.

I'm now on the other side of things and being prescribed, but due to the endless nonsense that Nottingham GIC were insisting on I got fed up and started self medicating. I never tried to get a doctor to prescribe or even monitor me, I just wanted them to agree to do the blood tests so I could monitor myself (to the best of my abilities, I'm not in any way trained to do so!).

This is definitely good advice, though, and something I wish I'd known a few years ago. Also, I didn't realise that the Nottingham GIC were using a different protocol to other places, you'd think that treatment, especially guidelines for something like this, would be standarsised across the NHS.

But, I suppose, this comes back to the main topic, which is the shambles the NHS is in when it comes to treating trans people.

[T90]

If you've read some of my other posts then you'll know I was referred to a psychologist for my dysphoria all the way back in June. Finally today I got confirmation of my first appointment, which will be in a little over three weeks time. It's felt like a hell of a long wait just to get to this stage, so I'm really pleased I don't have long to go now. 

[stephaniec]

congrats. Being in the US it's a bit different

[T90]

And now I know I'm going to be seeing a female psychologist, which is an enormous relief. I wouldn't have been as comfortable with a male psychologist.