English GICs, NHS vs private

[naa]

Are there any differences between what happens at NHS GICs and private GICs, besides obvious stuff like the wait times?

Things like, number of visits before you get prescribed anything,  types of things they ask, etc...?

[pyhxbp]

OK - for the MtF pathway....

They generally follow the same protocols. Neither is likely to prescribe hormones at a first visit, they have to establish that you understand what hormones will do to you and the likely outcomes you will face. Expect hormones to be prescribed on the second or third appointment for either.

The differences are that NHS GICs will prescribe GnRH analogues to block testosterone. These are expensive at £300 per shot but extremely effective. Paying privately for them is not an option for most people. I have known people who went private and the Dr refused to prescribe AAs saying that oestrogen should be enough.

The next big difference is referral for GRS. As far as I recall the private Dr.s only refer to Brighton Nuffield and you will have to fund the surgery yourself at about £12K. With the NHS you still might wind up in Nuffield or you could opt for Parkside and Imperial (both in London) or Methley (Leeds) but at least you are not billed for the surgery. Of the four only Imperial is an NHS hospital, the other three are all private.

[emma-f]

OK - for the MtF pathway....

They generally follow the same protocols. Neither is likely to prescribe hormones at a first visit, they have to establish that you understand what hormones will do to you and the likely outcomes you will face. Expect hormones to be prescribed on the second or third appointment for either.

The differences are that NHS GICs will prescribe GnRH analogues to block testosterone. These are expensive at £300 per shot but extremely effective. Paying privately for them is not an option for most people. I have known people who went private and the Dr refused to prescribe AAs saying that oestrogen should be enough.

The next big difference is referral for GRS. As far as I recall the private Dr.s only refer to Brighton Nuffield and you will have to fund the surgery yourself at about £12K. With the NHS you still might wind up in Nuffield or you could opt for Parkside and Imperial (both in London) or Methley (Leeds) but at least you are not billed for the surgery. Of the four only Imperial is an NHS hospital, the other three are all private.

That wasn't my experience. I have gone private (Dr Curtis is my Dr) but I get my Triptorelin injections on the NHS under his recommendation. I've found keeping your GP in the loop to be the best approach. Point is don't look at it as an either or when considering your treatment path choices. Likewise when it comes to surgical referrals you can as above go with the "automatic" referrals, or you can find your own surgeon and then ask your psych for letters. Just because you're on the nhs, don't think that you can't decide to pay for surgery privately say if you wanted to go to Thailand, or Bowers or McGinn.

The big difference I found from when I was on the nhs to private is that private is more patient led and informed choice. I found that the nhs would only treat if you intended on full gender transition, whereas privately the myriad of options in between were available. Although I do take hormones and have done for quite a while, whether I will ever fully transition is uncertain. Dr C is fully accepting that the goal is to find where I am happy and able to live my life. The nhs were very clear that it was male or female and that I would only be prescribed hormones after a time living as a woman (in my case I was told three months) which I was not willing to do. Waiting times etc are obviously a huge bonus too.

Good luck whichever path you choose