Gender Identity Clinic Appointment: what to expect?

[Squircle]

The only condition for getting into the pathway is a diagnosis, and you don't need to have any RLE under your belt for that.

Hormones, they generally prefer 6 months from my experience. They won't take proof that you've been self medding as proof of RLE. My GIC wanted proof from a place of work or study, or something similar.

At the end of the day guidelines are just guidelines and not protocol. Each GIC is slightly different in the way they go about things. I've got a few friends who have self medded and none of them were asked to stop, just made aware of the risks. 

[Richenda]

Hello everyone,

Well I had a fabulous consultation. First the bloods:

About 2 weeks ago I had a full suite taken: everything imaginable just to make sure I hadn't damaged myself by self-medication. All the results are 'excellent' to quote the consultant. I do run every day, so consider myself fairly fit (sub  3hour marathon runner) but that doesn't mean you can't damage, or even kill yourself, so I repeat what I'd said previously: I wouldn't recommend self-medication to anyone. Aldactone (Spiro) in particular gave me big trouble a year ago.

On the two key indicators:

Estrogen: 305 pg/mL
Testosterone: 14.5 nmoL

The estrogen is okay I think, and probably higher now as my dosage has risen by 40% since the bloods. The T level is a little high for MtF but that's not surprising given I'm only taken a low(ish) dosage of finasteride. What I would say is that my breasts are growing noticeably at the moment, including the last fortnight. It's also worth saying that I've only been back on regular meds for 2.5 months, and started with very low dose. I'm very pleased about the estrogen all things considered and he said the bloods do show my medication is working.

Anyway, the consultation was super duper. He has recommended me for transition, saying I fulfil all the criteria. Even better my second consultation is going to be later this week when I will meet with the prescribing consultant. I'm absolutely over the moon about this as that should have been another 1 year waiting list for the clinician in question. It's partly because of another cancellation which just came in. So, fingers crossed, there's a chance I might get prescribed this week. Even if I don't I'm well in the system for the NHS, including blood screening, and that can only be a good thing.

In terms of the consultation, I found it to be thoroughly professional as you would expect, non judgemental, accepting: but not in a rubber stamping way. The questions were good and appropriate. My responses fulfilled clinical criteria and hence the recommendation for full transition. Whoop Thank you so much for all the valuable advice. It helped me go back over paper trails and prepare myself for the sorts of things which might be asked. I was totally open and honest: 100% so, telling him everything about my past and I would certainly recommend this to anyone else in this position.

[pyhxbp]

Congrats

Make sure you ask for decapeptyl or prostap. They are liquids. The other option (Zoladex) is a pellet and is more painful to get

[Debstar]

Ok this has me worried, I have my my first GIC appointment coming up but curently I am not full time, nor out at work, nor had my name changed.

I thought the GIC might be able to help me getting on HRT and then I would come out after that and then go full time.

Don't get me wrong I know others may see this as backward but for me it is how I have planned to manage my transition.

How is this going to effect me with the NHS... I have this constant worry that they will rubber stamp me as NOT TRANS and kick me to the kurb.

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[pyhxbp]

How is this going to effect me with the NHS... I have this constant worry that they will rubber stamp me as NOT TRANS and kick me to the kurb.

They will not "... kick you to the kerb" but your path through the system may be longer than Richenda's. The more you do for yourself the quicker you get through the system.

[Kayla88]

Ok this has me worried, I have my my first GIC appointment coming up but curently I am not full time, nor out at work, nor had my name changed.

I thought the GIC might be able to help me getting on HRT and then I would come out after that and then go full time.

Don't get me wrong I know others may see this as backward but for me it is how I have planned to manage my transition.

How is this going to effect me with the NHS... I have this constant worry that they will rubber stamp me as NOT TRANS and kick me to the kurb.

Sent from my SM-G900F using Tapatalk

Well depending on who you see or what GIC your going too will depend on how quick things can be, Charring cross is very slow as an example, it took me a long time to get there and had an appointment in November, my 2nd appointment is in May. Wherever you go your looking at 2 appointments for HRT.

What you are doing is not backwards, many people prefer HRT prior RLE, it makes sense really.

Tbh the way I think about it for if they have a solid reason as to class you as not trans because its not something they can really prove either way. Best way would explain the situation, thats all you can do really.

[Richenda]

Hi Debstar,

First up, from one near-newbie to a new poster: welcome.

Second, I don't think you should feel at all discouraged, I really don't. So please please don't take that knock. From my experience yesterday, which picks up on something pyhxbp told me earlier in the thread, no-one is going to tell you you're not trans, at least I don't think that's the case. All that may happen is that the process may be slightly longer, but heck it's long under the NHS for all of us. I've lived for 47 years in the wrong physical body (I knew when I was 4 when I used to put on my sister's underwear.)

Others on here, third, know far more than me about this, which is why I began the thread so I'm only just learning. FWIW, which may not be much, I agree with you in theory. I can definitely see a place for hormone treatment occurring as a precursor to so-called RLE. After all, stepping out as a woman in the UK before any treatment has begun is a brave thing to do. One of the reasons I didn't answer the question about where I was referred is that I didn't want to misquote any clinician but let's just say that your view is also shared amongst some professionals. The current guidelines can be perceived as rigid, so it probably depends on who you see and how they interpret them. My understanding is that there's a move to make them more flexible and, interestingly, the Gov't have this last week said they may look at whether gender binary thinking i.e. just male and female categories are appropriate or whether there needs to be recognition for transgender people who are either on a journey from one to the other or who wish to stick somewhere in the middle. Don't be discouraged: you're on the path and they will recognise that. Hugs xx

[Debstar]

Thanks, yes I'm booked in to Nottingham. The advice was only that current wait times are 1 year for the first appointment.

I'm trying to be patient but it's getting hard.

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[Richenda]

I've heard good things about Nottingham. You probably know the waiting list used to be about 6-7 months and is now, as you say, a year. So that's great if yours is coming up soon? Am I allowed to ask who you are seeing there?

I really think you will be fine. And at the end of the day only you know your true self and the dysphoria with which you live. The fact that you are taking this step and seeking treatment should be proof enough for an outsider. x

[Debstar]

The current guidelines can be perceived as rigid, so it probably depends on who you see and how they interpret them. My understanding is that there's a move to make them more flexible and, interestingly, the Gov't have this last week said they may look at whether gender binary thinking i.e. just male and female categories are appropriate or whether there needs to be recognition for transgender people who are either on a journey from one to the other or who wish to stick somewhere in the middle. Don't be discouraged: you're on the path and they will recognise that. Hugs xx

Hi,

Yes I have read a story of another who transitioned in the 80's who said that ridged thinking was why many felt regret post SRS.

For me at this point while I want to fully transition, I suppose I can not know how I might feel after HRT and that may be enough.

An introduction to myself, I am a 39 year old genetic male who after some therapy has decided to stop avoiding the main reason I have been so unhappy my whole life.

Debs.

Debs.

[pyhxbp]

Hi,

Yes I have read a story of another who transitioned in the 80's who said that ridged thinking was why many felt regret post SRS.

The 1980s were totally different. You cannot draw any conclusions about today based on the 1980s other than things are a lot better now than they were then.

[Debstar]

I guess that's the problem. People responding to this thread may have transitioned in the 80's 90's. Sorry I am new here so do not know you or all your stories yet. None of the current guidelines I have read say turn up in a dress or else

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[Richenda]

Hi Debs,

That sounds really great about your transition and that's such a wise approach too. I think they will like that kind of honesty. Anyone who goes into it claiming 100% confidence is probably more likely to ring alarm bells.  Actually, the current guidelines make that point.

I'm sure you're right about that rigid thinking in the 1980's. It was so interesting reading reviews of David Bowie yesterday. Although not someone who transitioned, he certainly helped pioneer re-thinking about gender stereotyping. What a pioneer.

Good luck with it all. Please keep me (us) posted on progress. I really wish you the very very best. You will be fine. Have confidence. Hugs x

[Cheska]

Ok this has me worried, I have my my first GIC appointment coming up but curently I am not full time, nor out at work, nor had my name changed.

I thought the GIC might be able to help me getting on HRT and then I would come out after that and then go full time.

Don't get me wrong I know others may see this as backward but for me it is how I have planned to manage my transition.

How is this going to effect me with the NHS... I have this constant worry that they will rubber stamp me as NOT TRANS and kick me to the kurb.

Sent from my SM-G900F using Tapatalk

I had planned to manage my transition in the same as well, it didn't work out that way. They supported the diagnosis of gender dysphoria and acknowledged that I was progressing in my transition in other ways and that I was moving towards going full-time but felt that I wasn't ready to enter into the treatment programme, specifically because I hadn't legally changed my name or transitioned at work.

[byanyothername]

That's not good news Cheska! What did you do in the end? I thought the NHS guidelines specifically state that you don't need RLE to get onto HRT?!


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[Debstar]

I had planned to manage my transition in the same as well, it didn't work out that way. They supported the diagnosis of gender dysphoria and acknowledged that I was progressing in my transition in other ways and that I was moving towards going full-time but felt that I wasn't ready to enter into the treatment programme, specifically because I hadn't legally changed my name or transitioned at work.

That does not sound good. What year did you do this?

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[Debstar]

That's not good news Cheska! What did you do in the end? I thought the NHS guidelines specifically state that you don't need RLE to get onto HRT?!


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The guidelines do state that. Although I am still unclear about the interum protocol. It seems like because it is interum and not an adopted standard of care the individual clinics may adopt any position? Correct me if I am wrong please.

If that happened to be I would be self medicating or going private soon after.

Debs.

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[Cheska]

That's not good news Cheska! What did you do in the end? I thought the NHS guidelines specifically state that you don't need RLE to get onto HRT?!

It has been pretty demoralising. I've just continued how I was though, I'm in the process of changing my name already and everything else between now and my next appointment.

That does not sound good. What year did you do this?

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That was just a couple of months ago.

[Debstar]

It has been pretty demoralising. I've just continued how I was though, I'm in the process of changing my name already and everything else between now and my next appointment.

That was just a couple of months ago.

Wow yes I bet. I really feel for you. But wonder also if they gave you any insight with respect to the protocols as to why they came to that conclusion? What clinic did you go to ? Also if it is not to personal me asking your age?

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[Cheska]

Wow yes I bet. I really feel for you. But wonder also if they gave you any insight with respect to the protocols as to why they came to that conclusion? What clinic did you go to ? Also if it is not to personal me asking your age?

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Nottingham, 26. They didn't really say anything beyond that. They sent the same thing went back to my GP as well.