Seeing a mental health professional UK

[LilyMelody]

Hi everyone,
so first of all I am a 27 year old MTF living in the UK. I first explored my gender identity about 14 years ago but it never led anywhere until about 4 years ago. About a year and a half ago I started identifying myself as female, though I still present male.

A few months ago I went to a GP about this, but he decided to refer me to a counselor rather than directly to a gender clinic. I can't say I blame him, given I have a history of depression, and he was only a locum. He said the counselor would be better able to determine whether to make a referral than he was, and had the power to do so.
Anyway, a few months go by and I get my appointment letter, and it looks like I have been referred to see a doctor working in mental health rather than a counselor who is part of the mental health team.

I have no idea what to expect. Could you please advice on how I might prepare for this appointment, with the hope of receiving a referral to a clinic?

[Devlyn]

First things first, welcome to Susan's Place! Congratulations on getting the ball rolling. I assume it's going to be an intake session where you tell them your goals. Presumably you want HRT as a minimum?

I did most of my transitioning before I sought out the medical steps, which is bass ackwards from a lot of people's approach. We're all on our own paths. 

See you around the site!

Hugs, Devlyn

[LilyMelody]

HRT as a minimum, yes.

I wonder if it is worth trying to familiarise myself with NHS guidelines and so on before the appointment, or whether I should just explain myself as naturally possible?

Lily

[Devlyn]

Forewarned is forearmed. Learn the system, more importantly learn yourself, something I'm sure you're well into already. Honesty is best. You want to be calm, honest, and aware of what you really want. With that information your provider can plan a course of treatment.

Hugs, Devlyn

[Devlyn]

These are the WPATH Standards Of Care that your providers will follow. It's not light reading. 

Hugs, Devlyn

[Megan.]

Hi! Old NHS policy was that a GP would refer to the local mental health team for them to then refer to the GIC if appropriate. This policy was changed some years ago,  but many GPs still go this road due to ignorance or a lack of confidence in this area; This happened to me too.
It did add to the excessive wait times of the GIC,  but was quite straight forward. After a 1 hour appointment with the mental health team,  they fully agreed with my need for a GIC referral,  and instructed my GP to do this and how.
In short,  your GP should refer you directly,  but sometimes jumping through these bearucratic hurdles is just a bit easier.
There's some value in seeing the mental health team. If you have any other ongoing issues (ie anxiety,  depression etc...) as I and many of us tend to,  you will have a name and contact for support with these.
For your appointment,  just be open and honest about your journey to this point,  and if you have any specific aims or desires.
Good luck.  X

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[Megan.]

These are the WPATH Standards Of Care that your providers will follow. It's not light reading. 

Hugs, Devlyn

Just beware that the NHS GICs typically add extra to these standards,  ie two years of RLE before GRS rather than one year.
The GMC (general medical council) publishes the guidance for GPs,  this is free to read on their Web site.

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[LilyMelody]

Thanks!

[LilyMelody]

Less than 36 hours until the appointment. Uggghhh :S

[LilyMelody]

The appointment has been

He thinks I might be confused and wants me to try to deal with my anxiety and depression first. I feel empty. Not disappointed but a bit directionless. Maybe i have got this all wrong.

But hey, no one can stop me being me

[Megan.]

That's disappointing to hear,  they can often be related (were for me),  you can't fix one without addressing the other.
Can you ask your GP for some sessions with a therapist (not the mental health team), so you can talk through these issues?

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[LilyMelody]

I am sure there is someone.

Right now though I am seriously doubting that I am transgender at all.

[Megan.]

I can't say if you are or aren't, it's a wide spectrum,  where you are on it,  and what if anything you choose to do about it is entirely up to you.
Try to find a good LGBT friendly therapist who ideally has experience in gender identity.

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[LilyMelody]

That might help, right now I more or less want to hide away for a bit.

I know what questions I want to ask myself, I just don't know if I will like the answers.

[Megan.]

I was 37 before I was ready to ask myself those tough questions. Do I wish I'd done it sooner,  yes,  but being honest,  I wasn't ready until then. If you take things further it will be if/when you're ready. Regardless where your journey takes you in life,  enjoy it! X

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[LilyMelody]

All I know for certain is that I really, really, really don't want to be a guy.

[Megan.]

Download the referral template from the link below,  take it back to your GP,  and TELL them to sign it and send it.

https://gic.nhs.uk/referrals

Once that's done,  you'll then have plenty of time to make any changes you want,  at a pace you're happy with; there's plenty of 'next steps'  advice here. X


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[LilyMelody]

Ok.

So if I understand, they will sign the referral if I instruct them to?

I know these some silly questions but I want to be clear.

The psychiatrist strongly implied that there was no point in making a referral unless I am definitely seeking SRS.

Is he talking nonsense or is he just saying what he has to say according to the way the system is structured?

[Megan.]

I don't think you can force the GP to sign it,  but GMC guidance is that is the process they should be following,  so tbh,  they don't really have an excuse not to given your feelings. Some GPs are great,  others are bigoted,  and some just ignorant.
Only a percentage of those who are referred to the GIC ever have GCS,  so it's nonsense. You  may identify as non-binary,  you may only want HRT,  or may not even want that,  but that's what the GIC is there for,  to at least some extent.
The state of understanding on gender in the NHS is broadly woeful (though slowly improving). Be informed,  know your rights,  and the processes that should be being followed. X

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[LilyMelody]

Is it worth investigating transferring GP to one who is trans friendly, even if temporarily?

Also, my family doctor is retiring and there will be no full time GP at my local surgery, only locums. Could this be an issue?