Getting treatment under the NHS

[lady amarant]

So, off I went to TransLondon last night...

Did I see anybody there?!!! 

Anyway, turns out they had a couple of doctors from the Charing Cross Gender Identity Clinic (GIC) there, and it actually turned out to be quite an informative evening. Turns out that, while the GIC does have a number of holy cows in need of slaughter, not all of the difficulties in transitioning in the UK are really their fault.

The big issue is that there is not just one, but four different groups of people all have input, often with conflicting goals.

The GP: The home doctor. You register with one depending on your post-code. They quoted a horrible figure of 84% of UK GP's not believing that GID was a valid thing to treat. Worse, many are ucooperative or downright obstructionist.

The Local Psychiatrist: Because they are classed as 'tertiary healthcare', you cannot be referred directly to the gender clinics. Your GP has to refer you to a local Psychiatrist who then decides whether to send you on to the clinic.

The Primary Care Trust (PCT): The PCT's are regional trusts set up by the public health system to oversee funding. To get funding for services other than basic healthcare, funding needs to be applied for, and can take a long time to be approved, if at all. Problematic here is that many things that are considered essential to transition such as voice therapy or hair removal (above and below. Ouch!) are not seen as such by many PCT's, and it becomes a battle back and forth between the GIC, the transitioner and the PCT.

The Gender Identity Clinic (GIC): The clinics usually have a group of Psychiatrists and Endocrinologists as their core staff along with (possibly) speech therapists, hair removal staff and the like. The GIC uses a modified version Harry Benjamin SOC, adding RLE before hormone therapy, amongst other things.

So really, alot of the problems have to do with beaurocracy, and the fact that care-givers lower down the chain of care are either ignorant about or unwilling to help. The GIC doctors did talk about the need for better communication, both between themselves and transitioners, but also with GP's and PCT's.

To my mind, the biggest obstacles are really the GP 's themselves. Prescription of HRT and services gets devolved to GP level, and they are often difficult to deal with in this as well. Add to that the PCT's reluctance to fund, and it does present a sticky situation.

Anyway, hope that gives some perspective on the matter, and who you actually need to get on your side when for things to happen. I am making progress by having contacted the PCT directly to find out about funding ahead of my second GP visit, but even so, the GP's are ... difficult to deal with at the best of times, either because they do not want to take responsibility, or because of personal attitudes.

BTW, if I misunderstood or misrepresented anything through ignorance, please correct it!

~Simone

[Davinia]

Thank you, Simone. That was useful and very informative. As a new transitioner I can only hope and pray I am in one of the better health authorities, maybe the idea is we grow old and die before they have to spend their ... er .. our money

[lady amarant]

Thank you, Simone. That was useful and very informative. As a new transitioner I can only hope and pray I am in one of the better health authorities, maybe the idea is we grow old and die before they have to spend their ... er .. our money

Hehe... There was actually a comment last night:

"Under EU law governments can't deny you treatment as a transsexual."

"Yeah, but the can add enough hoops for you to jump through so that it takes four years and you kill yourself..."

[Berliegh]

So, off I went to TransLondon last night...

Did I see anybody there?!!! 

Anyway, turns out they had a couple of doctors from the Charing Cross Gender Identity Clinic (GIC) there, and it actually turned out to be quite an informative evening. Turns out that, while the GIC does have a number of holy cows in need of slaughter, not all of the difficulties in transitioning in the UK are really their fault.


The Gender Identity Clinic (GIC): The clinics usually have a group of Psychiatrists and Endocrinologists as their core staff along with (possibly) speech therapists, hair removal staff and the like. The GIC uses a modified version Harry Benjamin SOC, adding RLE before hormone therapy, amongst other things.

The Primary Care Trust (PCT): The PCT's are regional trusts set up by the public health system to oversee funding. To get funding for services other than basic healthcare, funding needs to be applied for, and can take a long time to be approved, if at all. Problematic here is that many things that are considered essential to transition such as voice therapy or hair removal (above and below. Ouch!) are not seen as such by many PCT's, and it becomes a battle back and forth between the GIC, the transitioner and the PCT.



~Simone

So where is this Gender Identity Clinic (GIC) in the U.K that does hair removal? I've never heard that one before and having attended two Gender Identity Clinic's in the U.K over a 6 year period none would ever consider help with hair removal and they have always made that quite clear. They do not employ hair removal staff and Stuart Lorimer from Charing Cross became quite angry when I made the suggestion in January 2007 and asked why don't Charing Cross employ someone to do laser treatment..

Also PCT's do not fund or consider funding for hair hair removal, FFS or Liposuction...

[lady amarant]

Thanks for pointing out the errors Berleigh. The PCTs not funding hair removal was one of the issues they talked about yeah. The endo said he couldn't see how the PCT could call it elective if a surgeon said you needed it, but anyway, the beaurocracy sucks, no matter how you look at it. I am an outsider, so yeah, I can only comment on my own brief experiences with a GP and a PCT, and on what was said in the group, but I do think there are people who want to change things, it's just a problem of so many others wanting to change it in the other direction.

[tekla]

I'm going to stop complaining about US health care if you all keep this up.

[lady amarant]

I'm going to stop complaining about US health care if you all keep this up.

I've found the NHS VERY good for most everything else. It's just a question of priorities. And sadly we aren't one. That and the fact most of them think we're all perverted sex-freaks rather than people with a real problem.

Posted on: 21 March 2008, 14:58:28In all honesty though, if I were on the board of a PCT, and had to choose whether to fund an application for SRS or a kid needing a new heart, I wouldn't even blink. Trans or not, there are priorities.

[tekla]

That is the trouble with any sort of rationing of health care, someone has to decide who gets what amount of support.  What is strange (or not, in fact it makes sense) is that 90% of your lifetime health care bill (on average) will come in the last year of your life.  By cutting out that last year, we could drop a lot of cost.  But who makes that decision?

[Berliegh]

Thanks for pointing out the errors Berleigh. The PCTs not funding hair removal was one of the issues they talked about yeah. The endo said he couldn't see how the PCT could call it elective if a surgeon said you needed it, but anyway, the beaurocracy sucks, no matter how you look at it. I am an outsider, so yeah, I can only comment on my own brief experiences with a GP and a PCT, and on what was said in the group, but I do think there are people who want to change things, it's just a problem of so many others wanting to change it in the other direction.

It's not the fault of PCT's or GP's but the biggest problem lies with the NHS gender clinics themselves. They are set up as a filter and will try and put off, filter away and stall as many people as possible for as long as possible until they hope the patient will give up. The have no treatment plan or timescale and don't have any treatment facilities that would comply as a normal medical clinic.

Psychiatrists who work at these clinics employ bully boy tatics in order to humiliate the patient as much as possible. They should be there to provide medical referrals but getting them is very difficult and lenthy.

Here's just a few dissatisfied customers....

The NHS made me want to commit suicide, if i didnt have a loving partner i would have. i hate the NHS loath digusted sickened by the way my gps then charing cross dealt with me they are sick in the head... if you dont like it go private i did. (http://www.transhealth.co.uk/) and that saved my life... full stop the end the end the end (the Nhs are sick) Lucy Maund

I Support this petition 100\%. The care available to tg girls is diabolical, and thats being kind! We wouldn't treat our animals the way we are treated by CXH. Very long waits for appointments (4 years for my 1st appoinmtment). The fact that CXH is the ONLY clinic in the UK is seriously not good enough. I have to travel 350 miles each way everytime I have an appointment. That means taking time off work and spending a fortune on fuel. There are no facilities on the nhs for Facial hair removal which is a necessity for a tg to be able to change full time. We have to pay for everything. What the bloody hell is my national insurance being taken out of my wages every week for! I thought it was for NHS CARE! From what I have experienced with CXH it is NHS Dont Care! CXH has shattered my confidence which it took me a very long time to build. I don't know if I can ever get it back. The whole system need a major overhaul. Rachel Nicholas

I endorse this petition 100\%. Charring Cross is unhelpful, manipulative and offers a very poor and predjudiced service. G. P. Andrew Smith

From my personal experience, Charing Cross GIC perpetuates misery and makes competent individuals feel disempowered. Gerry Small

the present system tears families apart close down CX and reopen it along patient centred lines with new management and clinicians. Stacey Widdison

spent six years trying to get to GIC! Only now have appointment for Jan 2007!
Adrian Dalton

got fed up waiting for treatment from CXH and went private to get hormones. I am unable in my present financial position able to pay for surgery. I finally got a first appointment at CXH in Jan 2007, 2 years after starting the process. We deserve better treatment than this, if you don't hassle CXH then they ignore you. Patients shouldn't have to constantly pressure CX to be able to get an appointment date. Jack Hallett

After having Being "treated" by Charring Cross GIC for over a year, I now feel that my only option is to go Private and work every hour of the bloody day to pay for it. I feel it is a real shame as my GP has been superb and it is only the rigid and punitive policies of the C.C. GIC that have driven me to this decision. When HM GOVT were talking about a more patient centred and flexible NHS, certain people clearly had their heads in the sand - or more likely somewhere else! Jennifer

The treatment of transgendered people in this country is diabolical. They should be treated by doctors and not as psychiatric patients. Transgendered people know more about this than the 'experts' they are seeing. This country needs to stop treating transgendered people as 3rd class citizens and treat them with the respect and dignity they deserve. Paul Hughes

I have to say the same about the standards of care...They stink...long overdue an overhaul, we get treated like idiots (even though we probably know more than good OLD Mr Green, Mr Montgomery just likes to offend to the point of distressing his patients).......And from what i have seen of Charing cross Hospital and it's dirty toilets (wish i had a camera that day!!!....also latex gloves laying in a corridor), i'm in 2 minds whether the place is clean enough to have Major surgery!!!.....Please, Please, Please do something about this diabolical situation, Before anymore girls decide to end their lives because of neglect and distress..... Miss Tamzin Beauchamp

Dr. Montgomery is an interrogator who demonstrates limited knowledge in some areas and Dr Barrett's attitude is dictatorial and quite bizarre in some of his ideas. Caroline Monroe

I have a supportive GP practice but chose to go privately because of my age.Other m2f firnds have experienced repeated cancelled appts at CHX. I have also witnessed at first hand the way a patientis greeted in the waiting room there. I wouldn't speak to my dog like that. Jan Scobey

I was on CHX's books from 1988 to 1998-with no resolution of my condition. I was able eventually in 2003 to get my surgery after coming into some family money-this FIFTEEN years after first going to CHX. There may be a new building but there are the same old faces, same old 1960's attitudes and it needs to be brought into the 21st Century. Years of lost records, cancelled appointments and an out of sight out of mind attitude have made me sign this petition. Any way I can be of help I will. Gemma Handford

How long will it take before the NHS finally realise that we have a genuine problem that requires attention & not to be pushed to one side. please allow me to quote a few words from a friend who visited Charring Cross the other day. "I had my appointment yesterday at charring cross and they have shattered everything that i have been working to .they were rude overbearing and controling in a god like way taking no consideration to individual circumstances". Andrea Logan