When to seek a diagnosis and with whom [UK]?

[Papillon]

OK.  My position.  In myself, I know I am transexual.  Always have been.  Always will be.  However, I have adapted to this and have lived as a woman for over 40 years.  Now I have reached a point in my life where I feel it might be time to do something about it.  However, I am attempting to stay super-rational and not rush into making this momentous decision.  There are pros and cons of transitioning and I could live with it if it were not possible.  However, I don't want to continue bringing all this stuff up too much as it will make it a whole lot harder to push it all down again if I decide to leave things as they are.

I know that I will need counselling to help me make my decision and my issue at the moment is when to seek a diagnosis.  At the moment, my feeling is to do that first.  If, then, I am not diagnosed as gender dysphoric, I am still at a point at which I can put the lid back on all of this and continue to make the best of a bad situation (I hope).  If I am diagnosed, I will then make arrangements for counselling to help me decide next steps.

Now, the first question is, can anyone see a flaw in this cunning plan?  Is there something that I might have missed here?

Secondly, I want to seek a diagnostic assessment from a specialist and so will need to go privately.  I have had Richard Curtis at Transhealth in London recommended to me by a number of people.  Have others had experience of him or can recommend others in the South East of England?

Is there anything else I need to consider at this stage?

Thanks all for your help.

[Ryan]

First step is to speak to your GP, even if you're going private.
I went private with Dr Curtis and I would seriously not recommend him. I've had a lot of problems with him. (Check my "Accusation from Doctor" video for more info) He is the most well known trans specialist though, and definitely one of the quickest ways to get hormones. You'll have an hour's meeting with him for the first appointment and then he'll hand you the informed consent form. This means that 4 weeks later, you will be able to return and start testosterone assuming that your blood tests came back clear.
Dr Curtis is also very picky about the different forms of testosterone. He highly recommends T-Gel and Nebido and hates Sustanon, which is the standard form of T prescribed by the NHS. If you want Sustanon, you'll have a hard time convincing him to prescribe it.

There are other trans specialists, and I would recommend doing some research and maybe finding someone else. From what I hear, the others are cheaper too. (£90ish for appointments instead of Dr C's £230 for first appointment and £120 for follow ups).

Your GP should be able to sort you out with counselling with either the practice's counsellor, or the local mental health team. Before starting T, it's usually required that you have a mental health assessment to make sure that you don't have any mental health issues that maybe affecting your decision making or reasons for believing you're trans. It also helps the process if you've legally changed your name, have been living as male and have a letter from your GP.

Of course, if you're happy with waiting, then the NHS is completely free. Living in the SE, you should be able to get a referral to Charing Cross Gender Clinic in London which is by far the most reputable and reliable in the country. Problem is that you need to have lived as male for a year on the NHS before hormones will be prescribed. There's obviously a reason why that measure is in place though. You'll find far more "gate-keeping" on the NHS. They want to make sure that it is definitely the right decision for you. Whereas hormones are given out far more freely if you choose the private route.

Hope this helps.

[Papillon]

Thanks so much Ryan.  Yes, my very first step would be to talk to my GP.  I understand that even the private practitioners prefer a GP referral.  I was pleased to hear that counselling could also be arranged via the GP.  However, I suspect the waiting list is huge, this being the NHS.  I will talk to her and find out.

Personally, I would find it nigh on impossible to live in role for a year before hormone treatment.  I am a womanly-looking woman and would in no way pass without it.  I am therefore planning to go private and have the option to go on T as soon as I feel ready to.

And I have so far heard some lukewarm reviews of Charing Cross.  A number of people in my trans support group have been there and have not been satisfied with the service.  However, this seems largely to revolve around waiting times, and this an NHS issue and is not specific to one clinic.

I will seek out your video and views on Dr Curtis and ask around a bit more for the experiences of others before I decide on a practitioner.

Thanks for your help!

[Ryan]

My GP practice has a counsellor there. You're only allowed a maximum of 12 sessions to keep waiting lists down. If you're practice does this then you may be able to access the service with no wait.
Your local mental health team will probably be a different matter in terms of waiting lists though. But you'll need an assessment from them to prove that you aren't nuts.
Are there any independent charities/organisations that offer counselling near you? I was referred to one of them and they've been great.

As for Charing Cross, I've heard that they're great. The only problem is that the NHS are very prone to losing things, cancelling appointments, etc.

[Papillon]

I am utterly nuts.  There is no hpoe for me

Yes, I do have a local independent group.  This is the one whose meetings I attend.  And they do have an in-house counsellor, so it might be worth me having a word with her about what she can offer.  However, I suspect that it is not long term therapeutic input that she offers, just quick bouts as and when needed by the group members.  Still, worth a try, eh?

[Ryan]

I get hour sessions with a counsellor every 2 weeks. She does offer them every week too though. There's no limit on sessions either.
So yeah, definitely worth enquiring about.

[Papillon]

Just to say thanks for the help.  I am due to start seeing the counsellor at my local support group in the next fortnight and I will be seeing my GP on Tuesday to talk about a referral to Dr Curtis.  Moving forwards!

[GamerJames]

Just to say thanks for the help.  I am due to start seeing the counsellor at my local support group in the next fortnight and I will be seeing my GP on Tuesday to talk about a referral to Dr Curtis.  Moving forwards!

Congrats on the progress! Keep us updated on how everything goes.

[Ryan]

Glad to be of help Good luck with it all!

[~Jay~]

Hope things go well for you with your GP I'm also off to see mine next week its my 2nd appointment so will let you know whats happening.

[Turtle]

Thanks for the advice Ryan - it's been much harder than I expected to get straightforward info on "What to do next". My GP is lovely, but clueless, which could work in my favour, as she is very eager to support me (so far). RLE terrifies me, but you've got to do what you've got to do, and I have put my notice in at work so that from Christmas I can live as a man to my heart's content.

Oh and James - looking goooooood!

[GamerJames]

Thanks Turtle