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I received a letter today saying that I do not fulfil the criteria to be referred to the London clinic.
at first I read the diagnosis "gender dysphoria" and I felt excited. then I read the part where he said it is not gender identity disorder and he would not be referring me to the gender identity clinic.
for the first time in as long as I can remember, I started to cry in relation to something in my own life.
I've cried plenty of times watching films etc, but relating to my own life? not in as long as I can remember.
yet today, I did.
Just now, I feel worried. There is a chance I may start locking up my emotions and feelings again. I am sad because I've discovered so many things that I like. painting my toenails was kinda nice. I don't want to reach a point where I feel depressed to look at my painted toenails and end up removing the colours. I don't want to reach a point where I feel so negative looking at my dresses that I end up giving them away to charity.
I love my pink dress. I love it so much, it is a lovely material and feels nice ad smells nice and a lovely colour and my underwear is so pretty too. I feel like If I can't get the referral, I may end up withdrawing again and losing all this.
I'm actually crying again. never experienced this before.
Sorry, I'm not looking for sympathy, I just needed to talk to you all. I feel like sharing will make thigs easier and also if any of you have had a similar hurdle I'd like to hear how you got through it.
I've already located my doctors email address and sent him an email.
since my first meeting with him, I started writing down all of my thoughts and feelings. I felt that I was ill prepared for that first meeting since I didn't know what the appointment was even for. I've explained this to him and told him that I had kept the lid on my feelings up til that point so I could cope. a lot has changed since that meeting. I now own 4 pairs of knickers, 1 bra, 3 top and 3 dresses, nail varnish and a bracelet. I opened up to so much. I even managed to sing last night ad not feel very depressed afterwards. singing makes me feel very feminine you see.
ah... I think I have stacked the deck well enough with what I sent to him, but is it too late? it can't be too late. I cannot abide that.
there is no way I want to go to some therapy to make me OK with being a man. I am not a man. I cannot yet say for certain that I am a woman.... but I feel like I get closer to that each day. I feel like it is something that I want to be able to say.
in case I come up against a brick wall, what other options are there in the uk? is there private clinics where I can get hormones?

I'm sorry to hear this. I'm not very well educated about private clinics in the UK but I know for definite you can get a second opinion if you think he was wrong. Go to a different doctor. It all depends on the doctor and their understanding on certain issues. I went to one doctor and told him I tried to kill myself and am suicidal. His response? 'Everyone feels like that sometimes'. I wasn't happy with his care so I went to another doctor for a second opinion. She made an emergency referral to the child and adolescent mental health service. What I'm trying to say is, doctors vary massively. Whilst this guy thinks you're not suitable, another doctor may think you're perfectly suitable. Anyway, a referral to the London clinic doesn't mean you have to have GID, it's for you to tall through with an expert about your feelings and go from there. Your doctor (is it your GP?) isn't in the place to diagnose you. There's a procedure he needs to follow. I'd seriously ask to see another doctor. All the best.

it's not my GP, it's part of the mental health dept. I think it's a centre specialising in gender issues because there were a few other people there that seemed to not fit in to the 'societal norm'.
Thanks, I will certainly try and see another doctor if I don't manage to change his diagnosis.
You are right, this is my life, I have to fight for what is best for me.
Thank you.

Ah right I see. You're still within your rights to ask for a second opinion. Usually they only refuse a referral to a gender clinic if there is a mental health issue that could be making you think you have GID. But even if that is the case, he should talk through this with you. Did he give you any reasons why you're not being referred or even talk it through with you?

Yes, there are private clinics in the UK. You'll go through their screening process like any other patient. If you do have Gender Dysphoria they'll prescribe hormones & refer you for surgery; if you don't have Gender Dysphoria they'll point you in a more appropriate direction. There are a couple in London that I know of - and one of them is the private practice of one of the specialists working at Charing Cross. If you Google "gender clinic uk" you'll see some options there.

I reiterate Joey's advice that you're always entitled to a second opinion. And the NHS's rules have just changed (on 1 Aug, in fact) so that your GP can now refer you directly to a gender clinic without you seeing a mental health professional first - so go to your GP and ask them to refer you to your nearest gender clinic. I presume you're in England; here is NHS England's brand-new Protocol for Gender Dysphoria: http://www.cliniq.org.uk/sitebuildercontent/sitebuilderfiles/nhsenglandinterimgenderprotocolcpag12072013.pdf (http://www.cliniq.org.uk/sitebuildercontent/sitebuilderfiles/nhsenglandinterimgenderprotocolcpag12072013.pdf)

So yes, please do get a second opinion. Please also be aware that there are some conditions that can give you some symptoms that are similar to Gender Dysphoria, so if your doctor says you haven't met the criteria then ask him to explain exactly how you do not meet the criteria and what his actual diagnosis is.

Good luck.

I would definately get a second opinion or at least if you see the same doc again, show them your painted toes and all the other feminine things that you do and ask him what is his opinion on that. Or if you have the courage go dressed full on femme and ask him what that means. Sorry for the little rant 'cause I usually give the therapist the benefit of the doubt but did he even discuss the dignosis with you face to face? Or was it on line sessions? Definately though, I believe it would be second opinion time for me.

Not to derail the thread but I just have to add because I just saw this and now its gone, "Posts: 666". Do ya' think the universe is trying to tell me something? ;)

I'm sorry to hear this. I don't know if it's appropriate to your situation but if you haven't already you could go to your local support group to get recommendations for doctors that are the most helpful with trans issues. That way you can give your second opinion the best chance.

At the end of the day I think it is honestly BS that we should have to go to see a therapist in the first place. People go to a tattooist if they want their skin PERMANENTLY inked. People get their skin pierced, their skin tanned, their hair dyed, etc.

Why should we be made to feel like we have mental issues if we want to go through procedures to change our gender? It's nonsense. The NHS are idiots.







Edited improper language.

I do know there are private clinics, as others have mentioned, and of course you can get a second opinion as well (probably better since it means you will get the country's health care coverage). But I'm mostly posting to say how sorry I am that this happened to you. I had to be diagnosed under Canada's health care and my very worst fear was that they'd say I wasn't trans and couldn't get treatment.

Quote from: Dreams2014 on August 08, 2013, 03:19:47 PMWhy should we be made to feel like we have mental issues if we want to go through procedures to change our gender? It's nonsense. The NHS are idiots.

I agree with you! It is nothing but doctors playing CYA!

The first shrink I ever saw told me I was homosexual and to accept it  :o I didn't stop there!!!








Edited quote.

If I had income I would choose private health care over the NHS any day. Here in the UK people treat it with reverence. Whilst free health care sounds good on paper, it is not without its problems.

thanks for all your replies everyone, I really appreciate your support :)
Today I spent the day with some girl friends to talk to them about this.
It just so happens I got an email from my doctor before we got on to the subject.

I had emailed my doctor earlier after Joey's reply. I sent him the file where I had been writing all my thoughts and feelings.
I told him that I can't abide that decision and that whatever it takes I would find my way forwards.
He replied saying that he is happy to reconsider his diagnosis and wants to talk to me about it in my next appointment. that's 2nd of September.
So I need to stack the deck. I know what is at stake now.
I need to find out what he expects to hear and what he will require in order to refer me to London.  ( we really need a clinic closer to north Wales, London is FAR)

once gain, thanks for your empathy guys :)
I feel so much better now and I have gained strength.
I feel the event has also helped me to feel more sure of myself and feel more confident. I even bought some makeup today. I mean, I even told the assistant that it was for myself.
I think that thanks to some awesome friends and the support of this great community, I've turned it around and used it to empower myself.

The NHS protocol (instructions) for your situation changed with effect from 1 August 2013.
The new guidelines can be found here
http://www.cliniq.org.uk/sitebuildercontent/sitebuilderfiles/nhsenglandinterimgenderprotocolcpag12072013.pdf (http://www.cliniq.org.uk/sitebuildercontent/sitebuilderfiles/nhsenglandinterimgenderprotocolcpag12072013.pdf)
you should download the file, save it, print out all 28 pages and read them carefully before your next step.
Prior to 1 August, the procedure was that your GP referred to a local psychiatrist who referred you (or not) to a GIC (gender identity clinic).
No more. Now your GP is supposed to assess that you are of sound mind and refer you directly to a GIC of your choice (technically a GIC you mutually agree on).
The list of GICs is on page 25 of that document I pointed you to.
I know that the London GIC has a policy of 2 year RLE minimum, the Exeter GIC has a policy of 1 year RLE maximum.
The other GICs I don't know about.

Download, print, read, print a second copy to give your GP, go back and see him or her. If the GP won't play ball then switch to a new GP.

Oh, I was assuming you are in England, this does not apply to Wales etc.

[edited to fix page number error]

I also live in Wales. Moving to England before I transition lol.

Quote from: Dreams2014 on August 08, 2013, 04:38:03 PM
I also live in Wales. Moving to England before I transition lol.

I hope you like Exeter   ;)

Quote from: HenryHall
The Exeter GIC has a policy of 1 year RLE maximum.

I'm afraid that is not quite correct. I spoke to their Clinical Director recently, and he said that their general policy is 1 year RLE, but this does depend on the patient. Most patients will proceed further after they have completed 1 year RLE but a few have other issues that need to be dealt with so their wait could be longer if they need time to sort things out. Exeter is very much patient-led so your path depends on your individual needs & circumstances and could be longer or shorter than average.

Quote from: HenryHall on August 08, 2013, 04:48:13 PM
I hope you like Exeter   ;)

Why are you assuming I'd go to Devon? :O

yeah, I believe those guidelines apply to England, the NHS works differently in Wales.
I can't say for sure, but there are things like prescriptions being free in Wales, but certain cancer treatments are not available full stop.
reading those guidelines makes me feel sad. it's all so complicated.
I just need to make the doctor see that hormones etc are the best for me and then let him figure out the details.
looking at the following page, I think I know what The doctors want to see. 

http://www.nhsdirect.wales.nhs.uk/encyclopaedia/g/article/genderdysphoria/ (http://www.nhsdirect.wales.nhs.uk/encyclopaedia/g/article/genderdysphoria/)

QuoteCriteria for teenagers and adults

To be diagnosed with gender dysphoria, a teenager or adult should:

    feel persistently and strongly that they are the wrong sex and feel a strong identification with the opposite sex
    feel discomfort in their sex and its gender role and strongly dislike and wish to be rid of the physical characteristics of their sex, such as breasts, facial and body hair and genitalia
    not have a condition that causes them to display physical attributes of the opposite sex (although this is being increasingly questioned)
    experience long-term anxiety, distress and impairment in social and occupational areas of life due to their condition

Quote from: FTMDiaries on August 08, 2013, 06:14:48 PM
I'm afraid that is not quite correct. I spoke to their Clinical Director recently, and he said  ...

Lip service. The GICs all signed on to the new protocol but some intend to honour it mostly in the breach. But, yes, what I wrote is only broadly true, there will be a few exceptions but the clinics cannot or will not be entirely open about the exceptions.

In terms of a league table of enlightenment I would say (best to worst) Exeter, Sheffield, Nottingham, Northampton, Leeds, London (and I have no idea where Sunderland fits in). And it easily could be that Leeds belongs below London in their race to the bottom. It might be worth mentioning that the Leeds clinic (only the Leeds clinic as far as I know) is in an unsavoury (scary) location, but that may change in the new few months, the problem has been escalated within NHS.

Oh, and it seems I should not have posted a link, so if someone knows some other way to help you find out how to download the protocol document I will be happy to edit the posting it to use whatever method is OK under the terms of service to reach the pdf file at cliniq.

Quote from: HenryHall on August 08, 2013, 07:37:47 PM
Lip service. The GICs all signed on to the new protocol but some intend to honour it mostly in the breach.
In terms of a league table of enlightenment I would say (best to worst) Exeter, Sheffield, Nottingham, Northampton, Leeds, London (and I have no idea where Sunderland fits in).

Oh, and it seems I should not have posted a link, so if someone knows some other way to help you find out how to download the protocol document I will be happy to edit the posting it to use whatever method is OK under the terms of service to reach the pdf file at cliniq.

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Quote from: HenryHall on August 08, 2013, 07:37:47 PM
Lip service. Lip service. The GICs all signed on to the new protocol but some intend to honour it mostly in the breach.

In the case of Exeter, this is actual clinic policy and actual patient experience. Corroborated by several patients... including myself.

This may not be the popular consensus but in reply to an earlier post I really think that therapy needs to be done beforehand. With that said though the therapist should allow you to find yourself instead of the other way around. Yes, they can diagnose you but that usually comes about from what you tell them. I would rather know myself on an extremely intimate level and make sure that is what I want for my life before I make any decision which may become non reversable. I'll even go as far as hypnotherapy and pay out of pocket for it just to make for sure and to be sure for myself that there aren't any repressed feelings that are making me want what I want.

When it comes to therapist, a few really want to be the all deciding decision maker but most really want to help you to make your own inner discoveries. Its pretty much a toss of the dice when choosing one regardless of references. Most go by what you say unless they feel like the elite desicion maker so a client's attitude is important in seemingly wanting to work through the issues and doing what a therapist suggest on the journy. Sometimes it may take quite a few sessions to figure things out so be patient and eventually they'll probably see what you feel. For example, I go to therapy for social anxiety and have been for eight months with this one therapist I have now. A week ago my therapist point blank asked me if I had any gender identity issues and I told him, "maybe but that's not why I'm here because the social issues cause me more stress than gender issues." He picked up on that just from our talks and BS sessions before and after the sessions. This means that I may have a professional opinion under my belt in which the professional concluded on his own. Now I can use the gender issues as the underlying cause of the social anxiety and it's my move to bring it up when I'm ready. To him I am not impatient over the gender issues even though sometimes I am. When I do bring it up he will either refer me to a gender therapist in which I will sign a consent form for the new one to recieve his notes which will take a lot of pressure off of me to open up to a new therapist or stay with him and work it out.

In six sessions my therapist picked up on my gender issues by me letting little things out slowly and nonchalantly and he isn't even a gender specialist. Of course I went through five other therapist before I found this one that would talk and BS more on a person to person level instead of therapist to client. Have patience, be prepared to search for a good therapist and also be prepared to pay out of pocket. Aside from the other five in which the average was two seesions before I started looking for another one, with this one I have been out of pocket 450 dollars. In my opinion, a small price to pay in order to have it discovered instead of opening up. So really keep looking and get a second opinion, 'cause not all therapist are gate keepers and many over time can probably pick up on it just by little things you say that seem insignificant. One that will talk before and after session person to person is priceless 'cause with me that is where I could give bigger hints of who I am.

Just as a datapoint, I also went through psychotherapy. Perhaps ten different therapists (half of them only for one or two sessions before discovering the misfit), 100+ hours over two and a half years.
On reflection it was enormously valuable - for the therapists' bank accounts that is. For me, on reflection, it was a complete waste of a lot of time and even more money.

I am disgusted by the fact this level of paternalism towards trans people exists in 2013

Good luck OP - tell them what they want to hear

It has been very beneficial for me to have this time. I think it was foolish of him to make a decision after one meeting and also not giving me chance to prepare. I think he understands this anyhow and that is why he said he will reconsider his diagnosis. He did say in his notes that even if his diagnosis was not strong enough to send me to London, he felt that in a couple of years I may be ready for that. I believe that this is due to a misunderstanding.
I believe I was merely masking a lot and I have made so much progress recently that he can't possibly think that I do not need to be referred.
I never thought I would feel comfortable dressing, but here I am sitting in my chair, nicely tucked, and wearing nice underwear, and a nice red FEMALE top. I like it. I've also bought makeup. I am actually starting to think of myself as more woman than man... in a sense. I discovered that I had warped my own definition of man and hence why I probably didn't display what he wanted to see. so much stuff.
but hell, I have been feeling like I want to tell people. I want to tell my family and friends, everyone I meet. It's not a strong feeling and my mind tells me that I ought to still hold back for a bit. but I am feeling more comfortable with myself and uncovering more of the feelings I had buried.
uhm, I'm blabbering.  well I think If I show him this picture I am sure he will certainly understand that I need this.
https://www.dropbox.com/s/kn65khmhrb3im3d/2013-08-09%2000.13.48.jpg (https://www.dropbox.com/s/kn65khmhrb3im3d/2013-08-09%2000.13.48.jpg)
being bold is good.

Jess you are right, I do need to know myself better. I think the doctor sensed my many doubts. I think if I was absolutely certain I wouldn't need to use so many excuses, I could just cut straight to the point. I need to find that certainty before I see him again.

I'm really glad you're feeling more positive. If you ever need to talk or need advice don't hesitate to drop me a message. I think that's a really nice picture. You're face looks feminine to me, especially the bottom half inparticular. It can only go onwards and upwards! I really hope it works out for you the way you want it to.

Quote from: Yuki-jker86 on August 09, 2013, 06:05:49 PM
It has been very beneficial for me to have this time. I think it was foolish of him to make a decision after one meeting and also not giving me chance to prepare. I think he understands this anyhow and that is why he said he will reconsider his diagnosis. He did say in his notes that even if his diagnosis was not strong enough to send me to London, he felt that in a couple of years I may be ready for that. I believe that this is due to a misunderstanding.
I believe I was merely masking a lot and I have made so much progress recently that he can't possibly think that I do not need to be referred.
I never thought I would feel comfortable dressing, but here I am sitting in my chair, nicely tucked, and wearing nice underwear, and a nice red FEMALE top. I like it. I've also bought makeup. I am actually starting to think of myself as more woman than man... in a sense. I discovered that I had warped my own definition of man and hence why I probably didn't display what he wanted to see. so much stuff.
but hell, I have been feeling like I want to tell people. I want to tell my family and friends, everyone I meet. It's not a strong feeling and my mind tells me that I ought to still hold back for a bit. but I am feeling more comfortable with myself and uncovering more of the feelings I had buried.
uhm, I'm blabbering.  well I think If I show him this picture I am sure he will certainly understand that I need this.
https://www.dropbox.com/s/kn65khmhrb3im3d/2013-08-09%2000.13.48.jpg (https://www.dropbox.com/s/kn65khmhrb3im3d/2013-08-09%2000.13.48.jpg)
being bold is good.

Jess you are right, I do need to know myself better. I think the doctor sensed my many doubts. I think if I was absolutely certain I wouldn't need to use so many excuses, I could just cut straight to the point. I need to find that certainty before I see him again.

I don't really believe that a Psychologist can make a certain diagnosis, especially when it comes to something as extremely complex as being transgendered, in one setting. It may very well be his professional opinion from first impressions that you may not be dysphoric enough for the referral. I know that I can't just open up and let everything loose in therapy, especially the first session. I still hide behind my alternate, face the world personality. Like I said earlier, my therapist asked me not because what I said in therapy but rather things that I say before and after the sessions talking face to face like two people instead of client to therapist. These before and after moments are probably better for me than the actual sessions.

Sometimes if we try to live a lie, those aspects, actions and appearances die hard. When we finally decide to live according to our true selves those lies hold on fast. This may be what your therapist picked up on. Like I said, its hard to let down old guards when you fist meet someone such as a therapist and it's hard to judge a person's true self just in one meeting. You'll get there though it sounds like.

Yes. Definately get to know yourself better. You may find things out about yourself that you never even realized. I know me and have for a long time but I rarely ever let anyone else face to face know me. I am happy that you're feeling better though.

Quote from: Joules on August 10, 2013, 09:40:12 AM
Dysphoria is not a requirement

No, but the way some of 'em act you would think that it is.

I'd like to know what IS the requirements. ^_^;

I think it's those things I quoted from nhs wales website.
I can satisfy those criteria easily I reckon. I actually shaved my arm hair today. it crossed my mind, I thought maybe a bad idea, but as those thoughts were going through my head I realise the clippers were in my hand and half my arm was already shaved. ah well so much for caution. XD

Jess, you are right. making a decision in one session... that makes me a little angry. I will definitely express this to him in my next appointment.
I like what you said about living the lie. I twisted my own definitions of man to fit how i feel. I viewed other men as less than a man because they were stronger than me or more aggressive etc.  I think the ideal I held, is actually more like an ideal for a woman. but we construct these lies i order to cope with how we feel and live our lives without going mad. and yes, it is very difficult to start to take them apart.

Quote from: Yuki-jker86 on August 10, 2013, 09:55:11 AM
I'd like to know what IS the requirements. ^_^;

I think it's those things I quoted from nhs wales website.
I can satisfy those criteria easily I reckon. I actually shaved my arm hair today. it crossed my mind, I thought maybe a bad idea, but as those thoughts were going through my head I realise the clippers were in my hand and half my arm was already shaved. ah well so much for caution. XD

Jess, you are right. making a decision in one session... that makes me a little angry. I will definitely express this to him in my next appointment.
I like what you said about living the lie. I twisted my own definitions of man to fit how i feel. I viewed other men as less than a man because they were stronger than me or more aggressive etc.  I think the ideal I held, is actually more like an ideal for a woman. but we construct these lies i order to cope with how we feel and live our lives without going mad. and yes, it is very difficult to start to take them apart.

It' sad but when we lie to ourselves so much that we end up believing that lie and it does nothing more than make us worst off. My worst was the four years I was in the military. Before I joined I just sort of mixed and matched, pretty much "is that a guy or a girl" type gender fluidity. The four years I could in no way express myself really hurt so I tried the macho manly deal and hated everybit of it. It took me several years to get out of that attitude of machismo and I still have holdovers to this day and it's been 20 someodd years. Psychologial hoopla and such, ya' know? But at least I'm back to the "is that a boy or a girl" stage when I want to be with ease. Now though its "is that a man or a woman" but heavily , about 90%, leaning toward woman. ;)

Quote from: Yuki-jker86 on August 10, 2013, 09:55:11 AM
I'd like to know what IS the requirements. ^_^;

I think it's those things I quoted from nhs wales website.
I can satisfy those criteria easily I reckon. I actually shaved my arm hair today. it crossed my mind, I thought maybe a bad idea, but as those thoughts were going through my head I realise the clippers were in my hand and half my arm was already shaved. ah well so much for caution. XD

Jess, you are right. making a decision in one session... that makes me a little angry. I will definitely express this to him in my next appointment.
I like what you said about living the lie. I twisted my own definitions of man to fit how i feel. I viewed other men as less than a man because they were stronger than me or more aggressive etc.  I think the ideal I held, is actually more like an ideal for a woman. but we construct these lies i order to cope with how we feel and live our lives without going mad. and yes, it is very difficult to start to take them apart.

Hi Yuki,

To be honest, it's all about jumping through the hoops and doing as they ask. When i went to the London GIC and there are a lot of transwomen who have had the same experience, i was received by the comment that i wasn't dressed feminine enough. Really? I dress how i bloody well want thank you very much. I turned up in female clothing and yet as i wasn't in full makeup and in a flowing dress, i appeared androgynous as opposed to unequivocally presenting female - whereas i thought i looked like a man in womens clothing and half of the tube carriage let me know so as well! They don't seem to care about individuals, it's all about ticking the boxes and moving people along the line. And if you don't tick those boxes then they can stall seemingly indefinitely on prescribing hormones.

Try phoning the GIC directly, and tell them about the experience you have been having and what to do. The psychologist you have been seeing shouldn't be gate-keeping at all, unless he feels you have additional or conflicting mental issues that need to be looked into further. I don't feel he should consider himself best placed to diagnose GID (if it's even at all possible to tell someone who they are and may not be) and it might be worth mentioning that to him in polite terms.

i find it disturbing that we cant just decide for ourselves what we are and want to do with our own lives, i mean any other life altering chage you want to make is fine why do ppl make it so difficult i don't think it should be up someone who has no idea what your feeling to make that kind of decision for sum1

Quote from: lucy aylett on August 10, 2013, 04:29:13 PM
i find it disturbing that we cant just decide for ourselves what we are and want to do with our own lives, i mean any other life altering chage you want to make is fine why do ppl make it so difficult i don't think it should be up someone who has no idea what your feeling to make that kind of decision for sum1

I've said this before. People can sit in a tanning salon for hours risking skin cancer for a darker skin colour. People can bleach and re bleach their hair until it is brittle and dry for the sake of a different hair colour. People can permanently ink their skin. People can pierce their skin with metal. People can get plastic surgeries, breast implants, nose jobs, complete face reworks etc. We can get organ transplants. Heck, you can even get limb transplants now.

But despite all that. We have to be treated like we're mentally unstable if we want to change our gender? Irony abounds.

Quote from: yuki-jker86I have been feeling like I want to tell people. I want to tell my family and friends, everyone I meet. It's not a strong feeling and my mind tells me that I ought to still hold back for a bit. but I am feeling more comfortable with myself and uncovering more of the feelings I had buried.
uhm, I'm blabbering.

You're not blabbering.  You are growing.  :)

Quote from: lucy aylett on August 10, 2013, 04:29:13 PM
i find it disturbing that we cant just decide for ourselves what we are and want to do with our own lives, i mean any other life altering chage you want to make is fine why do ppl make it so difficult i don't think it should be up someone who has no idea what your feeling to make that kind of decision for sum1

It completely depends on where you live. In many areas of the U.S., there are informed consent options available to at least start hormones - no therapy required. That does not mean therapy is not a good idea; it definitely is given the magnitude of the decision involved. But it doesn't even work as well when they are a gatekeeper instead of a therapist - people are probably hesitant to really explore themselves when they are basically trying to pass a test

It will probably take awhile for the approval and diagnosis requirements to go away in places like the UK under the NHS.  They have an economic incentive to delay medical procedures and keep long wait lists, which then trickles down into the medical policy that is enforced by doctors. My comment isn't a "universal health care is bad" necessarily - there are trade-offs.

yes, I was considering this.
one thing we do need to consider is that the NHS operates in a way that we do not pay for our treatment, it comes from tax money. I personally feel it is correct that they make certain decisions, as it is part of their budgeting responsibility. This is not to say that if a person really needs the treatment that the doctors can decide not to, I believe they have more of an interest in making sure the patient is serious and not just going through a phase.
another thing to consider is that the funding for this will be obtained from the welsh assembly, so it is the responsibility of a welsh NHS hospital to be the gatekeeper in this case. of course, it would make more sense if the GIC were in wales and they were making the decisions, but I am sure my doctor has the appropriate qualifications to make appropriate judgement calls.  of course that doesn't mean he can't make mistakes. also doesn't mean that the time taken to make that decision was in any way appropriate.


Thanks Jamie :)

Quote from: Yuki-jker86 on August 10, 2013, 09:32:22 PM
yes, I was considering this.
one thing we do need to consider is that the NHS operates in a way that we do not pay for our treatment, it comes from tax money. I personally feel it is correct that they make certain decisions, as it is part of their budgeting responsibility. This is not to say that if a person really needs the treatment that the doctors can decide not to, I believe they have more of an interest in making sure the patient is serious and not just going through a phase.
another thing to consider is that the funding for this will be obtained from the welsh assembly, so it is the responsibility of a welsh NHS hospital to be the gatekeeper in this case. of course, it would make more sense if the GIC were in wales and they were making the decisions, but I am sure my doctor has the appropriate qualifications to make appropriate judgement calls.  of course that doesn't mean he can't make mistakes. also doesn't mean that the time taken to make that decision was in any way appropriate.


Thanks Jamie :)

These same funding issues will mean they will mostly likely prescribe you finasteride (if any AA) and progynova/estrace. I'm not slating pills but there is research out there about effectiveness vs other delivery methods, toxity to the liver etc and certainly the increased risks to people over the age of 40. Regardless of all this being put to the endo at CX, my friend who happens to be over 40 was told that was all nonsense and it would pills for her. Yes it's being paid for by the healthcare system, but do you realise how absolutely dirt cheap these pills are? And the fact that many of us all pay taxes and are thus in effect paying for a service we have no control over.
On the matter of surgeries, SRS as an example, conducted by the healthcare system your looking at costs of UP TO 20k. It can be done cheaper privately in this country, closer to the 10k mark, and yet that isn't allowed under Healthcare guidelines. They won't provide funding for surgery with a healthcare surgeon to do the same work privately, even though it would cost less. And of course, getting to the point of surgery will or should take a number of years on HRT, at which point the actual cost of transition under the healthcare system isn't that great at all.

As for determining someone's eligibility to start HRT, it should really be down to the individual working closely with a psychologist specialised in gender therapy. Yes it may be the case that not everyone is fully in control of their mental faculties and may need additional help to resolve additional or underlying issues, but after a series of 4-5 sessions it should be safe to assume to a reasonable extent how determined someone is to transition (and that shouldn't be determined solely on someone's external presentation).

Bardoux, everything you are saying sounds good. so what can a person do?
Does that mean you would recommend finding a private clinic and keeping away from the NHS?

Quote from: Yuki-jker86 on August 11, 2013, 07:50:55 AM
Bardoux, everything you are saying sounds good. so what can a person do?
Does that mean you would recommend finding a private clinic and keeping away from the NHS?

Whilst I'm not Bardoux, If there were an option to go private rather than through the NHS, I'd choose private.

I totally respect that viewpoint and I think I am agreeing with it.
the benefit of the NHS is that we don't have to pay money out of our own pocket.
But one big drawback is that we may feel that we have little control.
I am just now feeling like I have far more control over my life. now I consider that i could go to a private clinic and sort out my own stuff... I feel very powerful.
I still think that NHS would be very helpful with things like laser hair removal, but I am thinking that for other stuff like hormones, I feel I would be better off finding my own path and making my own decisions, with the help of a private clinic perhaps.
I didn't realise that the NHS would stick to the pills and not have any options.
of course going private will result in me footing the bill... I'm not very rich. but this is my future we're talking about.
just need to find some information about clinics near me.

Quote from: Yuki-jker86 on August 11, 2013, 09:46:09 AM
I totally respect that viewpoint and I think I am agreeing with it.
the benefit of the NHS is that we don't have to pay money out of our own pocket.
But one big drawback is that we may feel that we have little control.
I am just now feeling like I have far more control over my life. now I consider that i could go to a private clinic and sort out my own stuff... I feel very powerful.
I still think that NHS would be very helpful with things like laser hair removal, but I am thinking that for other stuff like hormones, I feel I would be better off finding my own path and making my own decisions, with the help of a private clinic perhaps.
I didn't realise that the NHS would stick to the pills and not have any options.
of course going private will result in me footing the bill... I'm not very rich. but this is my future we're talking about.
just need to find some information about clinics near me.

Yeah free health care is a plus, but given the state of the NHS at the moment, they are constantly cutting corners. Not only that, but they are being tighter about treatment in order to save money.

You're right about lazer treatment, I'd gladly accept that from them, and even hormones, but never ever surgery, oho no.

Sorry Yuki, i didn't mean to come across so strongly, it's just that i am so very fed up with the healthcare system... as you may of already guessed :P

Here is a link to a message i wrote to someone else who was wanting to know more about alternative options. https://www.susans.org/forums/index.php/topic,145322.msg1189231.html#msg1189231

There aren't many to be honest, but at least it gives you more control, i.e: choice of hormone delivery, timetable, seeing a gender therapist etc.

Please don't hesitate to message me for a chat :) x

I didn't feel you came across strongly :)
you have learned some things that are very helpful to share!

Okay, I know I'm a little late on this, but nevertheless:
I'm sorry for what you have to go through, Yuki. It is not okay, that you have to endure so much pain to find yourself. That said, your therapist has a responsibility for what is done to you. It might be that he sensed your doubts. Is there any news about it? Did he reply to your mail?

Quote from: Dreams2014 on August 08, 2013, 03:19:47 PM
Why should we be made to feel like we have mental issues if we want to go through procedures to change our gender? It's nonsense.

We don't go there to ensure we have a mental illness. It's to ensure we don't. GID is a physical illness, but there are mental illnesses which have similar symptoms. Although it's hard I'm very happy to see a therapist soon. She will help sorting my thoughts, I hope.

Thanks PiaBianca, yes got a response from him saying that he will reconsider.
I am not sure how much his opinion matters though.
I've been doing a lot of reasearch and I found out that I can get private orchiectomy for about £1500.
aside from that there are various options for herbal treatments and there are private clinics that do endocrinology etc.
There are plenty of potential possibilities and I have always been very good at getting what I want.

I do sense though, that my attitude has changed to an incredible degree since that meeting and I have no doubt he will notice the huge change.

Quote from: Yuki-jker86 on August 11, 2013, 07:41:52 PM
I do sense though, that my attitude has changed to an incredible degree since that meeting and I have no doubt he will notice the huge change.

I'll keep my fingers crossed!

Quote from: Yuki-jker86 on August 11, 2013, 07:50:55 AM
Bardoux, everything you are saying sounds good. so what can a person do?
Does that mean you would recommend finding a private clinic and keeping away from the NHS?

The problem with that is that there aren't any private clinics that are any good in the UK.
Which is why so many go to Thailand for hormones and surgery. The surgery there is good, the rest of it is merely less wretched.

Quote from: HenryHall on August 12, 2013, 07:34:01 AM
The problem with that is that there aren't any private clinics that are any good in the UK.
Which is why so many go to Thailand for hormones and surgery. The surgery there is good, the rest of it is merely less wretched.

You kidding? How can the UK not have any good private clinics?

Quote from: Joules on August 10, 2013, 09:40:12 AM
Dysphoria is not a requirement

I guess that depends exactly what you mean, exactly what is the context.

However dysphoria positively is a requirement to get NHS medical assistance with transition according to paragraph 2.2.3 of the NHS England Interim Protocol CPAG Approved July 2013.
http://en.wikipedia.org/wiki/Dysphoria

QuoteDysphoria (semantically opposite of euphoria) is a medically recognized mental and emotional condition in which a person experiences intense feelings of depression, discontent, and in some cases indifference to the world around them.[1]
...
[1] Abbess, John F. "Glossary of terms in the field of psychiatry and neurology"

Quote from: Dreams2014 on August 12, 2013, 07:38:03 AM
You kidding? How can the UK not have any good private clinics?

Sorry, I should have been more clear.
There are good private medical clinics in the UK.
There are not any good private clinics for the treatment of transsexualism and similar conditions in the UK.

Quote from: HenryHall on August 12, 2013, 07:43:10 AM
Sorry, I should have been more clear.
There are good private medical clinics in the UK.
There are not any good private clinics for the treatment of transsexualism and similar conditions in the UK.

Nowhere? We're a first world country. In the G8 and all that jazz. Are you telling me there's nowhere? I was clinging on to that because I don't trust the NHS!

there is trans health and gender care in London.
I haven't done any personal research but they are said to be good by some people.

Ah, yes. London. How typical the only place to go would be there haha. Don't you love how London-centric the UK is?

Quote from: Yuki-jker86 on August 11, 2013, 07:41:52 PM
I've been doing a lot of reasearch and I found out that I can get private orchiectomy for about £1500.

I'm no expert but I did read a post where a girl couldn't get SRS because of the way her orchiectomy was done. So it might be worth checking up on this before making any decisions.

That's true Andrea. If you have had a circumcision or not greatly endowed a surgeon will have to use some skin from the scrotum for the vaginal wall lining. With the testicles removed there could be the issue of the scrotal skin shrinking back leaving less to work with.

it's worth trying to go through the nhs, but only if you're prepared to jump off the train at any station if you notice it's going somewhere you don't want to end up, or at a to high or low speed.

doctors often tend to be that type of people who need to be told what you want, very explicitly, with quite a lot of paragraphs backing you. it's important to know what you're after and be prepared to reject the wrong prescription. when your doctor told you that your problems aren't gid, you should have asked what it really was and demanded treatment for that then. of course, that's not easy to do when you're already insecure about everything, many sick people don't get better so fast as they could just because they're too sick to tell the doctor what they need.

Find a doctor who will say Yes. Don't give up.

thanks for the heads up about the orchiectomy. I don't know if that will be an issue, I have above average material to work with down there, but perhaps I can ask if there is potential for prosthetic or something to keep the scrotum a decent size.
I am just thinking, I'd rather find a T suppressing method that wont cause havoc on my system.

taka, lots of paragraphs? oh goodie! I have written loads of notes in my phone notepad.