Susan's Place Transgender Resources

In my Trans-journey there's something I've noticed in the health care field among those that feel Tran sexuality is wrong. Knowing that they need to be careful to not open themselves to any adverse treatment because of their views, they will employ a tactic of stalling treatment, keeping the help you need just out of reach.
Anybody else notice this? I would appreciate your thoughts on this subject...

Quote from: Jonie on July 15, 2007, 12:42:12 PM
In my Trans-journey there's something I've noticed in the health care field among those that feel Tran sexuality is wrong. Knowing that they need to be careful to not open themselves to any adverse treatment because of their views, they will employ a tactic of stalling treatment, keeping the help you need just out of reach.
Anybody else notice this? I would appreciate your thoughts on this subject...

I was stalled for 6 years!

I spent 6 years attending a clinic in the NHS GIC system in the U.K (2001 - 2007) and wasn't able to access any treatment though the NHS. The NHS is a kind of tax we pay towards our own healthcare in the U.K and according to the medics there are facilities for treatment of gender dysphoria through the NHS.

After 2 years of begging the NHS GIC clinic for hormones I eventually went to see a private consultant to start on them. The same happened with my requests for 4 referrals, I was denied everything. The clinic aknowledged that I complied with the HBSOC and their own protocol, had been living RLT for over 4 years yet I was denied any form of treatment without explanation. My health authority (PCT) are now looking inro this case on my behalf as they have lost £1,000 a year on sending me to a clinic which did not facilitate treatment but instead chose to profit from my health authority and other health authorities.

I am now slowly working my way through private treatment which is very expensive. I have lost 6 years of my life and I am seeking legal advice. I reported the clinic to the Healthcare Commisssion, Department of health and various other legal bodies who are now looking into this case and many others like it.

Quote from: Berliegh on July 16, 2007, 02:29:06 AM

Quote from: Jonie on July 15, 2007, 12:42:12 PM
In my Trans-journey there's something I've noticed in the health care field among those that feel Tran sexuality is wrong. Knowing that they need to be careful to not open themselves to any adverse treatment because of their views, they will employ a tactic of stalling treatment, keeping the help you need just out of reach.
Anybody else notice this? I would appreciate your thoughts on this subject...

I was stalled for 6 years!

I spent 6 years attending a clinic in the NHS GIC system in the U.K (2001 - 2007) and wasn't able to access any treatment though the NHS. The NHS is a kind of tax we pay towards our own healthcare in the U.K and according to the medics there are facilities for treatment of gender dysphoria through the NHS.

After 2 years of begging the NHS GIC clinic for hormones I eventually went to see a private consultant to start on them. The same happened with my requests for 4 referrals, I was denied everything. The clinic aknowledged that I complied with the HBSOC and their own protocol, had been living RLT for over 4 years yet I was denied any form of treatment without explanation. My health authority (PCT) are now looking inro this case on my behalf as they have lost £1,000 a year on sending me to a clinic which did not facilitate treatment but instead chose to profit from my health authority and other health authorities.

I am now slowly working my way through private treatment which is very expensive. I have lost 6 years of my life and I am seeking legal advice. I reported the clinic to the Healthcare Commisssion, Department of health and various other legal bodies who are now looking into this case and many others like it.

hi
i feel for you i am so sorry to hear how you was treated  its so wrong i pray you find some peace over this and that you dont let it affect you to much

i wish you all the best and success  with your case  and hope something is done about it

best wishes from a friend
amanda

I feel that I am being stalled too.
The clinic I attend in the UK would like me to attend the group sessions but due to my job I am unable to get regular days off each week to attend these sessions, so they wont allow me to partiscipate in any of them in case I upset the balance of the group by my coming and going.
Thats fair enough.
However I am being made to travel this path alone gleaning help from each person I pass hoping for information that will be usefull to me.
Take my beautician at the salon, she has some information for me from some of the other TS girls that attend her salon.
I dont mind paying for hormone treatment, and I can understand the system would rather check to make sure first that I am really TS before giving me access to hormones, just to cover their backs.
But the system is way too slow over here.
They get money in the form of grants but stall us moving forward so that we have to travel at their pace, as and when they are ready for me to take each step.

Quote from: Karen aka lolli on July 16, 2007, 07:03:45 AM
I feel that I am being stalled too.
The clinic I attend in the UK would like me to attend the group sessions but due to my job I am unable to get regular days off each week to attend these sessions, so they wont allow me to partiscipate in any of them in case I upset the balance of the group by my coming and going.

I dont mind paying for hormone treatment, and I can understand the system would rather check to make sure first that I am really TS before giving me access to hormones, just to cover their backs.

Sounds like Charing Cross GIC to me....they blackmailed me into going to the group sessions and said if I didn't attend the sessions they wouldn't give me any treatment.....I attended the group for two years and they still didn't offer any treatment....

As for hormones I attended the Charing Cross clinic for two years and they still didn't let me go on hormones (I had already changed my name, ID, Driving licence, bank details etc) so in the end I had to see a private psychiatrist consultant. I started on hormones the same day and arranged an NHS prescription through my GP. It was money well spent and if I had done this at the start I would have saved myself 2 years...

The NHS U.K gender clinic system is a waste of time and I urge anyone who is serious about transitioning to avoid it......

sometimes avoiding it isn't an option though. I'm currently waiting for my first appointment at the gender clinic. I've already bee referred (earlier this February) but they contacted to tell me my 1st appointment is very likely to be in 2yrs time.

And there is absolutely no way i'd be able to get any money together to get any private treatment. Otherwise i would. I'd give almost anything up to just get on hormones right now.

Quote from: wishy on July 16, 2007, 03:00:47 PM
sometimes avoiding it isn't an option though. I'm currently waiting for my first appointment at the gender clinic. I've already bee referred (earlier this February) but they contacted to tell me my 1st appointment is very likely to be in 2yrs time.

And there is absolutely no way i'd be able to get any money together to get any private treatment. Otherwise i would. I'd give almost anything up to just get on hormones right now.

The NHS GIC waiting list can be anything up to 4 years! They will stall you as much as possible in order to get the maximum amount of money from your Health Authority (PCT) without treating you. They will lose notes, mix up files, cancel appointments at short notice and generally make things difficult for you. It's a cat and mouse game from start to finish...

When I went to Charing Cross GIC in London I thought they would have a proper treatment program, treatment timescale and technicians and surgeons trained in gender dysphoria but this wasn't the case and some people had been attending the clinic for 10 years and still hadn't accessed any treatment. It was a huge let down and it was clear the aim wasn't to help people but merely bully and cause them distress.

I can't afford private treatment either but it's my only option..

As for hormones you don't need to wait two years to go to a NHS GIC clinic to start on hormones.....go see a private gender specialist consultant and you might get on them straight away.....speak to your GP about it....

upto 4?
try 6,which is how long im waiting just to SEE a therapist. thankfully im seeing an endo and getting my hrt now because im IS and its seen as corrective.

I knew another Ts in Plymouth (Devon) whom I had had a relationship with and she read me straight away and gave me the book True Selfs to read.
Also she told me to go and see my Doctor and Jayne gave the details of everyone she had used to help her.
I duly contact my doc and asked her to refer me to the south devon clinic and could she apply for Pct funding.
Three months later I reveived a phone call from my doc saying funding had been agreed and that I would be hearing from the clinic.
About a month later I received my first of three appointments each one a month apart.
Now I am on the second stage of funding which entails meetings with my Therapist and laser treatment in Exter.
But as yet no Hormones and cover letter.
I need the letter for work and many other things I do in my social life.

hardly stalling... lucky for some...

Quote from: Karen aka lolli on July 18, 2007, 07:21:06 AM
I knew another Ts in Plymouth (Devon) whom I had had a relationship with and she read me straight away and gave me the book True Selfs to read.
Also she told me to go and see my Doctor and Jayne gave the details of everyone she had used to help her.
I duly contact my doc and asked her to refer me to the south devon clinic and could she apply for Pct funding.
Three months later I reveived a phone call from my doc saying funding had been agreed and that I would be hearing from the clinic.
About a month later I received my first of three appointments each one a month apart.
Now I am on the second stage of funding which entails meetings with my Therapist and laser treatment in Exter.
But as yet no Hormones and cover letter.
I need the letter for work and many other things I do in my social life.

You must be doing well to get PCT funding for laser treatment. I tried for many years to get my laser NHS funded but was unable to get it. I paid in excess of £3,000  on laser and LHT.  Your PCT may be a lot more generous..

her pct seems magical! :o

Quote from: Rachael on July 18, 2007, 08:09:53 AM
her pct seems magical! :o

Yes, it's a bloomin' miracle Rachael.....I've fought tooth and nail with my PCT. But it is very unusual for a PCT to fund laser...

very, but it can happen, just not as a Ts thing. i know a friend who got it, as her endo said shes a woman, and other women can have it...

Quote from: Rachael on July 18, 2007, 08:16:48 AM
very, but it can happen, just not as a Ts thing. i know a friend who got it, as her endo said shes a woman, and other women can have it...

Yes, a genetic female is more likely to get laser than a TS , that's obvious....

As a TS is more naturally inclined to have beard growth than a genetic female and PCT's emmediately will see that as a different case..

but would they give a ts female with less facial hair than a natal female laser over a hairyer natal female? or is it just trans women they block hmm?

I would like to thank you all for answering this post. It has become clear to me that I am not the only one who has faced this problem. I find it puzzling that in all the world, England is the only place this happens.  I live in the US and yet it happened to me, but why isn't anyone from the US or anyplace else talking about this?

Quote from: Rachael on July 25, 2007, 10:26:16 AM
but would they give a ts female with less facial hair than a natal female laser over a hairyer natal female? or is it just trans women they block hmm?

They would be more inclined to block a transsexual than a genetic female which is probably deep rooted in prejudice. Although genetic females fight tooth and nail just as we do to gain an access in this area.

The NHS is a tough nut to crack..

as i thought, the system that heals us hurts us...

Quote from: Jonie on July 25, 2007, 11:11:14 AM
I would like to thank you all for answering this post. It has become clear to me that I am not the only one who has faced this problem. I find it puzzling that in all the world, England is the only place this happens.  I live in the US and yet it happened to me, but why isn't anyone from the US or anyplace else talking about this?

Quite literally, its not as much of an issue in the US.  Most gender therapist in the US are under AEGIS, which basically states three months of therapy than HRT, some are even more loose with the SoC minimum and ignore it for HRT.

The US we pay for it, but HRT is readily available.

Additionally in big cities with LGBT clinics are actually BETTER than UK gender clinics.  The gay community has basically given us a way to get HRT on the cheap and easy, because we are seen as "traditionally underserved" group of queer people.  You have to live within driving distance of one of these clinics, but I know people who travel 2-3 hours just to get to one.  No waiting list either.  They are also very cheap and are on a sliding scale, so even if you do not have insurance, you still get inexpensive medical care.  These clinics often have therapist on staff for inexpensive prices as well.  LGBT clinics are the closest thing to socialized medicine in the states, the queer community has develoted a ton of fundraising to forming and maintaining these clinics, its is probably the ONLY benefit to being LGBT in the US. 

The complaints are going to come from the UK and Canada because there is a Blanchard system in place in many places in the UK.  Which is RLT and maybe HRT, if you are lucky.   US on the other hand...its very different.  Blanchard is seen as a hack who ruined the DSM at this point. 

I could go on, but you will hear very few stories from the US and a ton from the UK.  The only thing you will hear from the US is lack of insurance coverage.  But taking many of the LGBT clinics are now in network and insurance carriers will cover any bill from there...even the exclusions do not hold that much weight for HRT.

So its complicated.  TS is the one area where the UK system fails quite often.

The US the issue is cost, not stalling treatment.  Treatment can be found if you look.   

Quote from: Amy T. on July 25, 2007, 12:12:50 PM
The complaints are going to come from the UK and Canada because there is a Blanchard system in place in many places in the UK.  Which is RLT and maybe HRT, if you are lucky.   US on the other hand...its very different.  Blanchard is seen as a hack who ruined the DSM at this point. 

Amy, What does Blanchard system mean? and how does it relate to HRT and the RLT? I've never heard of it and I've been living a RLT for many years...

er? the uk its almost CERTAIN to get hrt IF your ts... it just takes a while.

Quote from: Rachael on July 25, 2007, 12:27:05 PM
er? the uk its almost CERTAIN to get hrt IF your ts... it just takes a while.

That is a problem in of itself, the time it takes.  Here its three months of therapy and you have your letter most of the time.

The Clarke Institute of Psychiatry in Toronto (also known as the Toronto Gender Clinic) set up a system designed by Ray Blanchard that required a one year real life test before one can go on HRT.  He was known though for delaying it even longer, and especially delaying and denying SRS. Every bad thing I hear out of the UK, stinks of Blanchard.  All the multi-year delays can cause major issues, especially if you are forcing a RLE just to get hormones.  In the US the thought is HRT is okay to use to relieve gender discomfort even if the person may never go full time.  It is also seen as a way to prepare for the RLE.  While the insurance and pay issue is huge here, the actual clinical practice regarding TS in the US is SIGNIFICANTLY BETTER and are more focused on individual decisions, not delays or insane hoops to jump through.  Its a massive difference in philosophy, for Blanchard is seen as the problem he always was.  Because it came out how Blanchard was treating his TS patients much of that "treatment" bordered on degrading sexual abuse. 

He is the man behind the DSM inclusion of transsexuality as a mental disorder and the poorly conceived definition, and the bunk diagnosis of autogyphelia. 

In the US this is looked down upon, and severely criticized.  Most gender therapist in the US belong to Gender Education and Advocacy (Used to be AEGIS) this is the official policy of AEGIS with regards to requiring a RLT for HRT.

I constantly hear they REQUIRE it for many clinics in the UK.  These are based on the principles of Blanchard, no HRT till real life test.

The thing is Blanchard constantly  delayed HRT as well as SRS.  He also put TS through very misogynistic and embarrassing tests and routines. 

The medical establishment in the US is not trying to undo all the damage Blanchard has caused, thus the AMA's policy statement.  But it seems like the UK and some other national health systems still have people who follow his crackpot methods.  RLT should NEVER be a requirement for HRT.
Just to note, this Texas clinic is closed.  There are no Blanchard style clinics or practitioners in the US for the most part who specialize in gender identity. 

Blanket Requirement for Real-Life Test
Before Hormonal Therapy
In Our Opinion, Inadvisable

A number of gender clinics, including the Clarke Institute of Psychiatry in Toronto and the Rosenberg Clinic in Galveston, texas, have a blanket criterion for the initiation of hormonal therapy: the individual must make the necessary arrangements to change gender roles and cross-live on a full-time basis for an extended period of time before hormonal therapy is initiated. This is not required by the Standards of Care of the Harry Benjamin International Gender Dysphoria Association, Inc.

The reasons for this requirement have been given as clinical judgement, a need for the individual to experience the new gender role before making irreversible hormonal changes, and concern about some of the effects of hormones and the medical risks involved in their administration. In a few cases (not necessarily at the facilities we have mentioned), this criterion seems to have been set up as a roadblock, with the idea that those who want sex reassignment badly enough will persevere, no matter what the obstacle.


Advisory

It is our position that the psychological and social effects which occur as a result of preparing for and beginning a period of full-time cross-living are in most cases potentially far more disruptive than the lingering effects or physical dangers of a short period on hormones. We believe that requiring a mandatory period of real-life test before initiation of hormonal therapy can be and often is harmful, and should not be a universal requirement or even the usual rule. While we agree that the individual should have some experience in the new gender role, we urge practitioners who adhere to this practice of global requirement of full-time cross-living before hormones to change it. [1] [2]


Discussion

Hormones are not without danger, and some of their effects, like breast development in the genetic male and hirsutism and voice- deepening in the genetic female, are indeed irreversible. [3] Hormones should not be administered except in accordance with the Standards of Care of the Harry Benjamin International Gender Dysphoria Association, Inc.; that is, the individual should be in therapy and have been given a diagnosis of gender dysphoria by a clinical behavioral scientist. Before hormonal therapy is initiated, care should be taken to rule out other conditions which can masquerade as transsexualism.

Real-life test does not occur in a vacuum. Friends and family must be informed, marriages must be dissolved, and accommodations must be made at work--if the individual is fortunate enough to keep his or her position. No only the primary client, but others are affected: parents, children, husbands and wives, neighbors, employers, co-workers.

The result of failed hormonal therapy is at worst some physical characteristics which run counter to type and which may be difficult for the individual to explain. The results of a failed real-life test is a life in shambles. Family, friends, and employers cannot be un-told about transsexualism, marriages and family life are unlikely to be resumed, and lost employment is unlikely to be regained. A non-passable appearance, which is likely if the individual has not been on hormone for a significant period, can be highly stigmatizing, and can place the individual in physical danger in this era of hate crimes. Furthermore, a failed real-life test can result in a high potential for self-destructive behavior, including suicide.

A stigmatizing appearance is not necessary a contraindication for sex reasignment, but it is certainly a disadvantage, an done which can be lessened by the provision of hormonal therapy prior to actually changing gender roles. The individual who has had such treatment is more likely to be viable--and therefore successful--when the role of choice is assumed.

Globally denying needed medical treatment, including hormonal therapy, in persons diagnosed as transsexual, or making it contingent on the individual structuring his or her lifestyle according to the demands of the caregiver or clinic, is in our opinion needlessly obstructionistic, a holdover from the days of less sophisticated treatment.

We believe that although conservatism is usually given as a reason for requiring cross-living before initiation of hormonal therapy, it is not in reality a conservative approach, except from the purely medical standpoint of the effect hormones have on the body--a narrow viewpoint in light of the profound and largely irreversible social changes that real-life test requires.

Notes

[1] Administration of small doses of estrogens has proved to be a useful tool in differential diagnosis. Male transvestic fetishists on a regimen of estrogens or progesterone are likely to show reduced desire for sex reassignment.

[2] Procedures such as orchidectomy, hysterectomy, or sex reassignment surgery should not be performed before the individual is living successfully in the gender of choice. This is in accordance with the HBIGDA Standards of Care. We support the Standards of Care.

[3] Hormonal therapy in genetic females has more profound and irreversible effects than in genetic males, and more precautions are in general indicated, but this advisory applies to both genetic males and genetic females.


Position Statement
Originally Released in 1992

http://www.gender.org/aegis/
www.gender.org

Quote from: Amy T. on July 25, 2007, 02:27:07 PM

Quote from: Rachael on July 25, 2007, 12:27:05 PM
er? the uk its almost CERTAIN to get hrt IF your ts... it just takes a while.

That is a problem in of itself, the time it takes.  Here its three months of therapy and you have your letter most of the time.

THREE MONTHS!!!!!!!!!!  It took me 2 years of fighting with the Charing Cross GIC in London and they still didn't facilitate HRT.......in the end I had enough and went private and got on HRT the same day.......this highlights the stalling process at it's worst...

im waiting 6 years to START my therapy \o/ go nhs! (god knows how long after that)

In the US its either all self financed or through insurance companies, and most companies do not cover HRT.

But the LGBT clinic loophole exists in most big cities (San Diego, DC, LA, Chicago, Boston, NYC, and San Francisco) where insurance may be able to cover it completely.  But these clinics are extremely cheap, cheaper than most regular clinics. They run on a sliding scale, so its often $5 for therapy sessions, $25 for doctors visits (thats the price here in DC).  Which is about on par with co-pays for insurance companies for doctors visits.  In fact those going to a clinic pay LESS for therapy. 

Not everybody lives in a big city though.

Either way delays are not a problem in the US, cost is, but even here there are ways to do things within the medical system cheaply.

Obviously...this is very location dependent.  Big city trans people have better opportunity for services than rural trans people.

But we in no way face delays.  Its the sole benefit for being trans in the US.   

Quote from: Amy T. on July 26, 2007, 04:17:40 PM
In the US its either all self financed or through insurance companies, and most companies do not cover HRT.

But the LGBT clinic loophole exists in most big cities (San Diego, DC, LA, Chicago, Boston, NYC, and San Francisco) where insurance may be able to cover it completely.  But these clinics are extremely cheap, cheaper than most regular clinics. They run on a sliding scale, so its often $5 for therapy sessions, $25 for doctors visits (thats the price here in DC).  Which is about on par with co-pays for insurance companies for doctors visits.  In fact those going to a clinic pay LESS for therapy. 

Not everybody lives in a big city though.

Either way delays are not a problem in the US, cost is, but even here there are ways to do things within the medical system cheaply.

Obviously...this is very location dependent.  Big city trans people have better opportunity for services than rural trans people.

But we in no way face delays.  Its the sole benefit for being trans in the US.   

Amy, where is this clinics at in DC; I live in Alexandria, VA and would like to know where this clinic is located

Ericka,
I sent you a message.  Its the Whitman Walker clinic.
Do you have your HRT letter yet?

Quote from: Rachael on July 26, 2007, 04:10:11 PM
im waiting 6 years to START my therapy \o/ go nhs! (god knows how long after that)

Rachael, I wouldn't wait any longer if I were you.......I don't know what part of the country you are living in but it would be well worth seeing a private consultant Psychiatrist to start on HRT. I did this and started on HRT the same day and the private consultant also arranged my NHS prescription, blood tests through the NHS with my GP. He was very professionan and unlike NHS clinics. Hence, avoiding the 'brick wall' effect of stalling by the likes of Charing Cross GIC..

Just to note here is a long indepth clearinghouse on the Clarke Institute (the Toronto Gender Clinic) and its methodologies.
This also underlines the major issues with the Autogyphelia classification and all other issues related to Blanchard. 
It is quite obvious that many of the treatment issues in the UK are directly related to the Clarke institute in Ontario (the "research" from this place is also to blame why TS cannot get insurance coverage in the US, thankfully the AMA has recently pushed forward a clear statement of policy which may help undo some of the damage the Clarke has caused us in the US, and insurance companies have been more lax with regards to HRT).


Site:
http://www.tsroadmap.com/info/clarke-institute.html

Seriously read into it.  It may be used to help lobby for a change in policy in the UK.  The history of the Clarke is pretty damning.

Quote from: Berliegh on July 27, 2007, 02:50:29 AM

Quote from: Rachael on July 26, 2007, 04:10:11 PM
im waiting 6 years to START my therapy \o/ go nhs! (god knows how long after that)

Rachael, I wouldn't wait any longer if I were you.......I don't know what part of the country you are living in but it would be well worth seeing a private consultant Psychiatrist to start on HRT. I did this and started on HRT the same day and the private consultant also arranged my NHS prescription, blood tests through the NHS with my GP. He was very professionan and unlike NHS clinics. Hence, avoiding the 'brick wall' effect of stalling by the likes of Charing Cross GIC..

i cant afford a private shrink, or id have done it by now... the nhs is my only realistic option. its all i have, im self medicating hrt at the moment, and my gp is performing blood tests.

Quote from: Rachael on July 27, 2007, 01:14:35 PM

Quote from: Berliegh on July 27, 2007, 02:50:29 AM

Quote from: Rachael on July 26, 2007, 04:10:11 PM
im waiting 6 years to START my therapy \o/ go nhs! (god knows how long after that)

Rachael, I wouldn't wait any longer if I were you.......I don't know what part of the country you are living in but it would be well worth seeing a private consultant Psychiatrist to start on HRT. I did this and started on HRT the same day and the private consultant also arranged my NHS prescription, blood tests through the NHS with my GP. He was very professionan and unlike NHS clinics. Hence, avoiding the 'brick wall' effect of stalling by the likes of Charing Cross GIC..

i cant afford a private shrink, or id have done it by now... the nhs is my only realistic option. its all i have, im self medicating hrt at the moment, and my gp is performing blood tests.

Rachael, Just be careful where you get your medication from......

its apparently reliable enough, and the drugs are working so far, and im healthy 7 months in according to my doc.

There's plenty of reliable sources of hormones on the internet, they're well known if you're looking for them. The cheapest usually are sourced in India since India doesn't really respect patent law which means drugs are generic almost right away. Also drugs sold for 10X in the US are sold by the same company at price X in the indian market.

Quote from: Rachael on July 27, 2007, 03:12:58 PM
its apparently reliable enough, and the drugs are working so far, and im healthy 7 months in according to my doc.

If your GP knows you are on hormones (illegal at that) wouldn't it be in his best interest to organise a proper NHS prescription for you. He could in fact be in more trouble for knowing you are taking illegal hormones......

I also would not take the advice of the post above. You need to get your hormones from a legally registered source, preferably in this country. Buying hormones on the internet is dangerous and I've heard about sources like Asia and India and would definitely not recommend these options.

oh he knows, and has followed official guidelines to say 'pls stop ktnx' but respects that i wont, he wont organise a script, he has sent me to an IS specialist endo hopeing they will put me under the nhs's watch for my own safety :)

Quote from: Rachael on July 28, 2007, 02:59:18 PM
oh he knows, and has followed official guidelines to say 'pls stop ktnx' but respects that i wont, he wont organise a script, he has sent me to an IS specialist endo hopeing they will put me under the nhs's watch for my own safety :)

Stick to your guns....if he's difficult you can always get another GP....make sure the endo appointment happens..

Y'know, what seems to be needed, is for someone from this community to get a degree in psychology, and then to start pushing people thru to transition. Their liability would be extremely low, because very, very few ever have any regret. Those that are unsure seem to turn back on their own.

I'd like to at least see a situation where a therapist has a set number of sessions to review a person, before they have to push them thru or refer them for another limited number of sessions. There should be exacting questions that cut to the chase. This would put pressure on clinicians from the insurance companies to s&%$ or get off the pot. Presently, a therapist or clinician can sit on someone indefinitely. This would limit the financial liability of the insurance carriers and the patient. It would effectively remove the bottleneck.

Since just about anyone with half a brain can find out from someone else at this point, how to pass thru the mental health gauntlet, then the system should simply recognize that fact and adjust to it. A person could get their paperwork sooner, and then begin saving money for the other things like FFS or SRS, that actually help a person to adapt to their chosen role.

The emphasis needs to move from someone proving themselves, to helping the patient become happier and thus more productive. Eventually, the SOC would sort of just fade away like a lot of rules that lose their function. I can tell you this. The number of people that transition, if you removed all of the hardships, would double or quadruple. Would that come with more risk? Probably. But a risk so small, that it is warranted.

Until then, all that you can do, is grit your teeth and bear it. Realize that you are in charge of the situation. You have to be rational at all costs. Being overly emotional, even though you feel it is warranted, might get you further obfuscated. A lot of clinicians are stoically rational, and will expect you to be also to get their stamp of approval.

i have the endo appointment, my gp is lovely, and helpful. hes had a f2m paitent before me, so isnt new to the system. im just hopeing the endo plays ball.