Susan's Place Transgender Resources

Good morning all from the UK where, for the first time in 12 years under the NHS, I am left without hormone therapy.

How so?

My Transgender Health Centre (formerly Gender Identity Clinic) in Nottingham wrote to my GP Surgery 10 days ago requesting that they increase my dose from Evorel 75 to Evorel 100 because my levels were a little low after switching from gels to patches.

I then hit a roadblock.

Surrey NHS now have in place a deliberate roadblock on all Transgender treatments, meaning that Transgender Clinics and GP Surgeries are, literally, not allowed to prescibe hormone therapy to patients without their Committee's prior approval via an individualised 'care plan'. Any attempt to prescribe hits their drug formulary traffic light system of 'amber'. So there's no prescribing until the petty little bureaucrats intervene. The process for obtaining this appears to be lengthy and will further damage the physical, hormonal, emotional, and mental wellbeing of transgender patients.

They have also blocked all blood tests for me until such time as a 'Care' Plan is agreed by them, the committee.

This has Health Secretary Wes Streeting's oily hands all over it.

I almost feel like emigrating right now.

So I've written to them a fairly stinging letter:


17 February 2026
To: Dr [Redacted] GP Transgender Healthcare
BMedSci, BMBS, DRCOG, MRCGP, DFFP and Clinical Team
Nottingham Centre for Transgender Health
12 Broad Street
Nottingham NG1 3AL
 
Ref: [Redacted]
NHS Number: [Redacted]

URGENT!
 
Dear Dr [Redacted],
 
Thank you for your excellent letter of 09 February 2026 which clearly set out my updated care plan from you, the NHS experts, in the field of transgender care.
 
Regrettably however, Surrey Heartlands are blocking my care. They have refused to permit my GP to issue the prescription because they, a committee, have enacted a new policy of refusing transgender care unless there is an Agreed Care Plan in place between yourselves and them. As I understand it, you just need to re-tune your letter to include that phrase. Which is kind of ironic because anything less caring or careful than the Surrey bureaucrats you could scarcely conceive. It all smacks of gatekeepery, bullying, and transphobia: traits entirely in keeping with Wes Streeting and Labour, for whom I mistakenly voted.
 
There's nothing amusing about this, however. Following my bilateral orchidectomy in 2016 I have no naturally occurring hormones and am about to run out. Less resourceful transgender patients than myself would be left flailing without provision. And our demographic are often already highly vulnerable patients. Perhaps that is, after all, part of Surrey Heartland's plan: their Final Solution to finish us off so that we don't have to besmirch their leafy lands. Surrey Heartlands Integrated "Care" System Area Prescribing Committee truly are complete clowns.
 
Please could you re-write your letter with an 'Agreed Care Plan' request stuffed into it to tick their small-minded bureaucratic boxes?
 
With warmest best wishes,
 

Grrrrrrrrrrrrrrrrrrrr

I'm intending to go and live in Scotland and just hope it's better up there. The NHS there is run entirely separately from NHS England and Wales. I won't repeat here so as not to cross-post. See here: https://www.susans.org/index.php/topic,250751.new.html#quickreply_anchor

I'm so sorry disruptions in you healthcare, I hope it gets resolved quickly.  It's such a horrid turn of events. 

Please keep us updated. 

Prayers
Paulie.

I have recently encountered similar gatekeeping from the VA.

My approach is slightly different. According to my medical records, I transitioned in 2022. Since the VA policy no longer supports Gener Affirming Care, I have insisted that I am not seeking that.

I am only seeking to maintain my hormone therapy, which is to replace the hormones that are not being produced by my ovaries (because they have never existed). By framing it in that light, it is not GAC, which they don't do, and is inline with standard medical protocol for women my age.

If you continue getting roadblocked, try changing your approach to fit a "non-transgender" medical criterion and see if that helps.

Well my GP has driven through the amber traffic light. She told me she was going to try to do this as she didn't agree with their policy. I hope the cops don't catch her.

The only trouble is that she could only issue 4 weeks, and it had to be for the old dose of Evorel 75 instead of the new request from Nottingham Transgender Clinic for 3 months of Evorel 100. So slightly pointless but at least she tried.

What a state of affairs. Big Brother. And an ignorant Big Brother at that.

xx

Quote from: Lori Dee on February 17, 2026, 11:58:17 PMI am only seeking to maintain my hormone therapy, which is to replace the hormones that are not being produced by my ovaries (because they have never existed). By framing it in that light, it is not GAC, which they don't do, and is inline with standard medical protocol for women my age.

If you continue getting roadblocked, try changing your approach to fit a "non-transgender" medical criterion and see if that helps.

Yes indeed. Good points. That's exactly how I got my private prescription which arrived on Monday after I ordered it Friday: 3 months of Evorel 100 for £34 including postage and packing. I can live with that. I went down the cis female route on a 'needs must' basis and it all worked fine.

But the refusal to conduct blood testing would be a serious issue and there would be many others in our community who are at a less relatively stable point in their transitioning.

It's awful. Absolutely awful.

xx

So sorry to hear this. I really hope you get something sorted soon as it's completely wrong. It doesn't surprise me though as the NHS seemingly leaves people suffering for ridiculous reasons and amounts of time.

Charlotte x

I'm sorry. I'm sorry so many people here in America voted for hate and intolerance and that so many still support it. It paved the way for the cruelest element of humanity to emerge elsewhere and begin to do its evil work.

Quote from: Tills on February 18, 2026, 01:25:59 AMYes indeed. Good points. That's exactly how I got my private prescription which arrived on Monday after I ordered it Friday: 3 months of Evorel 100 for £34 including postage and packing. I can live with that. I went down the cis female route on a 'needs must' basis and it all worked fine.

But the refusal to conduct blood testing would be a serious issue and there would be many others in our community who are at a less relatively stable point in their transitioning.

It's awful. Absolutely awful.

xx

You shouldn't need to do this but if you need private blood testing it's about £40 through Randox. Cheapest i could find. I use them as I'm diy. Just an option if you're totally stuck. If you want a discount use support10 as the code!!

Quote from: Charlotte_Ringwood on February 18, 2026, 07:29:04 AMYou shouldn't need to do this but if you need private blood testing it's about £40 through Randox. Cheapest i could find. I use them as I'm diy. Just an option if you're totally stuck. If you want a discount use support10 as the code!!

That's really helpful Charlotte.Thank you so much.

xx

Hi gals and others,

An UPDATE.

Here is the letter from NHS Nottingham Centre for Transgender Care:

date:  24/2/2026
Date printed: 
 
Private & Confidential
GP/Clinician
Sunny Meed Surgery, Sunny Meed Surgery
15/17 Heathside Road
Woking
GU22 7EY

Dear GP/Clinician

Re:    [Redacted]
Address: [Redacted]


Thank you for your letter dated 18.2.26. In it you request a shared care agreement prior to commencing treatment. As we are a national Centre we are not able to provide specific shared care agreements for each APC region. However, I hope the following is helpful and acceptable to you so we can work together to provide ongoing transgender healthcare for your patient. At the time of writing we are unable to prescribe for patients and cannot administer medication as we are a national centre. These services are currently not commissioned by NHS England.

The expectations from primary care would be:

•   The prescribing of advised hormone therapy under clear direction from the Specialist (which includes the dosage, a change to dosage, dosage frequency and any change to dosage frequency).

•   The undertaking of blood monitoring with advice from the Nottingham Centre for Transgender Health. This will normally include: FBC, LFTs, prolactin, oestradiol, testosterone and SHBG. The conditions under which the bloods should be taken, as well as the timings, will also be indicated. If the blood results are forwarded to us, we will interpret these and advise primary care on any alteration to the treatment regime as required.

•   When the hormone regime is stable and discharge is appropriate we will send out very clear guidance for ongoing treatment after discharge. You will then be responsible for ongoing care. You can re-refer if you have concerns.

•   If you become concerned and make contact with our service, we will advise accordingly.


The expectations from the Nottingham Centre for Transgender Health would be:

•   We will review your patient on a regular basis while they are in the treatment programme at our Centre. We will send documentation from these reviews to you. This will include a review of hormone therapy as well as general wellbeing. It will also include a clear care plan regarding their hormone therapy and any onward steps.

•   We will advise on any monitoring that needs to be undertaken including the specific bloods as well as the time frame.

•   When monitoring bloods results are forwarded to us, we will interpret these and incorporate these into our care plan.

•   We will advise on all aspects of your patient's hormone therapy which will include the specific form, dosage and frequency/dosage interval. We will advise on any changes to this.

•   When your patient has come to the end of her treatment process at the Centre, I will advise on what is required in the future hormone therapy, the monitoring of as well as suggestions to commonly occurring situations.

•   If you have concerns after discharge we will accept a re-referral and/or give advice on what would be necessary as appropriate.

We hope this is acceptable to you and believe that this is very much in keeping with NHS England's guidance as well as the GMC's ethical/good practice in transgender health care.

If you still feel unable to support the care of transgender patients please contact your local ICB to help resolve the issue and ensure care is offered to these NHS patients.

I did try to ring the surgery to discuss this issue with you but was unable to reach reception at a busy time for your team.

Yours sincerely

Dr PA Nathan Bmed.sci.,BM.BS.,DCH.,FRCGP.,MSc
GP transgender health care

And here's my missile to Surrey ICB and APC:

24 February 2026
To: Surrey ICB and Area Prescribing Committee
Surrey Heartlands
&
Dr Mehdi
Sunny Meed Surgery Woking

Ref: [Redacted]
URGENT!

Dear Surrey ICB and Sunny Meed Surgery,

Further to letters of 17th February 2026 copied to yourselves please see the attached letter from NHS Nottingham Centre for Transgender Care, under whose auspices I have been for the past 14 years. During all those years no-one has ever blocked my treatment and refused their guidance.

In the light of their letter setting out their position with regards to my treatment kindly unblock my medication with immediate effect. Specifically this is:

Evorel 100 2x per week. An initial 3-month prescription
Testogel 16.2mg 88 gram 0.2 ml microdose p.d.

Blood tests also need to be within my care plan as per NHS Nottingham's letter

Your attention is drawn to the fact that following a bilateral orchidectomy in 2016 I have no naturally occurring hormones. Failure to unblock my prescription for Evorel 100 would constitute an act of gross negligence resulting in physical, hormonal, and mental ill-health. Should you persist in blocking treatment the matter will be taken further to include legal proceedings against Surrey Heartlands ICB, the Area Prescribing Committee, and Sunny Meed Surgery.

It is to be hoped that you will find a way to discover sense.

Yours sincerely,


[Redacted]

c.c. Dr Mehdi Sunny Meed Surgery

I think we're in a serious situation here. I've been told this policy is being rolled out throughout NHS England.

xx

That's a good letter you wrote Tills. If you're right about this being rolled out everywhere then there will likely be legal cases coming in to the various trusts in their droves.

I can't quite believe the change in our country over the last year. I thought we were a caring society and were better than this.

Is there any scope to purchase the medication privately then seek redress? Completely dropping to no hormones could be dangerous and definitely bad for your health.

Honestly this doesn't surprise me. I think in reality anything other than physical, immediately life threatening conditions are being completely ignored by the NHS. As a professional employee I know I would have far superior care under a private system. Instead stuck under a system that's breaking down further year after year.

I hope you can sort something...seems like you are well prepared to take them on even though you shouldn't have to!

Charlotte 😻

Quote from: Tills on February 24, 2026, 03:43:41 AMIt is to be hoped that you will find a way to discover sense.

The epistolary you shared is straight out of Kafka, Orwell, and Heller and would almost be amusing if so much was not at stake. I sincerely hope you get things sorted out to your benefit soon, Tills. And if by some miracle they find a way to discover sense, please share the path with US politicians.

Thanks so much ladies ^^^^ for your excellent posts.

I have a private prescription at the moment but this is a point of principle and I don't really want to operate outside the NHS

xx

Quote from: Tills on February 24, 2026, 11:15:51 AMthis is a point of principle and I don't really want to operate outside the NHS

If no one complains, nothing will change. They will assume that what they are doing is acceptable to everyone. I hope it resolves in your favor, without the legal hassle.

In the US we can use LabCorp and self-pay if you really have to. In the UK you actually have several private blood testing options available that don't require NHS or GP involvement at all:

Randox Health – Charlotte already mentioned them upthread, and they have 40+ clinic locations across the UK and Ireland. No GP referral needed. They offer comprehensive panels that include oestradiol, testosterone, SHBG, prolactin, liver function, and FBC — basically everything Nottingham's letter specifies for monitoring. Charlotte's tip about the discount code is worth noting. Their home test kits start from around £21-69, while in-clinic health check packages start higher at £139+.

Medichecks – Another well-established option that offers both home finger-prick kits mailed to you and venous draw appointments at partner clinics nationwide. They have hormone panels covering the same biomarkers. The Gender Hormone Clinic specifically recommends their TRT Check Plus panel for trans patients. Important note: if you're on any gel-based hormones, they recommend venous draw over finger-prick to avoid contamination from residue on your hands.

Lola Health – A newer service that also offers home visits from a phlebotomist, which is convenient if clinic access is difficult.

For our London-based members, 56 Dean Street runs 56T, a dedicated trans and non-binary sexual health and wellbeing service every Wednesday (4:30-7pm, Level 2, appointment only) that includes hormone blood testing and injection services.

CliniQ at King's College Hospital runs a similar holistic service for trans and non-binary people every Tuesday (4:00-6:30pm, Caldecot Centre, by appointment). Both are primarily sexual health services but include hormone level monitoring as part of their care.

The results from any of these can be sent to your specialist — Nottingham's letter specifically says they'll interpret blood results forwarded to them and adjust the care plan accordingly.

None of this should be necessary. The fact that the NHS is blocking routine blood monitoring for established patients is genuinely dangerous, especially for people who are post-orchiectomy or oophorectomy, and have no endogenous hormone production.

At least these options exist as a stopgap while the bureaucratic battle plays out.

Thanks so much @Susan for your brilliant post. What a great resource this is.

It's so good to know that there are these options because for a while I felt abandoned. And if I feel that, how must so many others be faring under this cloud? This forum is a lifeline.

Which reminds me that a donation will be on its way. I have finally set up a new paypal account.

Hi Tills

You said this:

Quote from: Tills on February 24, 2026, 03:43:41 AMYour attention is drawn to the fact that following a bilateral orchidectomy in 2016 I have no naturally occurring hormones.  Failure to unblock my prescription for Evorel 100 would constitute an act of gross negligence resulting in physical, hormonal and mental ill-health.  Should you persist in blocking treatment the matter will be taken further to include legal proceedings against Surrey Heartlands ICB, the Area Prescribing Committee and Sunny Meed Surgery.

A thousand times this ^^^^^.

That paragraph alone clearly establishes medical dependency, foreseeable harm and liability.

Denying medically required treatment, regardless of background, does constitute gross negligence.  Once they are formally notified of harm risk, continued obstruction becomes indefensible.  At that point it is no longer "policy", it is failure of duty of care.

Legal pressure is unfortunately the only mechanism that reliably breaks these gate keeping practices.  If more people document harm and pursue action individually, it creates a pattern they cannot ignore.

I am genuinely surprised there is a so-called "gender care plan" involved at all.  This is basic endocrine replacement following orchidectomy.  That should sit squarely with your GP and standard NHS prescribing responsibilities.

Stay firm.  You are entirely justified.  Also, make sure everything stays in writing.

Ask each body for written justification of any refusal, including the clinical basis, the named decision maker and the policy being relied upon.  Request copies of all correspondence between the ICB, prescribing committee and surgery.

That paper trail matters if escalation becomes necessary.

This also applies to the "American system".  In other words;  "you must have standing".

Best Wishes Always
Sarah B
Global Moderator
@Tills

Quote from: Susan on February 24, 2026, 06:06:23 PMIn the US we can use LabCorp and self-pay if you really have to. In the UK you actually have several private blood testing options available that don't require NHS or GP involvement at all:

Randox Health – Charlotte already mentioned them upthread, and they have 40+ clinic locations across the UK and Ireland. No GP referral needed. They offer comprehensive panels that include oestradiol, testosterone, SHBG, prolactin, liver function, and FBC — basically everything Nottingham's letter specifies for monitoring. Charlotte's tip about the discount code is worth noting. Their home test kits start from around £21-69, while in-clinic health check packages start higher at £139+.

Medichecks – Another well-established option that offers both home finger-prick kits mailed to you and venous draw appointments at partner clinics nationwide. They have hormone panels covering the same biomarkers. The Gender Hormone Clinic specifically recommends their TRT Check Plus panel for trans patients. Important note: if you're on any gel-based hormones, they recommend venous draw over finger-prick to avoid contamination from residue on your hands.

Lola Health – A newer service that also offers home visits from a phlebotomist, which is convenient if clinic access is difficult.

For our London-based members, 56 Dean Street runs 56T, a dedicated trans and non-binary sexual health and wellbeing service every Wednesday (4:30-7pm, Level 2, appointment only) that includes hormone blood testing and injection services.

CliniQ at King's College Hospital runs a similar holistic service for trans and non-binary people every Tuesday (4:00-6:30pm, Caldecot Centre, by appointment). Both are primarily sexual health services but include hormone level monitoring as part of their care.

The results from any of these can be sent to your specialist — Nottingham's letter specifically says they'll interpret blood results forwarded to them and adjust the care plan accordingly.

None of this should be necessary. The fact that the NHS is blocking routine blood monitoring for established patients is genuinely dangerous, especially for people who are post-orchiectomy or oophorectomy, and have no endogenous hormone production.

At least these options exist as a stopgap while the bureaucratic battle plays out.

Wow, Excellent information there Susan! Thank you!

Thanks again ladies for your further comments, superb insights, and helpful guidance. From which you'll also see @Sarah B that I am a lover of the Oxford comma so if quoting me directly, please leave my passion intact ;) Seriously though, the replies to this thread have been so brilliant. I need this forum. Had you not been here, and had I not been in a better place, something like this event might have tipped me over the edge. I fear for vulnerable others.

Anyway, there has been an update. My surgery have now issued a Collaborative Care Protocol to sign. In fact, it has come from Nottingham. I'm sure that somewhere within the system there are those who have convinced themselves that all of this was necessary and protective, even though I have been on estrogen for 14 years, the last 12 of which have been within the NHS.

I'll post the link in case it works and it case it is of interest.

From the surgery:

Could you kindly read through and sign the form on the attached link

https://www.nottsapc.nhs.uk/media/qaafcl52/feminising-hormones-information-sheet.pdf?UNLID=8732158592026225162944

We have also sent a form to the clinic to sign to accept the terms of collaborative care protocol, as it is an Amber drug.

Once we have received yours and the clinic's signed form back, we can prescribe under shared care

Kind regards

On behalf of Sunny Meed Surgery

p.s Methinks the the word "care" trips too easily off their tongues ...

Hi Tills

I must humbly apologise for the removal of your Oxford comma before the word "and" in your quote.  There is no way that I would ever intentionally alter someones post.  I faithfully copied the quote into my reply and as I check my reply I use a macro called "Clean_Up_Document" and as you can guess it removed all traces of a comma before the word "and".

I was not thinking of the implications when I ran the macro and the effect it would have on a quote.

As you can guess I do not like a comma before the word "and" and when cut and pasting into my documents from various sources, there is that ubiquitous comma before the word "and", hence my macro that removes them one and all.

Once again I must profusely apologise to you for my inherent behaviour.

Best Wishes Always
Sarah B
Global Moderator
PS Do not allow any administrative obstruction to compromise your health.  Your health matters.
@Tills

Quote from: Sarah B on February 25, 2026, 04:29:58 PMHi Tills

I must humbly apologise for the removal of your Oxford comma before the word "and" in your quote.  There is no way that I would ever intentionally alter someones post.  I faithfully copied the quote into my reply and as I check my reply I use a macro called "Clean_Up_Document" and as you can guess it removed all traces of a comma before the word "and".

I was not thinking of the implications when I ran the macro and the effect it would have on a quote.

As you can guess I do not like a comma before the word "and" and when cut and pasting into my documents from various sources, there is that ubiquitous comma before the word "and", hence my macro that removes them one and all.

Once again I must profusely apologise to you for my inherent behaviour.

Best Wishes Always
Sarah B
Global Moderator
PS Do not allow any administrative obstruction to compromise your health.  Your health matters.
@Tills

That's so sweet Sarah, very kind, and truly not something we should be fussing over. I was being a little playful. It's a running joke in my family as both my daughter and I like the Oxford comma. Our Alma mater has left its stamp. The whole 'Eats, Shoots & Leaves' thing amuses me, grammar fascists less so. When a previous Secretary of State for Health dictated that Oxford commas must be removed from all NHS documents, I ensured I inserted them everywhere :) All of this is reminding me of Jonathan Swift's description of arguments about which end to crack open an egg. Thank you though.

On much more serious and important matters, I feel like a breakthrough occurred. But I still feel as if I've been treated like a naughty schoolgirl. I am sure somewhere they must feel that they have been protective but isn't that a most loaded word?

xx

I support the Oxford Comma, and Grammarly agrees with me!
Long live the Oxford Comma.

Hi Tills

Thank you for your response to the comma "issue".  I genuinely did notice the glint of playfulness in your earlier comment.  The egg analogy sealed it.  No feathers ruffled here.

My apology was really about clarity for everyone reading.  I wanted it unmistakably clear that I do not alter members' words in quotes unless moderation genuinely requires it.  A macro on autopilot is one thing.  Quietly editing someone's prose is quite another.

As to the brave interloper and supporter of the "Oxford comma" invoking Grammarly as a higher authority, I feel duty bound to escalate matters.  The comma before the word "and" should not be shown the door.  It should be ceremoniously launched into orbit without a space suit.  Grammarly does not speak English or even for me.  It speaks American, which is a bold re-imagining of the English language carried out with great enthusiasm, minimal supervision, no spelling sense and certainly no grammar sense in the world.

So rather than "Long live the Oxford comma", I respectfully submit:  May the Oxford comma be catapulted into the Pacific Ocean where it can contemplate its choices.

All said with a gleeful smile.

Best Wishes Always
Sarah B
Global Moderator
@Tills @Lori Dee

Quote from: Sarah B on February 26, 2026, 04:21:03 PMHi Tills

Thank you for your response to the comma "issue".  I genuinely did notice the glint of playfulness in your earlier comment.  The egg analogy sealed it.  No feathers ruffled here.

[...]
All said with a gleeful smile.

Best Wishes Always
Sarah B
Global Moderator
@Tills @Lori Dee

🤣 Nice one

I really dislike the ambiguities generated by the absent comma.

However, although I don't 'own' this thread maybe we can leave it there respectfully to agree to disagree with one another on commas and return on topic.

Still no resolution from my GP surgery. Their pharmacist is waiting for the signed form from Nottingham before he/she will permit the prescription to be released.

It all feels incredibly gatekeepery and a hell of a palaver. If they put everyone of our community through this it's going to cause such damage, as well as add layers of bureaucracy.

xx

Well Surrey Heartlands have written to let me know that they still have not received the signed protocol from Nottingham Centre for Transgender Health. I don't know why, but I suspect Notts are double checking that they want to get dragged into this potentially litigious bureaucratic quagmire.

It's completely absurd.

I am losing my rag with Surrey over this. I've written to Notts with a copy to the Surrey top brass and my surgery.

xx

Dear Notts Centre for Transgender Care,

I have heard today from Surrey Heartlands that neither they nor my surgery at Sunny Meed Woking have yet received your signed protocol.

Without this they are continuing to refuse my treatment. They are doing this under the spurious pretext of my safety: which is of course nonsense but they are an intransigent block. Putting patients Last would be the most appropriate description for Surrey Heartless and my surgery.

Can you please let these bureaucrats know that either a) you are signing the agreement or b) you will agree to adhere to your own Terms within the document (even more absurd, I am sure you will agree!).

Just for your information, I began your advised dose of Evorel 100 2 x per week on January 30th as I am certainly not taking any notice of Surrey's transphobic gatekeeping. But I would prefer to come back under the NHS please, as the blood testing and monitoring is important and I don't see why I should have to pay privately when I've been under your sensible and safe auspices for 12 years. Your knowledge in these matters is of course a thousand times more extensive than all the medics in Surrey combined ... but there's seemingly no telling them.

yours, Tilly

A senior Doctor at Nottingham Centre for Transgender Health phoned me this afternoon.

Notts are tearing their hair out about this. They have several hundred different patients and this is happening with 3 or 4 different Health Authorities, of whom Surrey are one. It's basically a deliberate Anti-Trans block on hormone treatment. Up until now, GP surgeries accepted the lead advisory from the Transgender centres and prescribed relevant medications and conducted blood tests, feeding back the info to the centres.

When I said to him, 'What do I do?' his response was, 'Move to Brighton.'

The good part is that I was able to tell him that I am now obtaining my meds privately and was able to confirm to him that I'm on Evorel 100 as they advised. I'm a fairly robust person at the moment and won't be pushed around by bureaucrats. But many of our community are vulnerable people and it's deeply unsettling.

The situation is an absolute shambles and absolutely disgraceful. It clearly traces back to that odious anti-Trans wretch Wes Streeting. This Labour Government are failing all vulnerable groups. We are being turned into pariahs.

I'm seriously worried about the rate at which trans people are being attacked both in the UK and USA. At this rate there will be nothing left in a few years. But how do we fight this? As minorities and no one else really caring? Call me pessimistic but I don't see anything getting better in this world ever now. I honestly think humanity is on its way out. It starts with the minorities first until its each for their own.

Charlotte 😻

Quote from: Charlotte Kitty on March 12, 2026, 11:35:07 AMI'm seriously worried about the rate at which trans people are being attacked both in the UK and USA. At this rate there will be nothing left in a few years. But how do we fight this? As minorities and no one else really caring? Call me pessimistic but I don't see anything getting better in this world ever now. I honestly think humanity is on its way out. It starts with the minorities first until its each for their own.

Charlotte 😻

Going to courts is how we fight back I think Charlotte, it's becoming a violation of human rights now. Unfortunately, not many trans people have funds spare to fight the government or NHS trusts in court due to all the other expenses.

Tills - it is clear by now that there is nothing labour about this and previous labour governments. They don't care about minorities, they are bringing in policies that infringe on human rights, they can't even define what a working man is let alone represent them! They need to be ousted but who is available to fill the void? Farage looks to be next in line which is frankly terrifying. I honestly think only the greens in England have socialist leaning policies now. The SNP in Scotland too of course but I can't vote for them due to geography.

I said I wasn't going to post on political matters anymore but this takes the biscuit😡😡

To quote private Fraser "We're all doomed"!

Thanks so much ladies ^^^ and I totally agree.

The doctor this afternoon used the word 'negligent' for Surrey Area Health Authority's new transgender policy. Medical professionals don't use that word lightly.

There's someone on the support admin staff at my GP surgery with whom I interact by email. I've always stayed polite with her because she's caught in the crossfire and I can tell that she doesn't agree with the Surrey Health Authority's anti-trans block.

Last evening she sent me a lovely message:

'Although we have not met face to face, my interactions with you have always been so pleasant. I want to help you as much as I can, and help I will.

Have a good evening and I will be in contact tomorrow.

Kindest regards'

I'm posting this because although things may seem bleak there are always good people around. There's light in the midst of darkness.

xx

Yes there are good people around.

We must not hate people, we must love people.

How does one treat people you love?  With much kindness and consideration.


Chrissy

When it sounds like it is so widespread I'm surprised the media haven't picked up on it. Surely people can blow the whistle annonymously these days. Maybe they have and the media doesn't care.

It does make for depressing reading but as you say there are good people caught up in this. I doubt it is the medical professionals denying care as the medical evidence of gender disphoria and maintaing correct hormone balance for health is concrete. It has to be the management class at it again looking to save cash or finding a convenient way to get us off their books. It is these people, along with politicians, who are the real cause for the failings of the NHS. I think there should be a root and branch clearout and reduction in number of these people.

Probably won't happen but I can dream.

As you say, @Stottie Girl this has the hands of management all over it. The pharmacist linked to Sunny Meed surgery is the one initially blocking it, doing so because of the new policy from the area health authority.

Above and beyond them this feels like it has Wes Streeting's grubby anti-trans hands all over it.

For anyone who doesn't know who Wes Streeting is, he's the Minister for Health who used to be supportive of trans rights until Labour gained power whereupon he did a complete u-turn and began enacting a series of anti-trans policies.

Wes Streeting is in a gay relationship and once posted on twitter about the journalist Jan Moir that he "would like to push the bigoted old bag in front of a train." He repeated this several times, even saying that he would like to start a vigilante group "to push nasty people in front of trains". Also that he would "like to kick a dog in the face."
https://www.express.co.uk/news/politics/1628883/wes-streeting-abusive-tweets-labour-leadership-apologise-update

He is a self-serving career politician who is fuelling the anti-trans lobby

I personally don't think we can underestimate the influence coming from the USA and Trumps government. Until this there was none of this talk. The UK is and always will be a puppet to the USA or any other in power nation.

As the UK has no real resources to support itself, let alone offer to others, I don't see this position ever changing. The UK doesn't even have intellectual resource anymore so I'm unfortunately pessimistic for the entire future. Unless someone knows something up our sleeve that almost any other nation somewhere else doesn't have more of or do better.

I'm basically rushing to self fund everything I want to do as quickly as possible. I'll worry about the tens of thousands of debt later. When I'm bankrupt I can't pay it anyway! The NHS hasn't sorted aganosing polyps I have in 12 months yet; why would it care about gender affirming care!

Charlotte 😻

The UK is on a downward spiral across the board but it doesn't have to be this way at all. Trans people are human beings and we have a medically diagnosable condition which has a known successful treatment path which I fear we are starting to be denied. We deserve to be afforded human decency from our elected government.

On the rest of the decline, the people at the top or waiting in the wings need to look at countries that have built themselves up from disaster and decline and start investing in UK industry. Germany and Japan did it post war and surpassed us. Korea did it, China has done it (though off the backs of low paid labour) It is about time we re-invested in our people and our companies. We can start by stopping foreign takeovers of British companies. Re-nationalising our utilities, Rail network, Post office, Royal Mail etc. Subsidising energy cost for businesses, not putting public tenders out to foreign companies. Privatisation has been a massive failure. all it did was give short term gain to the coffers which was squandered on god knows what. Look where we are now.

It's time for a revolution. I think we should start the Trans Liberation Party (TLP) and sweep to power, who's with me?

I may have gotten a teeny bit carried away there!

The biggest problem with "nationalism" is not patriotism but the impact of foreign investments. All of those countries rebuilt themselves with the help of foreign investment, not to mention the labor force that came from immigrants.

When a country starts banning and/or removing immigrants (or any class), they restrict their own labor force that does the work of rebuilding infrastructure, farming, and production in factories. It isn't just manual labor either. Engineers, doctors, and others with higher education contribute greatly to the success of any country.

@Jessica_Rose had joked that with the number of transgender people in the U.S., if we all moved to New Zealand, we would have enough votes to take over. Sadly, New Zealand has passed some not-so-friendly laws, and I have crossed it off my list. At least until we can all move there and take over.

😆

Quote from: Lori Dee on March 13, 2026, 02:12:33 PMThe biggest problem with "nationalism" is not patriotism but the impact of foreign investments. All of those countries rebuilt themselves with the help of foreign investment, not to mention the labor force that came from immigrants.

When a country starts banning and/or removing immigrants (or any class), they restrict their own labor force that does the work of rebuilding infrastructure, farming, and production in factories. It isn't just manual labor either. Engineers, doctors, and others with higher education contribute greatly to the success of any country.

@Jessica_Rose had joked that with the number of transgender people in the U.S., if we all moved to New Zealand, we would have enough votes to take over. Sadly, New Zealand has passed some not-so-friendly laws, and I have crossed it off my list. At least until we can all move there and take over.

😆

WOAH LORI! I didn't say I wanted to ban or remove immigrants, you are putting words in my mouth there. I have said nothing against immigrants at all here. Please don't let this get misconstrued like the last time.

This isn't nationalism in fact it's called socialism! I said I don't want foreign COMPANIES taking over our companies. I imagine it is different in the states but over here our businesses are often taken over by foreign hedge funds or unscrupulous owners who end up sacking loads of the workforce, lower the wages and strip the business of the assets. Sometimes they buy them then move the whole brand and business abroad. Everytime a promising business gets started they get taken over. It has happened time and time again.

Loads of these foreign owners avoid paying tax in our country. Prime examples are Google, Amazon and the like. We have lost our steel industry to foreign companies who have ran the industry into the ground to the point where we had only one furnace left in the entire country that could make quality steel. The government had to step in to nationalise it to save the plant but it's only a matter of time before they sell it off again.

There are a few UK organisations doing this too don't get me wrong but the FTSE100 index companies are now nearly 60% foreign owned. I blame the british owners who sell them as much as the foreign investment funds. Hell we don't even own our water it's 70 % owned by foreign companies who fail to invest in the infrastructure whilst hiking water rates and creaming off the proffit.

This is the rotten part of capitalism/globalisation. We are headed in only one direction if we constantly sell everything off to make a quick buck. Capitalism is still the best system, I'm not wanting to endorse communism here by the way!

We used to have proud British businesses, made in britain used to mean something.

I've gone off on a total tangent here. Sorry Tills but I'm worried I get picked up for using far right terminology again here.

I knew I shouldn't have started talking politics again. I won't get involved in any more political stuff, I'll keep my opinions to myself in future.

As someone who comes from Sheffield, in the north of England, I can attest to the downfall of the steel industry. It really has nothing to do with immigration, at all. When the Tory government were in power, there were mutterings about selling off pieces of the NHS. Even Donald Trump showed an interest. But as a body, it is heavily reliant on immigration and medical staff from overseas.

That's kind of apples and oranges. I kind of agree with Sarah here.

Quote from: Sephirah on March 13, 2026, 04:46:09 PMAs someone who comes from Sheffield, in the north of England, I can attest to the downfall of the steel industry. It really has nothing to do with immigration, at all. When the Tory government were in power, there were mutterings about selling off pieces of the NHS. Even Donald Trump showed an interest. But as a body, it is heavily reliant on immigration and medical staff from overseas.

That's kind of apples and oranges. I kind of agree with Sarah here.

Thanks Lauren. I'll stop getting all political now! ooh kittens

I think there may have been confusion there between

nationalize: to invest control or ownership of in the national government

and

nationalism: an ideology that elevates one nation or nationality above all others and that places primary emphasis on promotion of its culture and interests as opposed to those of other nations, nationalities, or supranational groups.

@Stottie Girl

I was not accusing you of anything. I apologize if it came across that way.

We have the same problem here with foreign corporations buying out smaller companies. At the beginning of COVID, it was revealed that Chinese-owned companies were buying entire supply chains. For example, cattle and ranchland, feedlots, meatpacking plants, and distribution channels (Tyson, Jack's Links, etc.). That provided many jobs and tax revenue for states. The downside is that they could charge whatever prices they want because they control their own profits for the entire product. And that is just one example.

I agree with you that the ideal situation would be for locals to own and operate the businesses. But that is not feasible in many situations. In any given city, there are only so many people who want to own and operate a widget factory, even if the demand is high. The solution to meet the demand is for foreign investors to build, own, and operate the business.

Can it be abused? Absolutely. And that needs to be regulated. But even locally-owned monopolies can be abused, too.

Again, I apologize if it seemed like I was accusing you. I was not. I was only pointing out that post-war development was not done only by locals. It was done with foreign investment.

No it's me over-reacting again Lori. I've picked you up wrong. Sorry, I'm just paranoid of saying the wrong thing again. I can't help myself! I'd best stay clear of politics. It's just the treatment of Tills by our healthcare system got me so riled up.

A bit of an update which may relate to this issue I have faced in Surrey:

https://www.susans.org/index.php?topic=250751.new#new

xx

I'm just penning my letter to my MP and I will also write again to the area Health Authority

That this is a trans-attack is evident to me from 2 things.

1st, as you may know, I take a micro dose of Testogel. They have left this unaffected and on repeat prescription. The fact that Testogel is a far more potent and dangerous drug is part of the irony, but it demonstrates that they are treating me as inherently male.

2nd which is emphasised by the fact that the cis lady with whom I currently lodge, same address, has just switched from pills to patches HRT. Not one block or issue at all. No traffic light system.

It's a deliberate anti-trans policy.

xx

p.s. Health Secretary Wes Streeting's tweet saying he wanted to kick a dog in the face:

https://x.com/Morrigan_Wolfe/status/1305237628002983943

xx

Lovely people aren't they?

It's hard not to get emotional and passionate seeing how our fellow friends are being treated by this country. And ourselves too. I don't think being on a 6+ year wait list to see a gender specialist is great when the limit set by the NHS is 18 weeks. It's only because of DIY and me being in a professional job I can get the care I need. Still painful paying over £15k a year in income tax alone and getting no NHS support for me or my beautiful peers.

It's hard in the UK to not wonder each day why you bother. I'd write to my MP but she is now independent and pushing Advance UK. I think my words would be wasted!

I hope better for us all but can't help think we're on our own now and care quality is down to how deep our pockets are.

Charlotte 😻

Charlotte, Your words are never wasted. They may fall on deaf ears but others will hear them.

The state has shat on me at every stage of my life while I dutifully paid all my taxes like a good little citizen. The state has not given me anything in all my 50 years. Whenever I needed help there was always an official pen pusher there to say "oh yes, but that's not for you"! Such is life I'm afraid.

Tills, the words I would use to descibe them I dare not use on here for fear of being banned!

So here's what I've written back to the Chief Executive who had written to tell me that this was all for my care and safety:

Karen McDowell
Chief Executive
Surrey Heartlands
Dukes Court
Woking GU21 5BH

Ref Tilly [Name Redacted]


Dear Ms McDowell,

Thank you for your letter.

You claim that you have enacted this traffic light block on my hormone treatment out of patient safety. This is gaslighting.

I am a post-operative female, with no naturally occurring hormones, and for the past 6 weeks have been left without hormone treatment which is extremely dangerous for physical, emotional, and mental health. There is nothing about patient safety in these actions: it is an act of gross negligence.

My national Centre for Transgender Health in Nottingham, under whose safe expertise and auspices I have been for 12 years, are tearing their hair out over what everyone else considers your stubborn ignorance. Until now it has been the accepted and sensible practice of GP surgeries throughout England & Wales to liaise with the national Centres for Transgender Care, feeding back blood results and adjusting medications accordingly.

That this is a deliberate anti-trans policy is evidenced from two things.

1.   I take a micro dose of Testogel. This is a far more potent and dangerous drug than estrogen and yet you have left this unblocked and available for me to order on repeat prescription. In other words, you are consciously treating me as if I were a male, which is outrageous.

2.   My natal cis female friend [Name redacted], living at the same address, has just switched her HRT from pills to patches without any issue or block at all. Ergo, once again, demonstrating your anti-trans attack on me.

As it happens, I was born with a chromosome mutation which made me naturally intersex. That I should be outed to have to write such personal details to you and others is appalling, especially considering that I have a Gender Recognition Certitifate.

I have written to my Member of Parliament and I will not stop until this anti-trans ban on my treatment plan is lifted. I will not hesitate if necessary to take legal action against Surrey Heartlands, the GP Surgery and their Pharmacists. The last time I took an organisation to the High Court I won a six-figure sum so I'd advise you to think very carefully.

And please don't ever gaslight me again.

Yours sincerely,


Dr Tilly [Name Redacted]

c.c.
•   Will Forster MP
•   Richard Morgan-Jones, Sunny Meed Practice Manager
•   Clinical Pharmacists, Sunny Meed Surgery
•   Surrey Area Prescribing Committee
•   Surrey Integrated Care Board (ICB)

And here's what I've written and hand delivered this morning to my Member of Parliament, who is a Liberal Democrat:

15th March 2025

Will Forster MP
One Crown Square
Church Street East
Woking
GU21 6HR


Dear Mr Forster,

I am one of your constituents and I wish to complain about Surrey Heartlands and Surrey Area Prescribing Committee's newly enacted Anti-transgender medication block.

The Area recently brought in a traffic light system on certain medications which is a deliberate attempt to stop transgender treatment.

They are dressing this up as 'protecting patient safety' but this is gaslighting. I have been under the auspices of the national Centre for Transgender Care at Nottingham for 12 years and have never encountered any GP Surgery or Area Health Authority refusing to enact their medication recommendation. They have also blocked blood testing which is dangerous.

As a post-operative transgender female (I was actually born intersex) this is an act of gross negligence by Surrey. I have no naturally occurring hormones so they are exposing me to grave physical, emotional, and mental danger. I also have a Gender Recognition Certificate and I think it's equally disgraceful that I am being forcibly outed by this policy.

I would like you to raise this in Parliament please if possible and also to tackle the Health Authority. I would be happy to meet with you to discuss it further.

Please see the attached letter. As you may tell, I am angry but also hurt.

With kind regards,


Tilly [Name Redacted]

p.s. it's entirely true that I took an organisation to the High Court and won a six-figure sum. It was a battle but I won it. They settled on the steps of the Royal Courts of Justice.

If I sue these state-sponsored thugs it will not be for the money, but for all of our futures.

xx

TRIGGER WARNING: REFERENCE TO CHILD ABUSE

I might have given the wrong impression with that message ^^^ about legal action.

I think I should explain. I actually took my old school to court because it facilitated child abuse. This was documented and evidenced and several teachers were found guilty and one was sentenced to 10 yrs in prison. Their lawyers settled with me just as we were about to go into the court room and I got the school shut down.

So, again, it was about the principles not the money. I don't like injustices.

xx

Quote from: Tills on March 16, 2026, 12:20:23 PM TRIGGER WARNING: REFERENCE TO CHILD ABUSE

I might have given the wrong impression with that message ^^^ about legal action.

I think I should explain. I actually took my old school to court because it facilitated child abuse. This was documented and evidenced and several teachers were found guilty and one was sentenced to 10 yrs in prison. Their lawyers settled with me just as we were about to go into the court room and I got the school shut down.

So, again, it was about the principles not the money. I don't like injustices.

xx

Oh my god Tills, that's awful. I'm sorry you had to go through that. I hope that resolution helps you put it behind you at least.

Excellent letters. If I was one of the recipiants of the first one in particular I would be getting a bit worried now!

I think your blue touch paper has been lit! You go for it. Give them hell Tills!

Well there has been quite an update ...

I'm going to be careful what I post here but I had a call today from the Manager of my GP practice, who was copied into my letter to the Chief Executive of the Area Health Authority, known as 'Surrey Heartlands.' This time I also copied in the clinical pharmacists.

It turns out that the block was not coming from my GP surgery but from the Lead Clinical Pharmacist at Surrey Heartlands.

The Practice Manager paused as he relayed the next piece of news.

'She has been sacked: made redundant. Her replacement as Lead Clinical Pharmacist has phoned me this afternoon and is now on your case with the intention of having your prescription cleared and on file at the beginning of next week.'

I don't gloat about anyone's downfall (although personally I would make exceptions for Trump, Putin, Farage, and J.K.Rowling) but I hope that this now improves the lives for all transgender people in the Surrey Area.

xx

I too don't like to see someone being put out of a job Tills but when poor performance in that job is causing distress and health risks to others there is no choice. Excellent result in that regard. Very well done!

Now if you could just get the anti trans mob removed from Kier Starmer's government as well that would be appreciated!

Trans warrior Tills!

Just wow.  This is very good news.  💚

Quote from: Stottie Girl on March 20, 2026, 12:10:33 PMI too don't like to see someone being put out of a job Tills but when poor performance in that job is causing distress and health risks to others there is no choice. [...]

Yes agreed but the Manager gave me the distinct impression that she was sacked because of deliberately blocking a transgender patient's hormones not because of poor performance. Look for instance at the way my friend's switch from HRT pills to patches went through completely unblocked.

If I hadn't taken this to a fight then she could have carried on with this trans attack on others of our community for years.

xx

For the record I'm not defending her I was trying to be diplomatic. If it has been a personal agenda against trans people then she should never practise again. She is not fit to hold the role anywhere. In fact there should be criminal or civil prosecution but there probably won't be.