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 Yesterday at 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