Hi everyone,
so first of all I am a 27 year old MTF living in the UK. I first explored my gender identity about 14 years ago but it never led anywhere until about 4 years ago. About a year and a half ago I started identifying myself as female, though I still present male.
A few months ago I went to a GP about this, but he decided to refer me to a counselor rather than directly to a gender clinic. I can't say I blame him, given I have a history of depression, and he was only a locum. He said the counselor would be better able to determine whether to make a referral than he was, and had the power to do so.
Anyway, a few months go by and I get my appointment letter, and it looks like I have been referred to see a doctor working in mental health rather than a counselor who is part of the mental health team.
I have no idea what to expect. Could you please advice on how I might prepare for this appointment, with the hope of receiving a referral to a clinic?
First things first, welcome to Susan's Place! Congratulations on getting the ball rolling. I assume it's going to be an intake session where you tell them your goals. Presumably you want HRT as a minimum?
I did most of my transitioning before I sought out the medical steps, which is bass ackwards from a lot of people's approach. We're all on our own paths. :)
See you around the site!
Hugs, Devlyn
HRT as a minimum, yes.
I wonder if it is worth trying to familiarise myself with NHS guidelines and so on before the appointment, or whether I should just explain myself as naturally possible?
Lily
Forewarned is forearmed. Learn the system, more importantly learn yourself, something I'm sure you're well into already. Honesty is best. You want to be calm, honest, and aware of what you really want. With that information your provider can plan a course of treatment.
Hugs, Devlyn
These are the WPATH Standards Of Care (https://www.susans.org/wiki/Standards_of_Care_for_the_Health_of_Transsexual,_Transgender,_and_Gender_Nonconforming_People) that your providers will follow. It's not light reading. :)
Hugs, Devlyn
Hi! Old NHS policy was that a GP would refer to the local mental health team for them to then refer to the GIC if appropriate. This policy was changed some years ago, but many GPs still go this road due to ignorance or a lack of confidence in this area; This happened to me too.
It did add to the excessive wait times of the GIC, but was quite straight forward. After a 1 hour appointment with the mental health team, they fully agreed with my need for a GIC referral, and instructed my GP to do this and how.
In short, your GP should refer you directly, but sometimes jumping through these bearucratic hurdles is just a bit easier.
There's some value in seeing the mental health team. If you have any other ongoing issues (ie anxiety, depression etc...) as I and many of us tend to, you will have a name and contact for support with these.
For your appointment, just be open and honest about your journey to this point, and if you have any specific aims or desires.
Good luck. X
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Quote from: Devlyn Marie on August 06, 2017, 04:18:54 PM
These are the WPATH Standards Of Care (https://www.susans.org/wiki/Standards_of_Care_for_the_Health_of_Transsexual,_Transgender,_and_Gender_Nonconforming_People) that your providers will follow. It's not light reading. :)
Hugs, Devlyn
Just beware that the NHS GICs typically add extra to these standards, ie two years of RLE before GRS rather than one year.
The GMC (general medical council) publishes the guidance for GPs, this is free to read on their Web site.
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Thanks!
Less than 36 hours until the appointment. Uggghhh :S
The appointment has been
He thinks I might be confused and wants me to try to deal with my anxiety and depression first. I feel empty. Not disappointed but a bit directionless. Maybe i have got this all wrong.
But hey, no one can stop me being me :)
That's disappointing to hear, they can often be related (were for me), you can't fix one without addressing the other.
Can you ask your GP for some sessions with a therapist (not the mental health team), so you can talk through these issues?
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I am sure there is someone.
Right now though I am seriously doubting that I am transgender at all.
I can't say if you are or aren't, it's a wide spectrum, where you are on it, and what if anything you choose to do about it is entirely up to you.
Try to find a good LGBT friendly therapist who ideally has experience in gender identity.
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That might help, right now I more or less want to hide away for a bit.
I know what questions I want to ask myself, I just don't know if I will like the answers.
I was 37 before I was ready to ask myself those tough questions. Do I wish I'd done it sooner, yes, but being honest, I wasn't ready until then. If you take things further it will be if/when you're ready. Regardless where your journey takes you in life, enjoy it! X
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All I know for certain is that I really, really, really don't want to be a guy.
Download the referral template from the link below, take it back to your GP, and TELL them to sign it and send it.
https://gic.nhs.uk/referrals
Once that's done, you'll then have plenty of time to make any changes you want, at a pace you're happy with; there's plenty of 'next steps' advice here. X
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Ok.
So if I understand, they will sign the referral if I instruct them to?
I know these some silly questions but I want to be clear.
The psychiatrist strongly implied that there was no point in making a referral unless I am definitely seeking SRS.
Is he talking nonsense or is he just saying what he has to say according to the way the system is structured?
I don't think you can force the GP to sign it, but GMC guidance is that is the process they should be following, so tbh, they don't really have an excuse not to given your feelings. Some GPs are great, others are bigoted, and some just ignorant.
Only a percentage of those who are referred to the GIC ever have GCS, so it's nonsense. You may identify as non-binary, you may only want HRT, or may not even want that, but that's what the GIC is there for, to at least some extent.
The state of understanding on gender in the NHS is broadly woeful (though slowly improving). Be informed, know your rights, and the processes that should be being followed. X
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Is it worth investigating transferring GP to one who is trans friendly, even if temporarily?
Also, my family doctor is retiring and there will be no full time GP at my local surgery, only locums. Could this be an issue?
You're entitled to register with any GP.
I guess the ideal would be to have one (supportive) GP through the whole transition, but it's not really practical. My contact with my GP in this whole process has actually be quite light.
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I can do this. I can do this.
I did some meditation today. Interestingly I am less stressed and anxious (good result of meditation!) and MORE certain about my gender.
The psychiatrist has said my gender identity state is due to my anxiety, yet lower anxiety makes me feel more certain about being a woman?
Yet perversely I seem only to be able to get help with my gender identity if I CANNOT reduce my anxiety.
I should make it clear that I told him that I wasn't sure about my gender and surgery etc..
I am not sure this is clear.
Only by my second GIC appointment was I able to tell them that I intended to transition. At my first appointment I was honest and told them I still didn't know exactly what I was and what I wanted. It took me more than a year to answer that question.
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I suppose that when I am more peaceful I am more in touch with what I want and who I am.
I am me <3
Right now I really want these feelings to go. :(
As the old me slowly had to make room for the new me, there was a bit of a turf war that went on in my head. For me it was 10 steps forward and 9 back, but the overall direction was consistent, and the need was always present.
It seems the lower my mood is the less I feel female.
I took me months, but I learned to accept that my moods and feelings would ebb and flow. I learned to take a step back, and view the overall direction of travel. It's was that, and not my feeling at any one moment that I used to guide my choices.
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I've started keeping a diary. Hopefully it will help :)
Quote from: LilyMelody on August 25, 2017, 11:51:36 AM
I've started keeping a diary. Hopefully it will help :)
That's a really good idea. X
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GICs are specialists whose job it is to help you decide if/what surgeries etc you want, not GPs/ MH. The GP and/ or mental health can and should refer you directly to them.
I'm not NHS England, but I was referred to MH and had two unnecessary sessions with an untrained psych during which i mostly explained to her what being FTM meant and what medical options there were. It saved no time when I got to the GIC and achieved nothing.
the mental health person should be helping you with anxiety but not holding back your GIC appointments, especially if they're not trained in transgender care
I think he'd have made the referral if I had been more insistent. I'll see how I am in a few months.
Just told my GP I wanted referring and they did it there and then. They should not tell you what you want or try to dissuade you.
Quote from: LilyMelody on August 26, 2017, 02:28:17 PM
I think he'd have made the referral if I had been more insistent. I'll see how I am in a few months.
Just remember that you'll still have plenty of time once referred given the current waiting lists.
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