I really admire the strength and will of those who went through a horribly difficult transition under the strict application of the Harry Benjamin Standards.  But those standards do get revised to meet changes in society, medical practice, and improvements in psychiatric understanding of how patients must live within thier family and social constraints.   Hopefully those countries that lag behind will see the light soon and become as progressive as the US.

Kathy

Quote from: Carlita on September 20, 2012, 10:00:17 AM
I was completely freaked when I saw that ... my entire transition strategy will depend on delaying the point where I go full-time until I have already made significant progress with hair restoration, beard removal, voice and HRT. For personal and professional reasons I absolutely have to pass pretty much from the word go, certainly from the point where my transition goes public. I had got the impression from doctors and shrinks I'd spoken to that this would be possible. And it is. here's what the official NHS website has to say about treatment of gender dysphoria ...

<snip>

In other words, you CAN have hormone treatment before living in role. I think it's important that any other Brits reading this should be reassured. The link is here:

http://www.nhs.uk/Conditions/Gender-dysphoria/Pages/Treatment.aspx

It's also worth noting that you can go private in the UK too.  My therapist and psych follow the SoC v6 guidelines of 3 months of therapy prior to HRT. Did that. On HRT. No requirement to do anything beyond the therapy.   

To start the NHS process, first you need a "mental health check" from your local mental health authority.  I waited for my referral for 5 months. (By then I had seen my private psych.) Once that's done, it goes back to your PCT where they have a think and an argument over who is going to pay for you.  Then you get referred to a GIC.  This can take another 5 to a-really-long-time-to-get-sorted-out.  I've heard stories of up to 16 months to get into CharX.

Privately, 3 months of therapy, get HRT, go full time when you're ready, 12 months after that you can have your surgery letters if that's your path.  Three months of therapy at an average £50/week is £600, the two psych appointments and the letter to my GP cost me £450.  The psych "share-cares" with my GP, issues the prescription to my GP who turns it into an NHS 'script, and the meds are on the NHS (less dispensing fees).

So in 15 months, you can be through all the physical stuff, or possibly still be waiting on the NHS to get started.

Also, you can switch into the NHS from private, but they won't prescribe apparently in your first year in their care, nor will you get surgery in the first 2 (again if that's your path). However, you can get started on hrt ahead of that (by going private initially) and switch in later.  They wont make you stop hrt, as they at least understand people will DIY.  I think they'll kick you out of the NHS GIC if you don't swear your allegiance to your GIC by the end of your second visit, so you can sit on the fence and test the waters (or stay properly supervised for your HRT with your private Psych) while checking out the NHS.

There's more that one option in the UK. Private isn't cheap. Neither is transition in general.

Quote from: kathy b on September 20, 2012, 11:31:17 AM
I really admire the strength and will of those who went through a horribly difficult transition under the strict application of the Harry Benjamin Standards.  But those standards do get revised to meet changes in society, medical practice, and improvements in psychiatric understanding of how patients must live within thier family and social constraints.   Hopefully those countries that lag behind will see the light soon and become as progressive as the US.

Kathy

as someone transitioning in one such country and with no choice but to go out in boy-mode am wondering how will I ever be able to handle things if the girls ever got too big - I mean a part of me really wants them to be big and visible but am scared cause it means I can't go out in boy-mode anymore which can cause an insane number of headaches and heartaches for me.

anyways crossing my fingers and hoping I can get hold of a really good sports bra and take care of it without anyone noticing me wearing it or keeping one in the closet.

Quote from: michelle666 on September 19, 2012, 06:58:03 AM
After wearing this one for a day, it's way too constricting. I'm going to look into that ahhh-bra. I dont want to potentially damage what I have going on here.

I have a photo of myself in a white Ahh bra, (the third photo down in my flickr account) and a couple wearing a black one under a navy long sleeve T. The idea is to try and understate the obvious, obscure points and bounce until you're ready to let it all hang out. Hope this is helpful!

http://www.flickr.com/photos/87446629@N07/

Quote from: Naturally Blonde on August 24, 2012, 05:05:16 AM
In the United Kingdom we have to prove we are living full time as female in order to get prescription HRT. If we are living as a male HRT is not usually prescribed especially if there is no commitment to present as female. I had to live as female for two years before I got prescription HRT.

Over in America you seem to be able to take whatever drugs you like including HRT no matter if you are full time or not without any medical supervision. I think you need to decide if you want to transition or not but while you live on the fence and remain presenting as male you should probably not be taking HRT if the commitment isn't there.

I'm sorry your government's policies for HRT are so archaic and fundamentally transphobic, not to mention extremely dangerous psychologically and physically for those in RLE without hormones.

Here in Washington D.C. I go to a clinic that operates on a "patient consent" basis for HRT...if you want HRT and understand the risks by signing the release, they'll give you 'mones.

Most clinics in the U.S. do NOT operate on a "patient consent" basis and require a few months of gender therapy and a letter from the therapist supporting HRT

The right to gender expression is a fundamental human right, and the right to being comfortable in one's own body is also inalienable, so I'm in full support of "patient consent" policies.

If one hasn't done the research or doesn't understand the real physical and social dangers that HRT present and they end up at a liberal "patient consent" place and on hormones and then regret it, it's their fault for not being informed.

Their ignorance should not impede my right to swift and equitable gender transition & expression.  I know who I am and what I want, and I'm pretty bloody sure that's why "patient consent" has started to be adopted in some clinics.  To provide access to HRT for those who want it, fast and simple.

This policy of patient consent also really helps bi-gendered, androgyne, gender fluid/queer, or otherwise non-binary gender identified individuals achieve partial femininization/masculinization as needed/desired.

The policy in the UK is not (usually) that archaic nowadays. The situation varies from gender clinic to gender clinic, and also depends on the circumstances of the client. I got HRT very soon after I began living full-time, for example, and for many people it's a fairly straightforward process taking around 2 years from walking through the clinic door to being eligible for surgery.

  Sorta related to the topic - Today was the first in a long time that was cool enough to wear a jacket.  I had to go to the clinic I'll be dealing with in the future to take care of some paperwork so I used this as an excuse to 'put in my boobs' for the first time outside the house.  The leather jacket hid them completely.  I wasn't interested in showing off yet so this worked out well.  I just wanted to get used to the sensation of walking about with them in without any chance of trouble.  Kinda like an actor getting into character it really helped me feel the part in my head.  It's a wonderful sensation when there's more 'bounce' in your step than just in your step!  It's a feeling of completeness.  I'm really working hard at allowing my mind to flow freely as female on the inside first so when the time comes to present openly it won't be such a big leap.  There's a very special feeling in being out in public knowing I'm female but everyone else is hopelessly unaware.  I'd rather be empowered by that feeling than get my panties all in a knot because everyone is calling me "Sir".  It makes me grin when people sit down beside me on the transit and have no idea they're sitting next to a transwoman.

Quote from: ShawnaB on September 20, 2012, 12:26:48 PM
It's also worth noting that you can go private in the UK too.  My therapist and psych follow the SoC v6 guidelines of 3 months of therapy prior to HRT. Did that. On HRT. No requirement to do anything beyond the therapy.   

To start the NHS process, first you need a "mental health check" from your local mental health authority.  I waited for my referral for 5 months. (By then I had seen my private psych.) Once that's done, it goes back to your PCT where they have a think and an argument over who is going to pay for you.  Then you get referred to a GIC.  This can take another 5 to a-really-long-time-to-get-sorted-out.  I've heard stories of up to 16 months to get into CharX.

Privately, 3 months of therapy, get HRT, go full time when you're ready, 12 months after that you can have your surgery letters if that's your path.  Three months of therapy at an average £50/week is £600, the two psych appointments and the letter to my GP cost me £450.  The psych "share-cares" with my GP, issues the prescription to my GP who turns it into an NHS 'script, and the meds are on the NHS (less dispensing fees).

So in 15 months, you can be through all the physical stuff, or possibly still be waiting on the NHS to get started.

Also, you can switch into the NHS from private, but they won't prescribe apparently in your first year in their care, nor will you get surgery in the first 2 (again if that's your path). However, you can get started on hrt ahead of that (by going private initially) and switch in later.  They wont make you stop hrt, as they at least understand people will DIY.  I think they'll kick you out of the NHS GIC if you don't swear your allegiance to your GIC by the end of your second visit, so you can sit on the fence and test the waters (or stay properly supervised for your HRT with your private Psych) while checking out the NHS.

There's more that one option in the UK. Private isn't cheap. Neither is transition in general.

Personally, this is one aspect of my medical care that I would totally do as a private patient: you just have so much more control over and input into the whole process that way.

Tho' it should be said that it's pretty amazing that the UK has a system that allows people to be treated for free - and by the exact same people, pretty much, that look after private patients - even if it does take a lot longer on the NHS.

Quote from: Carlita on September 21, 2012, 04:51:48 AM
Tho' it should be said that it's pretty amazing that the UK has a system that allows people to be treated for free - and by the exact same people, pretty much, that look after private patients - even if it does take a lot longer on the NHS.

You have got me really angry now Carlita! I live in the U.K and I have never got anything for free! I have had to pay for all my treatment privately (including starting on HRT) and the NHS has never helped me in any shape or form with anything. It's not for the want of trying and I went through the NHS GIC system for 6 years. At present I am trying to save for my operations. You need a reality check girl!

Quote from: Naturally Blonde on September 21, 2012, 04:55:21 AM
You have got me really angry now Carlita! I live in the U.K and I have never got anything for free! I have had to pay for all my treatment privately (including starting on HRT) and the NHS has never helped me in any shape or form with anything. It's not for the want of trying and I went through the NHS GIC system for 6 years. At present I am trying to save for my operations. You need a reality check girl!

I'm sorry, but just because this has been your experience doesn't invalidate the truth of most other people's. Please stop universalising your own experience, grim though it clearly has been. I can understand why it would make you feel bitter, but it is a fact that most people get a very good deal from the NHS going through transition.

Quote from: Padma on September 21, 2012, 05:29:53 AM
I'm sorry, but just because this has been your experience doesn't invalidate the truth of most other people's. Please stop universalising your own experience, grim though it clearly has been. I can understand why it would make you feel bitter, but it is a fact that most people get a very good deal from the NHS going through transition.

Granted, some people do get help through the NHS in the U.K depending on their geographical location and the willingness and financial situation of their PCT (Primary Care Trust). But many are discarded and their NHS treatment is very limited. The best regions for getting NHS support seem to be in London and Scotland. I do not live in either of these areas, and for me personally I have found it hard to get funding or support from the NHS.

It is unfortunate that the treatment varies so much from one area to another. Can you contact the higher ups and explain the differing approaches? Hugs, Devlyn

Quote from: Naturally Blonde on September 21, 2012, 06:27:32 AM
Granted, some people do get help through the NHS in the U.K

Some areas and some GICs are better than others, but if you are prepared to create a fuss then the PCTs usually cave in. I was initially told I faced a 3 to 5 year wait for my first GIC appointment. A few sharp letters later and my wait was down to 18 weeks. At first my doctor did not know what to do with me as I was his first ever TS patient so I prodded him along a bit and that helped.  I was referred to the initial pysch review within 6 weeks and from that review straight to a GIC.

I personally know others in this region (N. Wales / NW England) who have been told of delays or given denials and who have fought back and had success. One person has her appeal against a PCT next month and is already getting her MP involved.

The three GICs used by that most people I know are Sheffield, Leeds and Charing X and a number of PCTs are in this area and they are all different but the message that comes across consistently is 'Stay in touch with the PCT and the GIC and kick-off the first time you get a bureaucratic problem and you will move through the system'. So far it works.

Quote from: Devlyn Marie on September 21, 2012, 06:33:03 AM
It is unfortunate that the treatment varies so much from one area to another. Can you contact the higher ups and explain the differing approaches? Hugs, Devlyn

Devlyn - everyone knows about the different approaches, twas ever thus, but next year the whole system gets ripped apart and replaced with GP commissioning and the PCTs are abolished. The GP practices will have all the money and so it will be my GP that decides what funding is available. That brings the whole system a lot closer to the patient and many have high hopes for an improvement in service.

Good information, and I'll cross my fingers that the system gets fixed so everyone gets the proper care. Hugs, Devlyn

Quote from: brc on September 21, 2012, 06:42:26 AM

Devlyn - everyone knows about the different approaches, twas ever thus, but next year the whole system gets ripped apart and replaced with GP commissioning and the PCTs are abolished. The GP practices will have all the money and so it will be my GP that decides what funding is available. That brings the whole system a lot closer to the patient and many have high hopes for an improvement in service.

Getting rid of the PCT's can't happen soon enough. All about box ticking, targets and lining their own pockets. The doctors will still continue to run rings round the gov't, but at least the service should improve.

And the gender clinics will have much more choice over what they spend on - I've been told that post-PCT, my clinic will be able to fund electrolysis, for example (I think they mean pre-op de-pubing).

Quote from: brc on September 21, 2012, 06:42:26 AM
Some areas and some GICs are better than others, but if you are prepared to create a fuss then the PCTs usually cave in. I was initially told I faced a 3 to 5 year wait for my first GIC appointment. A few sharp letters later and my wait was down to 18 weeks. At first my doctor did not know what to do with me as I was his first ever TS patient so I prodded him along a bit and that helped.  I was referred to the initial pysch review within 6 weeks and from that review straight to a GIC.

So in the UK you pay high taxes for this outstanding care by the National Helth Service, and that wonderfully personal touch by employees of the government?  Then to top it off many TS's have to go out to private clinics for more responsive care and pay all those costs also.  I'm just kidding around here, because if this is what we have to look forward to under the new Health Care Law in the US, I personally want the laws changed.  I'd like to stick to choosing my own insurance and getting decent care.  And I really don't want to pay extra taxes and fines to the IRS, then ultimately end up with a system like the UK has where I'd get a sub-par government bureaucracy making decisions about healt care. 

Hey, I don't want to get into a political discussion about this.  It's just how I feel.

Quote from: Violet Bloom on September 20, 2012, 04:52:16 PM
  Sorta related to the topic - Today was the first in a long time that was cool enough to wear a jacket.

Going camping in Yosemite today.  It's cold at night and warm in the day so I'm likewise wearing a jacket for the first time this fall, but also again relying on those loose tees and unbuttoned shirts to cover during the day.  I really have to come out to the rest of my family soon because on camping trips like this hiding the girls is getting tiresome.

Kathhy

It's an imperfect system but way better than what you have, it's just very badly managed.

I recently had a tooth abcsess flair up at 5.30 on a friday. My dentist (private obviously she can't be bothered with the paperwork) was finished for the weekend so I went to the all night clinic at the local hospital.

Three doctors standing three feet from me having a chat.
I asked the receptionist for an appointment with the doctors but told I'd have to ring the PCT 20 miles away. 

She handed me the phone and I told them I just needed some antibiotics.
No you'll have to go to the dental clinic 30 miles away on Saturday morning .

Soooo what if I had an abcsess on my leg, could the doctor here see me - yes - ok - I've got an abcsess on my leg.
Can I have an appointment? - I'll call you back
90 minutes later the receptionist rang them and said look the doctors will see him.

Got in to see the doctor who had heard the whole thing he said "so you have a tooth abscess here's some antibiotics."

1 other patient had been in and three doctors who had been shipped in from abroad had just been sitting around +1 receptionist + 1 person  in the PCT.

It didn't use to be like this.  In France recently we needed the doctor, went to the local evening surgery queued for 30 mins and saw the doctor, that's what we used to have.

Quote from: Padma on September 20, 2012, 04:18:42 PM
The policy in the UK is not (usually) that archaic nowadays. The situation varies from gender clinic to gender clinic, and also depends on the circumstances of the client. I got HRT very soon after I began living full-time, for example, and for many people it's a fairly straightforward process taking around 2 years from walking through the clinic door to being eligible for surgery.

I lived in and on the borders of London, so maybe that's why I had better treatment? But nothing can be proved really, beyond hearsay. I got my private HRT prescriptions converted to NHS ones the first time around, before I transitioned anything. I even got my GP to pay for my private psychiatrist (Russel Reid). I avoided the GIC route. And I don't want SRS on the NHS. My GPs have always been sympathetic and have always been virgin in regard to TS issues.

Quote from: brc on September 21, 2012, 06:42:26 AM


I personally know others in this region (N. Wales / NW England) who have been told of delays or given denials and who have fought back and had success. One person has her appeal against a PCT next month and is already getting her MP involved.

I got my MP involved too but Charing Cross GIC refused to reply to her letters. I also had another battle with the PCT for two years. I thought my transition would take two years max. I didn't know my transition would take over 11 years! and counting....