Well I've hopefully just been accepted on Nottingham gender clinics care pathway, I find out tomorrow at my appointment!! I've been told that I have fulfilled all the criteria, but I'm still nervous about it.
The process is very long winded and you do have to jump through the hoops they set to fulfil their criteria. The most important ones are:
• You have a history of gender dysphoria happening for a sustained period of time. They find this out during the sessions, and with a "gender story" that they ask you to write were they want you to detail when and how you have felt throughout your life, or rather from the time you realised that you was questioning your gender.
• You have to have begun your Real Life Experience. This is supported with evidence that details your name and gender change markers on documentation, as well as talking about the experiences you've encounter whilst been in your acquired gender.
• You have good support, and you don't have any existing mental health problems that may exacerbated by the stressful transition.
After fulfilling their criteria, they take over your health care, and give you HRT. To get through this process has taken about a year. I have been receiving HRT external to the NHS; and no, self-medication does not make them take over the care any sooner. Some clinics will say that you have to stop self medication prior to them accepting you on the care pathway, so be aware!
Once you begin RLE, and have proved to them that you have, they begin the countdown. They are weary about signing letters giving their consent for any surgery before one year of RLE (doesn't mean you can't go find private surgeons who will, or go abroad), the big one is that no SRS surgeon will accept you anywhere before 1 year. The NHS will refer you for their SRS at the two year mark (assuming you fulfil their criteria, again!).
Hope that helps detail the keys steps.