hi all

any advice will be very gratefull

i went to speak to my doctor 18 months ago now 3 weeks ago i asked him about hormones and he said "i am happy to prescribe for you i just need to get some details first come back next week,
i went back next week and he said sorry i cant find the info i need so i went back the folling week and he said sorry i can not do this as i have been told its best i dont do this and just send a referal off now me and my doctor get along very good and he is the first doctor i have felt relaxed with and i have been under his care for about 8 years now but i only accepted this 18 months ago  his problem is he says i am ready to start hormones but he just can not do it for me till i get approved from sexual health

btw i live in the uk

can any one give me advice please if they have come across this before and my options if any or is it just a sit and wait till i see someone in the field

i got angry because my gp knows me very good and this other person who has never meet me over ruled my doctor

thanks in advance

Lighting my dear friend, I am very much in the same boat as you. I havew been through cousilling for my depression and GID, I have been recomended by my counseller that I go to a GIC but no luck so far..

come back in a sec

Hi Lightening,
     There are others on here with more experience than me who will no doubt offer you some advice, but I would say you probably have a long and difficult path to follow to get HRT, so don't bank on getting it quickly.
     The state of the NHS in the UK is such that many G.P.s are not fully informed about gender identity issues and if referrals are going to cost the practice money there may be some foot dragging. I'm surprised your G.P. was initially so willing to prescribe, and I'm not surprised that he was overruled. The medical profession with follow the guidelines set out in the Harry Benjamin Standards of Care (SOC). I'm unsuccessfully trying to find a link to the SOC for you, maybe another member may be able to help.     I wish you the best of luck anyway.
Louise

Sorry about that but I am back, what I was getting around to saying has been covered, you will not get HRT from your GP and your only way is to see a specialist in this field. Getting to your local GIC is you best way through the NHS witch may take several months of waiting lists and then another 6 months after with consultations befor they will perscribe you HRT.

If you are working and can afford to then you can go private and see a specials sooner.

Sorry to be the bringer of bad news....

Quote from: Lucy on July 10, 2007, 07:53:02 AM
Sorry about that but I am back, what I was getting around to saying has been covered, you will not get HRT from your GP and your only way is to see a specialist in this field. Getting to your local GIC is you best way through the NHS witch may take several months of waiting lists and then another 6 months after with consultations befor they will perscribe you HRT.

If you are working and can afford to then you can go private and see a specials sooner.

Sorry to be the bringer of bad news....

The fact that many of the GIC are Blanchard (Toronto) Clinics which are absolutely awful and in many cases its better not to go to them than go to them.   I have heard such inconsistent stories with the UK, the very fact that some of these clinics follow a Blanchard model is disheartening.  Its a transmisogynistic model for treatment.  Keep pushing your GP.   

The reality is the more I hear about the inconsistancy of the NHS, the more I dislike it.  It may be I have to pay a premium in the United States, but I was on HRT within 3 months of therapy, many therapist do it in less time.  Yes I had to pay a premium in the US, but I have HRT 100% covered through a GLBT clinic here, no waiting lists, no run around.

Fair treatment of transsexuals seems to be the exception rather than the rule in the UK, and most have to resort to DIY for HRT in the UK at some point. While some say its great, there is an equal number who say its complete crap (and when its crap its worst case scenario).  Somebody posted its worse to be trans and poor in the US.  From what I have been seeing its worse to be thrown in the inconsistant NHS system where you might be thrown into a Blanchard style GIC, which are not trans friendly, or worse get no treatment at all. 

For one the fact the Blanchard model even exists in the UK is disgusting. 

Amy, I cant awnser for what happens at these centres, I have had advice from people in the past and told to go there. It is the only way I can get to see a gender theropist. I am fed up of the NHS as you say giving me the runaround but I have to play the game. Couseling, phycologists and phyciatrists. Even then I may not get any real help.

I have also heard that many people in the uk DIY but we can not condone this for the dager of it is emence.

Depending on the circumstances DIY is better than the alternative.  Plus in many cases it forces the hand of the GP to actually do blood tests and give a script for the hormones. 

DIY is discouraged, but those rules were primarily made for US TS where HRT is pretty easy to start and the barriers are far and few between.  Even the gatekeeper aspect is seen as more of a barrier that may be unnecessary than anything else, and this is from trans specialist in the medical field.

In the UK though it seems that there are huge barriers for many, if DIY is not done, it seems there is no access to hormones, and DIY is often the only way to force practitioners hands. 

There is a reason why dosages are not discussed, I understand that, but not everybody has the DIY should never be done attitude on this board.  Many do it here.  Yes, its risky.  But if you are careful and do you research you can reduce risk with DIY.   I don't advocate it myself, but it seems in the UK, for many, its the only option other than waiting YEARS hoping for HRT. 

Sometimes your doctor won't put you on hormones is beause they don't feel confident enough in this area, maybe you should see an endocronologist when it comes to your hormone therpay if that is possible.

thank you all for the comments

i have spoken to my Gp and i told him i dont want to go down the DIY way and that i want to do it the right way on the NHS he says he can not script me till i have seen someone in the field even though he wanted to script me my big regret now is that i have been speaking to him since Jan 2006 about this i wished i had asked for a referal back then but at the time we both thought it better i went to see him and talk with him before i moved forward as you can imagine my head was all over the place

he said he will do a private script if i get a private assement (sry cant spell that good) but he is worried that when the nhs are ready to start hormone that they might refuse because i went private first i hoped to go private while waiting for NHS

does any one know if going private to start could mess up NHS down the road

amanda

Posted on: July 11, 2007, 04:24:54 AM

---

i have decided that eventhough there is a waiting game when i first spoke to my doctor i said i wanted to do it th right way even if it means an extra 6  months wait well so be it i waited 18 months to ask for the referal to be sent so i can wait now

i will use the time i wait to get things and my self ready to be honest i need to lose weight and excise more so i can use this time for things like that letting my hair grow and few other things as i move to living full time as the female i am

hope this makes sence

i know what i mean

Amanda, mixing private treatment with NHS treatment does not go down too well in NHS gender clinics ... they're likely to say "well make up your mind who's care you want to be under" .... "if you can pay what are you doing here ?".

If you have had private sessions, and are receiving meds on private script its likely to act as a "black mark" against you (of course you don't have to tell the NHS GIC - though you might have to explain your source of HRT which blood tests will show up). 

If you want the NHS to pick up the tab for GRS then the only option is to co-operate fully with whichever GIC you fall under .... contrary to belief they're all reasonable these days, problems are invariably with Local Area Health Authority / PCT funding policy which varies so widely across the UK.

Most GICs will prescribe HRT on second or third visit (within 3-6 months, as per Benjamin guidelines) if they "diagnose" you as TS, especially if you've already started RLE.

You don't say where you are in the UK, but if you are in the majority who are sent to London CHX, then they only accept referrals from a registered NHS psych, not directly from a GP .... so there are two waiting lists, one for psychotherapy and however many sessions until you're given that referral, and then the wait to be seen by the GIC.

You can self refer to CHX NHS GIC on a private basis with the "introduction" being via your GP (£200 for the first appointment was what I was offered - same as going private) but then I guess you have to pay your way, except that your GP may be "easier" with converting their scripts to subsidised NHS prescriptions, and maybe NHS funded GRS would remain a possibility.

If you go the private route like I did (would be Dr Richard Curtis these days if you're near London) then its £200 first session, £100 every 3 months for subsequent ones .... a year RLE to get the "letter" .... but it sounds like your GP might re-write the private scripts to subsidised NHS - mine didn't although he was willing to refer me to a TS experienced NHS endo for full blood screening.

Private HRT is £750 per year, internet prices £1800, NHS "season ticket" I think about £120 ....  GRS is £10,000 in UK/America, half that in Thailand .... if you know what you want and can afford £8 -12,000 it will save you two years of waiting and give you control over your choices. 

What price do you put on each extra year you gain as your "true self" ?

Laura x

hi Laura

thank you so much for your reply its very helpful

i live in liverpool

this is what was said by my doctor on my last visit

i said did you send the referal off he said yes but let me explain

i have sent a letter to the pct for liverpool asking to fund my referal to manchester as there is nothing in liverpool no more (the doctor retired) he said once he gots the ok from the pct he will send a detailed referal direct to manchester clinic he said he should hear from the pct in the next few weeks

this was my long term plan i dont want to be a drain on the nhs with regards to the opp but i would struggle to do it all private so i thought i could do NHS upto my opp ans between now and then save the funds for the opp so the NHS did not pick up the big bill for the opp  does this make sence

amanda

I hope you can find a way to get onto hrt, and that the waiting lists aren't too long. The UK health system sounds like it has a lot of road blocks. The US system is about money. In Canada (where I live), it all depends on where you live. I live in in Alberta, probably one of the best places to be in Canada and trans (and I'm starting to wonder, if it's not the best in the world at the moment). Here, it's about waiting lists, knowing the process, who to talk to, where to send referrals, and so on.

Quote from: gothique11 on July 18, 2007, 05:05:33 PM
I hope you can find a way to get onto hrt, and that the waiting lists aren't too long. The UK health system sounds like it has a lot of road blocks. The US system is about money. In Canada (where I live), it all depends on where you live. I live in in Alberta, probably one of the best places to be in Canada and trans (and I'm starting to wonder, if it's not the best in the world at the moment). Here, it's about waiting lists, knowing the process, who to talk to, where to send referrals, and so on.

Its very much the same in the UK if you can get your doctor GP to send the referal to thew right place in the first place then you dont have to wait all that long. If you have a GP that does not understand TRANS and just gives you the run about he/she will send you any where apart from where you should be.