I've not been here for a while, and I don't post often, but I'm gravely contemplating the choices I have made.

It probably isn't what you think it is, but I hope you will take some interest nonetheless and provide me with perhaps some advice or solace.

First of all, let me introduce myself.

I'm 20, and I live in London. I'm currently studying a 3-year BA in programming @ Goldsmiths, so as you would think, I'm likely not going to have much money during or (immediately) after this.

I had told my GP that I was transgender when I was 18, and had fleeting feelings about it since about 12. I'm not sure of the month, but it was at least 3 months before I was sent for an analysis by a psychiatrist(?) in October 2012. He typed up my referral, and I eventually recieved it in the mail. After waiting a couple more months, I had gone to my GP, wondering why I haven't heard from anyone yet. It turns out that after that appointment, he only sent the referral to me. My GP then informed me that he had not recieved the referral that was meant to be sent to both of us, so he did not recieve it until I met him, at which point, I then photocopied so that he could.

That was in April of 2014. After a month or two, I went back to my GP, and he said he had sent it. I had to make another trip to the GP as he had asked me to photocopy my referral again just in case it might be lost in the post. He too was wondering why I haven't heard anything back from them yet. Charing Cross was the GIC I was to be referred to. Their lines were constantly swamped, so I just had to keep trying to call them. Sometime in the late Summer months, I was able to get through to them, only to be told that they had a "new" system where they would send acknowledgement letters. They told me that patients which were referred last September (2013) were just getting their letters back now. You probably could imagine how I felt at this point.

It wasn't until I started my BA in September 2014, and up til December, until I had gotten my letter. This letter was to make an appointment at CHX's GIC. I filled the form as fast and precisely as I could, and mailed it off the next working day. I phoned them up the following January, and they told me that my appointment, at their earliest convenience, would probably be in April (2015).

My GP has warned me that his last transgender patient took over a year to begin his HRT. But this is just ridiculous. I haven't spoken much about my GP yet, but he's been great about everything so far - He's very liberal, and definitely on my side. He's very easy to talk to and tactful, and has only tried his best to help me. Suffice to say, I haven't been making appointments with him as often as I should be, partly due to the fact that my GP Center had adopted a new appointment system where the Doctor you ask for will call you back, and then you have to wait for a call back in who knows how long. They will then discuss your problems with you on the phone (People are always in my home, it makes it very hard to talk about personal things) to see if you need an appointment.

Anyway, back on topic, one of my transgender friends, who I incidentally met in my newly-started course, had posted on their Facebook wall that their referral was accepted by Exeter. This was when alarm bells rang. I started talking to her about how she got her referral, and got to a point where I began to do some research on CHX about their reputation with patients. Now I had come cross CHX on the internet before, but never in such a way where I was to see the patient-side of things. It's as if all my fears about the clinic were confirmed.

People were saying how they wasted 2 years on them, and how the staff won't allow prescriptions for HRT unless they had already changed their names or began to live in role. Some of them have commented that the doctors are apathetic or outright rude. The best I can hope for is that these are just biased fabrications based on their own experience, but if they were vehement enough to voice their opinion so strongly, I guess even one patient having a bad experience is enough to frighten me. There are also articles written about this, how one person waited for years and recieved a 10-minute appointment.

Should I have gone with Exeter?
Did I have a choice?
Should I speak to my GP?
Should I go private?
Should I self-medicate?
I guess the answers to these questions should all be yes.

I feel like I'm in Limbo right now. I'm not asking any of you to feel sorry for me, as there's a chance that it's probably just me not being as proactive as I should, and if I'm honest, I don't expect much sympathy seeing as I'm just hoping for everything to fall into place. I'm just going to ask if anyone else has had different or better experiences with CHX, or rather, Exeter, Private and even DIY for that matter. If you've gotten this far, thank you. It's not the saddest story in the world, but I really appreciate that you read what I had to say.

Thank you, in advance if you have at least read this all the way through. It really means a lot!

P.S, if you haven't figured out the mistake yet, it was my decision to go with CHX, or perhaps, to stay with CHX, as I did little research throughout this.

P.P.S, I apologize if my writing is sometimes out-of-context or wishy-washy and off-topic in places. This happens often.

I can definitely relate, it's been 2yrs since I've realised I'm trans and done nothing about it bcos of my mental state. I've also only just now got a job so I can afford private as it is quicker. I've also heard sone bad things about charing cross but as you said I don't know if most have had good experiences and some for whatever reason didn't. At least being trans teaches you a lot of patience...

I think the mistake you are making is not the one you are thinking of. Look at the timeline

Quote from: Ruruko on February 05, 2015, 05:24:45 PM
I was sent for an analysis by a psychiatrist(?) in October 2012.
....
he did not recieve it until I met him, at which point, I then photocopied so that he could....That was in April of 2014. After a month or two, I went back to my GP, and he said he had sent it.
...
Sometime in the late Summer months, I was
...
up til December, until I had gotten my letter.
...
they told me that my appointment, at their earliest convenience, would probably be in April (2015).

My GP has warned me that his last transgender patient took over a year to begin his HRT. ...Suffice to say, I haven't been making appointments with him as often as I should be

Basically, you have done things and sat back and waited for the NHS to come back with a complete game plan and schedule. They will not. This is YOUR transition and you should be driving it forward, not sitting waiting to hear from doctors and GICs. Do not give them months and months, give them two, maybe three weeks maximum and then get on their case. Send things recorded delivery. Ask for other people's cancellations to be converted to appointments for you.

Find out what they are going to ask you to do and then do it before you go there. Turn up with your name change done so you do not waste a meeting being told to go and do it. Start making small changes to show that you are committed to your transition so they do not waste another meeting telling you to do that.

Quote from: Ruruko on February 05, 2015, 05:24:45 PM
Now I had come cross CHX on the internet before, but never in such a way where I was to see the patient-side of things. It's as if all my fears about the clinic were confirmed.

I was a patient at CHX. I was discharged from the GIC to the surgeon a few months ago. The clinicians are good and the appointments staff in the reception area are OK as well and always helped me get my appointments on a schedule to suit me. The back office staff, OTOH, are a waste of space so get the clinician's emails and deal directly with them, especially Dr Seal. Never leave the building without your next appointment letter in your hand.

I went through CHX in less than 15 months. I had 8 appointments from initial assessment to surgical referral.

Quote from: Ruruko on February 05, 2015, 05:24:45 PM
People were saying how they wasted 2 years on them, and how the staff won't allow prescriptions for HRT unless they had already changed their names or began to live in role.

That is the protocol they use. If you do not like it then there are other clinics or you can go private, but that is CHX's protocol so you can either anticipate it and use it to your advantage or you can go in and argue with the staff. Guess which method works best!

Quote from: Ruruko on February 05, 2015, 05:24:45 PM
Some of them have commented that the doctors are apathetic or outright rude. The best I can hope for is that these are just biased fabrications based on their own experience, but if they were vehement enough to voice their opinion so strongly, I guess even one patient having a bad experience is enough to frighten me.

I was worried by those sorts of opinions too, but in the end they turned out to be a vocal minority who either had unrealistic expectations or where their own worst enemies in the assessments. I know of one who was asked a reasonable question and just walked out. She had a good moan in reception (that is how I know what the question was) and then off she stalked. I will bet she is still stuck in the process if she has not been discharged.

This is YOUR transition. To the doctors you are one of thousands, so the person who has the most interest in getting this done is YOU. If you are prepared to be your own transition manager and anticipate the doctors you can get through all this in double quick time. Getting started is the slowest bit. If you are at Goldsmith's then you are only a few miles from Fulham Palace Road so go over there and press the GIC's buzzer and tell them you are a patient and sort out your paperwork. Get a signed receipt. Learn to be a polite, persistent nuisance.

All GICs are oversubscribed. Exeter may have a shorter waiting wait but it is as far away from London as Carlisle and the train fares will eat your money. CHX is on your doorstep.

Finally, remember that you need nobody's permission to transition. You can just do it. All the GICs do is prescribe hormones and refer for surgery but even when you are in the GICs care it is still up to YOU to do the transitioning. All they will do is supply you with a few pills and tell you to get on with it. That's it, and all GICs work the same way. There is nothing magical about them and they will not hand you a transition plan and schedule. All they ever handed me was a prescription letter for my doctor, a referral for my surgery and 8 appointment letters. Everything else was left for me to do.

It may seem daunting but it really is a simple sequence of steps. Start now with facial hair removal, try laser before electro. Start thinking about a name change. Start looking at androgynous clothing. Begin to practice your female voice. Start watching how women move and talk and interact. Start growing your hair, etc etc etc.

You can start your transition right now, so why wait?

Quote from: cbmwkd on February 05, 2015, 06:46:20 PM
I think the mistake you are making is not the one you are thinking of. Look at the timeline

Basically, you have done things and sat back and waited for the NHS to come back with a complete game plan and schedule. They will not. This is YOUR transition and you should be driving it forward, not sitting waiting to hear from doctors and GICs. Do not give them months and months, give them two, maybe three weeks maximum and then get on their case. Send things recorded delivery. Ask for other people's cancellations to be converted to appointments for you.

Find out what they are going to ask you to do and then do it before you go there. Turn up with your name change done so you do not waste a meeting being told to go and do it. Start making small changes to show that you are committed to your transition so they do not waste another meeting telling you to do that.



I was a patient at CHX. I was discharged from the GIC to the surgeon a few months ago. The clinicians are good and the appointments staff in the reception area are OK as well and always helped me get my appointments on a schedule to suit me. The back office staff, OTOH, are a waste of space so get the clinician's emails and deal directly with them, especially Dr Seal. Never leave the building without your next appointment letter in your hand.

I went through CHX in less than 15 months. I had 8 appointments from initial assessment to surgical referral.


That is the protocol they use. If you do not like it then there are other clinics or you can go private, but that is CHX's protocol so you can either anticipate it and use it to your advantage or you can go in and argue with the staff. Guess which method works best!


I was worried by those sorts of opinions too, but in the end they turned out to be a vocal minority who either had unrealistic expectations or where their own worst enemies in the assessments. I know of one who was asked a reasonable question and just walked out. She had a good moan in reception (that is how I know what the question was) and then off she stalked. I will bet she is still stuck in the process if she has not been discharged.

This is YOUR transition. To the doctors you are one of thousands, so the person who has the most interest in getting this done is YOU. If you are prepared to be your own transition manager and anticipate the doctors you can get through all this in double quick time. Getting started is the slowest bit. If you are at Goldsmith's then you are only a few miles from Fulham Palace Road so go over there and press the GIC's buzzer and tell them you are a patient and sort out your paperwork. Get a signed receipt. Learn to be a polite, persistent nuisance.

All GICs are oversubscribed. Exeter may have a shorter waiting wait but it is as far away from London as Carlisle and the train fares will eat your money. CHX is on your doorstep.

Finally, remember that you need nobody's permission to transition. You can just do it. All the GICs do is prescribe hormones and refer for surgery but even when you are in the GICs care it is still up to YOU to do the transitioning. All they will do is supply you with a few pills and tell you to get on with it. That's it, and all GICs work the same way. There is nothing magical about them and they will not hand you a transition plan and schedule. All they ever handed me was a prescription letter for my doctor, a referral for my surgery and 8 appointment letters. Everything else was left for me to do.

It may seem daunting but it really is a simple sequence of steps. Start now with facial hair removal, try laser before electro. Start thinking about a name change. Start looking at androgynous clothing. Begin to practice your female voice. Start watching how women move and talk and interact. Start growing your hair, etc etc etc.

You can start your transition right now, so why wait?

Thank you very much for this information, and in such detail as well!

It does sound like I've been putting things on the backburner for a while, hoping that something else will give me the motivation that I need, and yes, it is my transition, they're only really there to help now that you've put it that way.

I've been blaming it on these people when really, it's me who hasn't been proactive enough. My parents tell my they accept who I am, but don't really talk about it with me much, so I'm still unsure. I'm definitely going to talk to them more about it tomorrow.

This isn't really the same thing, but what of my Driver's license and my passport? It probably goes without saying that those need changing, I'm just wondering how that is all done. I'm not too worried about that, but I'm still wondering how it all gets handled. I guess I should probably mention bank accounts and birth certificate, NI number and everything else attributed to identity.

Other than that, you haven't just answered my questions, but you've given me a completely new perspective to the way I should do things. I probably sound a bit too optimistic right now, but I assure you that this is genuine gratitude!

Thank you so much, I'll be sure to tell you how everything goes. I hope this "Limbo" period hasn't hurt the GIC's opinion of me beforehand.

I,ve got a t-shirt, it says. . .  went to CHX & all I got was this lousy T-shirt.

Big thumbs up for the Laurels though CHX are swamped my GP has been trying to get a reply from them for 2 weeks, by phone & e-mail with no luck. The extra cost for travel will be money well spent & will probably reduce your waiting time

At any time in your transition you can change clinic, just ask your GP to take care of it, I've knocked months off my waiting times by switching & know 2 others who'd agree

Quote from: Ruruko on February 05, 2015, 07:05:26 PM
This isn't really the same thing, but what of my Driver's license and my passport? It probably goes without saying that those need changing, I'm just wondering how that is all done. I'm not too worried about that, but I'm still wondering how it all gets handled. I guess I should probably mention bank accounts and birth certificate, NI number and everything else attributed to identity.

The first step is to pick a new name you like. You then need to decide whether you want to change your name either by deed poll or statutory declaration. Deed polls are generally cheap or can be drawn up for little money. There are websites that can help with getting the wording correct for this for free, and then it is up to you to print it out on posh paper and get it witnessed by third parties. That is all it is for changing your name by deed poll. Statutory declarations carry legal weight, may be required instead of the deed poll by some organisations, cost typically about £10 and require you to have them notarised by a solicitor or justice of the peace.

Once you have either one of the above documents (with copies) you can begin the process of changing your name. Make a list of everything you want to change and deal with each in turn. Having made copies of your name change document will help speed up the name change process. You can change everything including your driving licence like this, but your passport will also require a letter from your GP or gender therapist to say that you are transitioning and any changes likely to be permanent.

Be sure to document all name changes ie what was changed and when it was changed and file them away to take to your next GIC appointment to show as proof of your transitioning progress.

Hi Ruruko
I can't even begin to fathom how the public system works in the UK, it sounds so utterly anachronistic sometimes it's amazing some people even make any progress through it. I guess that if you are able to go private then this should be an option to look into. I definitely recommend that you do not self medicate, you could cause yourself some very serious health damage which might also set you back in terms of your transition when you do end up in the system. Hormones aren't a one pill suits all proposition, what works for one will definitely not work for others and your biology needs to be monitored by a health professional.

But yeah, go private of you are able.

Under the new guidelines the NHS shouldn't push you to do anything that may put you at risk such as RLE or early name changes. The national deed poll is the most widely recognized way to change name, I'll try to post links over the weekend  for both of them

Quote from: Ms Grace on February 06, 2015, 02:14:13 AM
I definitely recommend that you do not self medicate, ..... your biology needs to be monitored by a health professional.

I am not a big fan of self-medding, but if you do self-med then it will not count against you at the GIC as long as you have being doing it responsibly. That means taking normal doses at regular times and informing your GP and requesting monitoring from your GP.

Quote from: Ms Grace on February 06, 2015, 02:14:13 AM
But yeah, go private of you are able.

A number of my friends went private. One of them got her initial prescription and took it to her GP and asked the GP to take it over. The GP did so and my friend is now on NHS prescribing so that is another option. There are two downsides to going private

1) Cost - it is significantly more expensive. It seems to be about £100 per quarter whereas I pay NHS charges of £8.05 and the biggie is that you have to fund your surgery at £11,000-ish

2) You do NOT get the most effective drugs. Things like Cypro and Spiro are OK but they have side effects and sometimes to not work all that well. The GICs these days prescribe GnRH analogues which are £200 - £300 per shot every 3 months and they will knock your testosterone down to female levels in 2 to 3 weeks.

The upside of going private is that it is quicker to get seen but no matter how quickly you get seen and get on oestrogen, your body changes at the speed bodies change at and it will take years. It does help to get seen sooner rather than later but no matter when you start you should expect your transition to take 3 to 5 years depending on how long your body needs to make the changes and how long you need to adapt to a completely new social role.

I chose to stay with the NHS system, but to run my own transition. I set up a transition project folder and everything to do with my transition got filed away in it and when I went to see anyone I took my folder. I had all the answers with me.

As far as passports and driving licences are concerned, you will need a change of name document such as a Deed Poll or a Statutory Declaration. They also like to see a letter from a medical practitioner saying that you are under treatment for Gender Dysphoria and that the change is likely to be permanent. That is where you are likely to have trouble at this point as I cannot see your doctor agreeing that the change is permanent. Without this medical letter the Passport Office will change your NAME but not your gender marker. The same is true for the Driving Licence which has a hidden gender marker in the licence number.

Quote from: Jayne on February 06, 2015, 03:40:47 AM
Under the new guidelines the NHS shouldn't push you to do anything that may put you at risk such as RLE or early name changes.

Just be aware that the guidelines are guidelines. The GICs do not follow them exactly and often have their own ways of doing things.

hi
as someone who used to pre judge and over think every things my advice is simple. forget what anyone says and go attend for yourself with no pre ideas of what its like. dont be afraid to ask any questions you want. dont self med its a fools game you need your body monitoring or you can screw everything up and they wont let you transition if you are dead. there are usually reasons that hrt ect can be delayed by a doc which you fail to see as you want it now and have a blinkered view. non of it is quick and time is your best friend believe me. before i started i was so shy i couldnt do a thing but as ive taken it step by step ive learnt how the system works and the time scale it can work on. remember the docs do want to help you so be nice to them and if they delay something just ask why nicely. a lot of girls think that the primary thing is to get on hrt.whilst it is important its also important to have time to adjust and settle into your new life. hrt doesnt do anything fast anyway i think its more a mental thing to begin with that something active is finally being done. ive tried it the bad way and the feeling of it not working if far worse that the feeling of thinga are going slow with the nhs. off subject if you want an example of slow the waiting time for leeds gender clinic is 3-4 years. its a real problem that to start to transition with normal male testosterone levels is dam hard and i believe that gentle antiandrogens should be given to make it easier. problem is untill you see the gender doc to make sure you are ok and serious then you cant have even mild hrt. going private can be an answer if you can afford it even if like said before its just to get started then see if you can jump over to the gp to prescribe before seeing the gender clinic. dont jump ito things like name change just with the hope it will make things seem better do it when you fel comfortable with it and are ready for the jump. im happy now telling people im transgender even though im at the start of feminizing and i do et the  well you dont look that feminine. i just give back as good as they give. a lot of it is about confidence in yourself. the gender clinics only help they dont do it for you and you will only see them a few times a year the rest of the time its down to you.it isnt easy at times and dam hard at other times but every problem you overcome makes life so much better. whether your transitioning or not life kicks you at times and its not how hard you fall its how well you get back up. i want every transgender to transition and have a happy life but some need to get a dose of reality sometimes or they are going to be worse off in the long run. im no expert its just what i see and the trans women ive talked to.

To add to what's been added I came out over. 3 years ago & went to CHX GIC, I'm now 1 yr along in my transition. Someone local who i've met from this forum was refered to the Laurels a year ago & should have finished the surgery part of transitioning already, their time between visits is 3 months whilst CHX is 6 months (minimum). The maths does itself. Cbmwkd is right about clinics varying the Laurels are patient led & CHX are stuck in a prehistoric tar pit.