Hi, I've been waiting for hormones for a long time (over 1 year). Due to NHS waiting times, I have been to Transhealth in London after booking an appointment with Dr Caspian. The first meeting was very disappointing. Caspian kept making snide remarks, intending that maybe I believe I'm trans just because of the recent 'popularity' in the subject, such as Caitlyn Jenner, etc and the growing community of transgender awareness online. Anyway, I was hoping for a proper diagnosis and it turned out (after receiving a very brief assessment of our session, littered with a constant humiliating use of misgendering pronouns) that he was unable to diagnose me as transgender.

I have been advised to have no less than six counseling sessions with someone not directly affiliated with the clinic, so I am not sure where I stand now and have a growing sense of distrust and disappointment. I have been told in order to be prescribed hormones by doctor Curtis, I will have to do rle ( either work, study, or volunteer while using my preferred name and pronouns). This is in conflict with what James Caspian said: How can you know what it feels to live as a man? Duh, this is WHY I am seeking hormone treatment, because only when I am on them will I only truly know what it feels like to pass and be accepted by everyone as man. That said, i already know this is the only way I'm comfortable living, as a man. I don't need to explain myself, I just know.

Overall, I feel that Transhealth has humiliated me and basically more focused on making money than on really caring about it's clients. My therapist basically confessed that I need to prove to them that I am not going to sue them in the future (as this is something that has happened before with past patients). Now, I feel forced to confirm to their standards of behavior in order to prove I'm trans enough to be allowed hormones. This is really saddening and I'm now looking into alternative routes since my bad experience (since I doubt even after my enforced therapy sessions I may not be prescribed testosterone).

Beware if you go to Transhealth, you may not recieve a proper diagnosis of gender dysphoria or ->-bleeped-<- and this may cause problems when you apply for legal change of gender....

I recently went to Transhealth last August and I didn't have any problems. Like you I saw James Caspian for an initial consultation to discuss what I wanted and my history. Yes he is very direct and I'm sure what he said wasn't meant to be offensive. He needs to make sure you have thought this through and to let you know there are some people who are cis but do question their gender identity. Dr Curtis is direct like this as well. Yes he did misgender me and use my birth name which I did find offensive  (although I hadn't changed my name legally at that point); but overall I found it to be a very professional appointment.
I was recommended 4 therapy sessions with a woman who worked at the clinic (Sharon Filingham). Even though she has a separate number from Transhealth to set up appointments she is still affiliated with the clinic. It's a common practice worldwide to have a few counselling sessions to know whether to prescribe hormones; although I know it's an outdated notion. It's understandable that they're more cautious since the inquest the had recently. I found Sharon to be very understanding and easy to talk too. After the 4 sessions I was given the go ahead for hormones; so it was a very simple process. Although I did change my name legally before the first therapy appointment.
Overall Transhealth was very professional and very quick compared to the NHS route. Yes they can be direct at times but they need to make sure you're capable of making this decision and the therapist even said they can't be 100%sure you are trans; they simply need to know you've thought it through. Which seems fair enough IMO.
Plus the law in the UK is that you need to live two years in your new gender to get a GRC. You don't need a letter stating you've been diagnosed with GD; a deed poll with your new name would do.

Well you might have a look here:
https://www.susans.org/forums/index.php/topic,204334.msg1816704.html#msg1816704

and here:
https://www.susans.org/forums/index.php/topic,197023.msg1753642.html#msg1753642

and here:
https://www.susans.org/forums/index.php/topic,135219.0.html

I'd say don't take it personal.

Imo the rle is not mandatory any more, there were new rules in 2014.
Its up to the doctors.
You might read that up, or ask at local transgender groups, for example
www.ftmlondon.org.uk


*hugs*

Sharon Fillingham is apparently booked up til the summer, so I've been told. I've unfortunately never had the chance to meet her. It may be that she is more experienced with FTMs, and may be more clued up on the current standards of care for transsexuals. However, my therapist insisted rle experience is needed in order to be prescribed hormones (this is coming from a therapist recommended by Transhealth). Also, I was informed that neither Dr Curtis, nor Dr Caspian are qualified enough to provide a diagnosis of transexualism (something about them being only psychotherapists and not actual psychiatrists). Therefore, I find that the claim on the Transhealth website (them saying they diagnose ->-bleeped-<-) is misleading. I will have to see how things progress further though, before I can totally write them off. There is still hope, and I'm keeping my fingers crossed that things get better soon

I had to wait longer for my initial consultation and first therapy appointment than usual due to an influx of new patients. So you were recommended a different therapist by James Caspian other than Sharon Fillingham? They didn't mention RLE being necessary to me. Sorry they're giving you the run around;  I hope things do get better for you soon

A lot of people have been very satisfied with their treatment at Transhealth, and some others have not. But different therapists suit different personalities, so it's entirely possible that James Caspian and yourself simply didn't 'gel' for some reason. You're certainly not alone in having had this experience. But you can rest assured that he is very familiar with trans people (including FtMs).

It does sound like that third-party therapist might be giving you out-of-date information; why not ask Dr Curtis whether that therapist is correct in saying that he requires patients to complete RLE in order to get hormones? If that's Transhealth's policy it'll need further investigation; but if it's just the therapist using old information then Dr Curtis can make sure they get the correct info.

It's actually very rare to be diagnosed on your first assessment especially if you have a history of accessing mental health services: they need to make sure that any other mental health issues are not causing your apparent dysphoria. In such cases, it's much more common to have several consultations before they can make a confident diagnosis.

Also, I'm afraid you've been misinformed about the need for a Psychiatrist to diagnose you with transsexualism: in actual fact, any qualified medical doctor can do so. So Dr Curtis is qualified to diagnose you, because he's a fully qualified medical doctor. Whoever told you that he can't diagnose you might've been confused: it's true that a psychotherapist (such as James Caspian) cannot diagnose you because he's not actually a doctor... but what happens is that he makes his recommendations to Dr Curtis, and Dr Curtis then makes the appropriate diagnosis. Any medical doctor can do it, but current NHS protocol makes GPs refer patients to specialist GICs rather than diagnosing them themselves - mainly because a GP would prefer to get an opinion from a mental health professional such a psychotherapist (just like they do at Transhealth) and it's cheaper for the NHS to concentrate that service in a few specialist centres. Just thought I'd clear up that confusion so that you don't have to think you've been misled.

I know it's hard to do when it costs so much money to see someone, but if you're really not happy with the service you're getting from Transhealth, you may need to go elsewhere. You could always try Gendercare or similar and see if you get along with them better. You should also (if you haven't yet done so) get yourself on the waiting list for an appropriate NHS GIC, which will save you a fortune if/when you want surgery.

You could also discuss the possibility of Shared Care with your GP, where they prescribe your hormones for you whilst you wait to see an NHS GIC. This often happens in conjunction with a local Endo... but there are no guarantees that you'll get this as it's up to your GP whether they do it. Still, it's worth a shot (pun intended).