I want to start this blog post by saying I love the NHS. I really fucking love the NHS. Without it, some of my nearest and dearest ( and in some cases myself ) would not be here. It is something that should be protected by our government and taken from strength to strength. But the sad reality is that they are understaffed, underpaid and overworked. And in regards to trans people, terribly undertrained.
There are some doctors who know what a trans woman is and that is a start. But even now, many do not know what a trans man is, or just assumed they’d never meet one. And when it comes to non-binary people… Well… Some of my nb friends have said that the majority don’t believe that someone could be non-binary.
In a recent check-up, my doctor was unable to see me, so a nurse saw me instead. When she read on my records that I’m trans, her reaction was to gently pat me on the knee, tell me I was a beautiful girl and that my true colours would shine through as soon as I was on oestrogen. It took me a moment to figure out what was happening, but when I told her that she was in the right area but facing the wrong direction, she was very surprised. To quote her: “Oh! I didn’t know it could go the other way too! How fascinating!”
Needless to say, I was rather uncomfortable for the rest of the appointment.
All of the above is why it can be a difficult and long wait to get the hormones you need via the NHS route. And even then, there are GP’s who may refuse to prescribe you hormones.
The best advice I can give for someone starting out on their journey is to get your name changed first. If I could go back and change anything, that would be the first thing I’d do. In the UK you have to live as your ‘chosen gender’ for a minimum of one year. I only found this out after months of being sent from pillar to post to doctor after doctor and therapists and counsellors. And then finally, I was told that nothing could be done until I had a year of living as a man under my belt.
As you can imagine, I was very frustrated. Those months spent running around and chasing after medical professionals and trying to prove I had gender dysphoria could have been better used going towards that one year goal.
Personally, I think that having to live a full year pre-t before getting any help is a bit much. I know that they have to be ‘sure’ that someone is transgender, but I feel that could be done in six months rather than twelve.
It’s going to be scary, but doing things this way will save you a lot of time and stress in the long run. So! You’re going to need to come out to everyone. Your family, your friends, your school, your workplace – Everyone who you interact with regularly. You need to be socially transitioned for a year before the NHS will prescribe you hormones.
Right. You’ve changed your name ( best to do it through deed poll so you have official papers to wave around ) and gotten all your ID changed over to your new name ( something I am STILL trying to sort out two years on – Make sure to get it all done asap! ) you’ve come out to all and sundry and you’ve been socially transitioned for a year. What next?
Make an appointment with your GP ( they should have some idea of what’s going on since you will have changed your name and asked for male pronouns to be used ) and tell them that you wish to medically transition. Inform them that you have been socially transitioned for a year and that you have been living under your chosen name for a year. Most GP’s will want to check up on this, which is why it’s a good idea to have people in authority know about your situation. So parents, teachers or your boss at work will be good people for your doctor to contact. This is the point where you can ask to be referred to a Gender Identity Clinic ( GIC ).
Now, this is where things can get a little bit tricky. It does depend on whether or not your doctor has updated information and whether or not they try to send you away. Both the former and the latter happened to me. I had to direct my GP to England’s 2013/14 Interim Gender Dysphoria Protocol ( there is probably an updated version now, it is best to double check ) when he said that the NHS wouldn’t fund this treatment without me getting ‘psychiatric help’ first. This is rubbish and the link I have provided proves this.
Whilst at your GP, I would take this opportunity to make an appointment with a nurse to get your blood tests done. The more things you can do in advance and just have them lined up, the better.
I only really know about Charing Cross GIC, so that’s the information I’ll give right now. But there are other’s in the UK, you just need to do a little bit of research and make sure you tell your GP which GIC you’d like to be referred to.
At Charing Cross you will have two appointments spaced six months apart. The first will be a little bit like a therapy session in which they talk to you about when you first realised you were trans and things linked to that. And the second will be a physical assessment. You will need to bring your blood test results with you. They will want to make sure you are physically well enough to take the testosterone, so do be honest with them.
You will be asked if you have any mental health issues and if so, how you manage them. Be prepared to talk about your childhood in detail and to be answering questions about your relationships with members of your family. There will be a lot of questions in regards to your dysphoria, and they will be very personal too. Grit your teeth on this one and battle through it. You can do this.
They will also want to know if you have had any time living in your ‘chosen gender’ and this is when you can mentally do a victory lap. Make sure to bring your name change forms with you as this will have the date you changed your name. And that will also be around the same time you socially transitioned.
Once you’ve had both these appointments, unless there’s something else they need to assess, you will be prescribed hormones at the end of the second appointment. You can choose between injected testosterone and testosterone gel. Both have their pro’s and con’s which I will go into in another post.
I think that’s everything for that one. But do remember to do some of the research yourself as this is very London centric and different areas of the UK may vary.
Next Wednesday I shall be discussing getting hormones through Private care.
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