Health and Life Gender Identity A Guide to Trans Healthcare "Your gender is valid and you deserve affirming healthcare." By River Solace | insta river.solace Medical Intervention It is your choice No one has the right to tell you what you should do Speak to trusted friends and family Find support from counsellors, mentors or a gender specialist Speak to other trans people about their lived experiences. Go at your own pace It's okay if you don't know straight away Take your time to make the decision that feels right for you Make sure you are not being pressurised by others, there is no pressure to make a decision, this is YOUR transition. Stay informed Understanding each stage of the process can make it less stressful The team of gender specialists will ensure you have all the correct information that will empower you to take the right course of action for you. Seeing your GP Preparation Speaking to your GP about your gender identity can seem scary, so preparing for the appointment can help: When making the appointment, let them know it is for a GIC referral so they can inform themselves of the process in advance Research GICs and have an idea which one you would like to be referred to, this could be influenced by waiting times Make a note of what you want to say so all the points get covered Write a list of the ways you are impacted by gender dysphoria, such as the effects on your mental health, physical health, relationships and social interactions. If you're feeling nervous… You can write a letter and either read it aloud or give it to the GP to read Take a friend with you to the appointment for emotional support Find an advocate, someone who can come with you and speak on your behalf The appointment You can ask your GP to change your name on the system and have your pronouns recorded on file. Remember if at any point you feel uncomfortable or overwhelmed, you are always free to leave It is okay if you cry, this release of emotion is natural when sharing something so personal You may be referred to CAMHS or CMHT for counselling You may be referred to the Gender Identity Development Service or a Gender Identity Clinic. Regardless of how it goes, your gender is valid and you deserve affirming healthcare! STRANDED - TRANSITIONING: Jude Harper shares a transition video about the cost of medically transitioning, the state of the UK trans healthcare system and ways they are fundraising for surgery! Current Gender Identity Services Source: Terrence Higgins Trust England Devon Partnership NHS Trust West of England Specialist Gender Dysphoria Clinic (The Laurels) Gender Identity Clinic (London) Indigo Gender Service (Manchester) Leeds Gender Identity Service Northamptonshire Healthcare NHS Foundation Trust Gender Identity Clinic Norther Region Gender Dysphoria Service (Newcastle) Nottingham Centre for Transgender Health Porterbrook Clinic (Sheffield Gender Identity Clinic) Trans Plus (Dean St., London) Wales Welsh Gender Service Gender Identity Clinic Process First appointment is usually with a psychiatrist. It will be an interview style appointment asking you about your life, family, mental health, transition goals etc. You can bring NHS referral form with you. Follow-up appointments: If you're wanting hormone therapy, get blood tests done to take to follow-up appointments. You can find list of bloods normally asked for here If you have one, bring your deedpoll to your first and second appointments Gender specialists can refer you to surgical teams of your choice You do NOT have to come out to family and friends in order to access care Gender clinics are obligated to treat non-binary people. You can call gender clinics for updated information on waiting times. There is a high demand for these services, so some have stopped taking new patients. Not enough clinics to meet the needs of the nation. The Informed Consent Care Model No assessment or evaluation of gender, only to empower patients by facilitating thoughtful decision-making with appropriate knowledge around risks and benefits; support structures and general health and patient expectations. Available services Hormones Takes time, be patientBe aware most GPs won't prescribe until you are seen at a GICTaking hormones can be for lifeYou might want to store your eggs or sperm before starting hormone treatments Testosterone Helps you develop more typically male biological traits Taken in form of gel or injection Effects: grow facial and body hair, clitoris may enlarge, deeper voice, periods may stop and muscle growth Side effects: male pattern baldness, acne and increased sex drive, may have increased risk of polycythaemia (thick blood) Estradiol (Oestrogen) Helps you to develop more typically female biological traits Taken in the form of gel, patch, injection or pill Effects: muscle-fat redistribution, a small increase in breast tissue and slowed growth of facial hair Side effects: reduced sex drive, may have an increase of blood clots and liver problems Voice training Non-surgical techniques are used to modify your voice. It is seen as an act of gender affirming care. Voice therapy can help to alleviate gender dysphoria and concerns on how your gender is perceived by others. Surgery Feminising surgery Orchidectomy (removal of the testes) Penectomy (removal of the penis) Vaginoplasy (construction of a vagina) Vulvoplasty/Labiaplasty (construction of a labia) Clitoroplasty (construction of a clitoris) Masculinising surgery Top surgery (chest reconstruction surgery) Double incision or peri-areolar technique, lipo-suction, nipple modification Bottom surgery Metoidioplasty (maximising length of clitoris) Phalloplasty (construction of a penis) Scrotoplasty (construction of a scrotum) Urethraplasty (construction of a urethra) Hysterectomy or vaginectomy (removal of the womb or vagina) Surgeries not routinely available on the NHS: facial feminisation surgery, breast enlargement or reduction, hair transplants, lipoplasty, tracheal shave or voice feminising surgery. There are limited surgical teams in the UK who provide these services, let alone NHS funded. Availability Waiting times on the NHS for a first appointment with a GIC can vary, but currently over 2 years depending on the clinic. Follow up appointments can take over 12 months. You can call the clinics for updated information or seek up to date online resources. Alternatives to the NHS waitlist Go private GenderCare: A network of individual healthcare practitioners, all qualified professionals experienced in the gender field. Although working independently of one another, we share a general commitment to providing friendly, accessible private services, tailored to individual needs and timescales, in a variety of comfortable London settings. The London Transgender Clinic: Provide transgender and non-binary individuals with guidance and support for safe and effective care, maximising their health, psycho-social well-being, and self-fulfillment, achieving lasting personal contentment with their gendered selves. This support may include primary care, reproductive options, voice and communication therapy, mental health services (assessment, counselling, psychotherapy), and hormonal and surgical treatments. There are other private healthcare clinics including Gender Doctors , Harley Street Gender Clinic and Northern Gender Network Bridging prescriptions If you are in danger of self-medicating with hormones (this can be very unsafe, please seek proper medical advice), GPs can provide prescription for hormones whilst you wait to be seen by the GIC. They might also do this if they believe you at risk of self-harm. Bridging Prescriptions: A Guide for Trans People Crowdfunding Private healthcare is inaccessible for many Trans people. You can crowdfund to cover the cost of private healthcare through sites like GoFundMe. Trans healthcare GoFundMes are becoming increasingly common. You can find examples here. There are also some existing community funds set up to support Trans people with their healthcare needs. Extra Reading Gender Care Pathways (Gendered Intelligence) Medical Transition Tips by and for trans, non-binary and intersex people (The Clare Project) TransActual Healthcare Resources TransActual Healthcare Gallery : Find trans people’s experiences of healthcare, lived experiences of being trans and having mental health difficulties and to explore some facts about healthcare for trans people in the UK. Trans Health UK: run by a group of trans people to provide resources to the UK’s trans community on healthcare issues we face. Trans Guide: Support for GPs and Trans Patients (LGBT Foundation) Support Trans Aid Cymru: aims to help Transgender, Non-Binary and Intersex (TIN) people through mutual aid support. The project is run by TIN people for TIN people, making it inclusive and understanding of the community needs. Mindline TRANS+: Emotional and mental health support helpline for anyone identifying as trans, non-binary, gender variant, and their families, friends, colleagues and carers. Their phone line is open Mondays and Fridays, 8pm to midnight. Ring 0300 330 5468. Gendered Intelligence: Trans-led charity that aims to improve the lives of trans and non-binary people in the UK, specialises in supporting young people. Black Trans Alliance: a black queer and trans led non-profit organization that supports black trans and non-binary people in London and the wider community. Gender Dysphoria National Referral Support Service : Book an appointment by calling or emailing: GDNRSS Support Line - 01522 857799 Email - [email protected] Support Line open - 9am-5pm (Monday -Friday, excluding BH’s) LGBT HERO forums: A space for LGBTQ+ people to connect, seek advice and ask personal questions.