A few words before we start…
Firstly, I want to thank you for taking the time to read the latest entry of my series, Transgendered Substantiation. The series has been adapted from blogs I wrote for my website during my transition, based on my thoughts and feelings at the time. They almost represent, then, a time capsule for that period of my life. I have done my best to edit and update them for this publication, but some areas may be out of the date, especially regarding the administrative side, as some parts of the process may have changed since I went through it myself.
My ultimate aim with this series is to help people by shedding a light on the transition process. While everyone’s experiences are different, and this is but one person’s perspective, if this is something you are going through yourself, it is my hope that it helps you know that though it may be a daunting process, it is not insurmountable and there is nothing that cannot overcome. Or, if you are a friend or loved one of someone going through the process, it helps you understand what they may be thinking or feeling or the challenges they are facing.
With everything said, please enjoy this week’s entry.
Transgendered Substantiation Volume 11: The gender identity clinic
We’ve finally made it to the Gender Identity Clinic (GIC). Depending on your age and location, there several clinics spread around England, some of which are private while others accessible through the NHS. For those through the NHS, your GP will refer you to the most appropriate to your situation and location. You can go to this NHS website to learn their details, or see the summary below:
London and the Southeast:
- The Tavistock and Portman NHS Foundation Trust: Gender Identity Clinic for Adults
- The Tavistock and Portman NHS Foundation Trust Gender Identity Development Service (GIDS) for children and young people
- Sheffield Health and Social Care NHS Foundation Trust Gender Identity Service
- Leeds and York Partnership NHS Foundation Trust Gender Identity Service
- Northumberland, Tyne and Wear NHS Foundation Trust Northern Region Gender Dysphoria Service
- Northamptonshire Healthcare NHS Foundation Trust Gender Clinic
- Nottinghamshire Healthcare NHS Foundation Trust: The Nottingham Centre for Transgender Health
- Devon Partnership NHS Trust West of England Specialist Gender Identity Clinic
The one to which I was referred was the first one on the list, which is located in London by the Charring Cross hospital. I covered how to contact them and be referred in my previous post, so I’ll talk in this one about what it’s like going there and what to expect when you arrive.
I had my first appointment at the clinic during the Spring of 2017 and was fortunate enough that my parents were up to the challenge of coming. From what I saw while I was there, this wasn’t the case for everyone, but some had brought friends with them for support. I recommend doing the same if your family isn’t up to the task. As much as you may want and need the help of clinic to go through the transition, it’s a substantial obstacle to see through alone. But for the actual consultation, this will be done an hour long 1-on-1 conversation with one of the consultants there at the clinic.
For mine, we went over again the process that had led me to the conclusion that I needed to go through the transition, the responses to my referral form and how they would be reflected in my course of treatment, the treatment options themselves and what their side effects would be, and lastly a timeline of events. Most of these I’ve covered in detail in their own sections during this series or will do so in the future, but I received a summary booklet and checklist at the end of the consultation. This, I’ll paraphrase below.
During the referral process, you may have your blood taken and the results sent to the clinic; however, due to the waiting list, they normally require a second batch taken more recently or which they do themselves at the neighbouring hospital. Be aware that when I had mine taken, they drew a lot of blood, around 6 vials, and I felt light-headed afterwards, so I’d recommend taking in some crisps, chocolate or an energy drink to have after to re-stock on sugars. And have a sit down.
Gender Dysphoria is a challenging thing to comprehend. It comes from a place beyond logic and many experience depression, anxiety and suicidal thoughts as a result, and this is something the clinic takes very seriously. As such, if they believe it necessary, they’ll offer access and referral to a system of specialist counsellors and psychiatrists. If you think you can benefit from this, I’d recommend taking it. I didn’t as, fortunately, my friends and family provided all the support I required, but from what meetings with counsellors I’ve had on this topic, they’ve been well-informed, compassionate and are a good sounding-board.
Speech and Language Therapy
I covered this somewhat on my post on Voice, but I’ll expand here. The GIC has their own team of speech and language therapists. While they are seeking to expand their team, due to the increased demand recently and their specialist knowledge, they have a long waiting list. Yet, I was assured this worth the wait. Due to my proclivity for the theatre and my vocal experience in that regard, I didn’t choose to take the individual speech sessions, but did elect to join a series of monthly group sessions that focused on public speaking, giving presentations and talking on the phone, which gave me the confidence to use my voice in a wider range of real-world situations, especially those that come up in a business environment.
Core Facial Hair Removal
I underwent this through a private cosmetic clinic in the months and years before my first appointment to get something done during the time spent waiting. If you go for facial hair removal through the NHS, it’ll be several months before you get you course started due again to the volume of recipients but also the funding hoops inherent in the system. As I didn’t do this, I can’t comment on the NHS process itself, but I have covered the differences between the different removal methods, such as laser treatment and electrolysis, in my post on Hair Removal.
This is the more personal aspect that’ll differ greatly from person to person. If you wish to undergo gamete storage before the start of hormone treatment, as one of the side-effects is infertility, you’ll be required to contact your local clinic (listed at: https://www.hfea.gov.uk/) and do so under you own steam, administratively and financially. It’s completely up to you in this regard and I can’t advise one way or the other. I decided to go for storing my gametes and found the workers at my local clinic understanding of my situation. The cost is around £300 per year to pay for the liquid nitrogen they use in the freezing process.
On this point, the clinic is very strict, expanding the criteria to encapsulate most recreational drugs, some of which can make you ineligible for treatment if taken within a certain timeframe before the appointment. For standard smoking, they give the cut-off date as three months before your next appointment and the prescription of hormones.
About that second appointment. You should discuss possible times at the end of the initial consultation, and receive your date and confirmation letter several weeks later. This is where, all going well, you’ll be prescribed hormones, though it’ll taken a few more weeks for the necessary paperwork to come through and to have the appointment with your GP to get the actual prescription. To offer some expectation of time, from first seeking referral to getting my hormones was about 1,000 days for me, which might seem like an insurmountable amount of time, but keep in mind that you’ll have many more days than that to enjoy the fruits of the treatment. Through the NHS, this second appoint takes place 12-18 months after the first. For me, my two appointments were ten months apart (April 2017 – February 2018), though the time has increased since due to the rising demand and ever decreasing funding.
This is another one of those awful waiting periods and did I could to fill the time, already fully prepared for what came next, but on top of continuing to grow my confidence and live everyday life, one thing I did use the time to do was to change my name, gender markers and come out to work. I discussed Coming Out earlier in this series so will leave that topic there, and Changing Your Name is the next entry, but I will say that the GIC doesn’t require you to have changed you name or gender, on paper, by the time of your first appointment and you need not present as your preferred gender to that initial appointment either (I didn’t, as I was on stand-by for work and they didn’t know at this point). For your second appointment, however, they do require either your name changed in advance or for you to bring evidence of it to the consultation, and for you to present as your preferred gender. It’s an annoying state of affairs but they do need to be sure before they commit the vast amount of resources it takes to undergo a gender transition.
Lastly, as a point of administration, when you go to the clinic and sign-in at the receptionist’s desk, they’ll give you a form with which you can update any contact information. I’d moved in-between referral and appointment and they hadn’t received my letters stating this. Also, ask to take a few of these forms home with you as this is what you’ll need to send them along with any name change documentation, if you’re alerting them prior to your second appointment. Also, ask if you can get a way to contact your consultant directly, such as a work e-mail. They may say no, but you can always post letters to them, which I found to be the most reliable form of contact with the clinic. I used this when I needed my consultant’s authority when it came to providing evidence to certain institutions that my name change was serious.
And that, as best as I can outline here, is all you’ll need to know about the GIC. I hope this has helped contextualise and prepare you for what’s coming up in the future.