Thursday, 10 January 2013
(In reference to the #TransDocFail 'campaign')
There's no way I can boil my experiences with the NHS to just 140 words so here is the full story to date...
Things started in the Spring of 2009. I saw my GP and explained that I believed I had gender dysphoria and thus wanted to have counselling to help me come to terms with what was troubling me. At that appointment she offered me hormones(!) which I said I didn’t want and said she’d organise some counselling for me. Months passed and nothing happened and because nothing happened I had to fund my own counselling at £40 ph which turned out to be counterproductive as my counsellor suggested my dysphoria was in fact internalised homophobia.
Not having any confidence that my counsellor was deluded or had overstepped the boundaries of a professional counsellor, I continued this counselling for ten sessions until May 2009 when I stopped seeing him and went back to my GP to ask again about NHS counselling – which is when she confirmed that she had forgotten to ask for counselling for me but would get it sorted this time.
However, I was again left to fend for myself and things came to a head and I started cross-dressing (androgynously) full-time.
During the summer of 2009, as I have “club feet” and problems with my ankles, I contacted my local NHS Foundation Trust’s Disablement Centre to arrange to have footwear made to help with my disability.
For every appointment with the Centre, I presented as female and stated that I wished to be referred to by my female name, “Claire”. I state “every appointment” as, despite asking them to amend my records and change my name, they never did so. So for every appointment I received a letter in the post and was referred to during my appointments by my male name, which was deeply embarrassing considering, as I say, I was presenting as the female I believed I was. Furthermore, I was pulled aside by the manager of the Centre after one of my appointments and was questioned about my presentation and received the explanation that they could not change my records, refer to me as female or use my female name without a Deed Poll evidencing the change of name (which I subsequently found out goes against guides for good practice). I was thus glad when I got my footwear and was not required to visit the Centre any more.
In October 2009 I was glad to receive a home visit from a mental health nurse who promised to “fast track” me as I had already waited so long. However, this promise appeared laughable when I received a letter shortly after promising a 4 to 5 month wait for NHS counselling! So I decided to fund my own counselling again, this time with a specialist gender counsellor in Salford (which is a 60 mile round trip from my home).
This counselling continued until February 2010 when, approx. 1 year after asking, I received a letter promising NHS counselling in March 2010.
I had asked for – and been promised - a counsellor with Gender Identity Dysphoria expertise but I guess they must be scarce on the NHS as my counsellor didn’t even understand what I was talking about! She did, though, help me come to terms with what was troubling me so I am happy to vouch for the success of NHS counselling (it’s just the waiting time and inherent expense, both mentally and financially, of that waiting time that I find bothersome).
Thus, having come to terms with the fact that I was a transsexual, I realised I needed to put myself on the “gender reassignment pathway”.
Which reminds me – I had sought NHS funding for laser hair removal in February 2010 but was denied said funding on the premise that I was not at that time on the “gender reassignment pathway”. To this day I can not fathom out why laser hair removal on the face should rely on the willingness to have my genitals removed and find such a condition on funding little less than barbaric! I also found out subsequently that, even if I had been on the “gender reassignment pathway”, funding would not have been guaranteed.
Thus, finding my facial hair intensifying my unhappiness, I had to self-fund my laser hair removal – treatment that I still continue to this day, 2 and a half years later (at an average of £100 a session!).
So, going back to July 2010, I asked my GP to refer me to a GIC and waited…
In August 2010, I realised I could no longer live androgynously and transitioned to live full-time as the female I believed I was. Doing so made me realise I needed speech therapy and so, in October 2010, I went to my GP and asked for her to refer me to an NHS speech therapist.
Also in October 2010, I finally got to see a psychiatrist who, hopefully, would refer me to a GIC and I could get the help I so desperately needed.
In that meeting, he seemed incredibly distracted and nervous by my presence and hardly asked me any meaningful questions at all – a point Charing Cross GIC seemed to confirm when we first met and commented that my notes were somewhat lacking in detail – but I left that meeting feeling reassured that my referral was a mere formality… if only that had been true!
In November 2010, having received no information in the 6 weeks since my appointment the previous month, I phoned the psychiatrist’s secretary for an update. She claimed that they were in the process of moving offices but my referral was in the outgoing pile waiting to be posted the next working day.
Having received no more information, I phoned a week later and was told the exact same thing. So I waited another week before phoning again and got the same answer yet again!
Up until that point in my life, having both parents employed in the NHS, I had believed the NHS was a trustworthy organisation that, despite severe limitations on its resources, always pulled out the stops to meet expectations.
However, despite my inclination to not make a fuss, I raised a concern with my local NHS Foundation Trust’s Customer Care Manager and my faith in the NHS was restored when notice of my referral arrived a week later! So now it was just a matter of waiting…
In January 2011, 3 months after asking, I had my first appointment with the NHS Speech Therapist who immediately disappointed me by revealing she had no experience in teaching people to develop a female voice. This was reinforced when she kept presenting information she had found on the internet and reassuring me that I needn’t worry too much because hormones would help fix my voice (completely bogus information!). Thus I suppose it shouldn’t have been a surprise when, six sessions later, my voice had become, in my opinion, strangulated and so I was glad that she then called a halt to things. (Incidentally, from the beginning of 2012, I have been taking singing lessons to help me develop a female voice and have subsequently learned the errors my Speech Therapist enforced upon me).
Meanwhile, back in February 2011 (2 years after first seeing my GP), I got a letter from Charing Cross GIC offering me an appointment six months later. I couldn’t believe that after all this time I would have to wait another six months and I was left distraught!
Matters were made worse in March 2011 when that original appointment was cancelled and one offered for 10.45 in the morning. I could not imagine how the clinic could seem it sensible to offer someone who would have to make a 228 mile trip an appointment for 10.45 in the morning and told them to rearrange it. I also asked them to put me on the cancellation list in case an appointment should turn up sooner.
In April 2011 I got a letter confirming an appointment for June but this was cancelled in a letter I received a day later(!) offering an appointment for July. This chopping and changing of appointments left me lacking confidence in what was arranged and thus I left it until the last minute to book my train ticket to London when I could’ve got it for less than half the price if I’d booked it when I first received the letter. This lack of confidence in appointments made by the clinic was still with me when I last visited them in June 2012 and why I booked myself an overnight stay so that, even if the appointment was cancelled, I didn’t have to waste the expense of a train ticket and could still come to London for sightseeing and make it a worthwhile trip.
So, anyway, in July 2011 I had the pleasure of getting my first appointment at Charing Cross GIC with Dr Lenihan.
I found Dr Lenihan to be very rigorous in her questioning of me in that first appointment, which reassured me that I was being taken seriously and we would get to the bottom of my gender dysphoria.
The next appointment wasn’t until January 2012 but I knew there was a minimum 6 month period between appointments beforehand so I knew what to expect even if I was disappointed by the time lapse.
When I came for my second appointment in January, though, I was appalled that a blood test asked for by the clinic had not been carried out by my GP, resulting in a delay in me getting hormones prescribed.
I then had to go back to my GP and find out why this test had not been carried out and was told that procedure had not been followed and the admin staff had not written to me when they had failed to make contact with me via the phone. The test was subsequently done and I started on the prescribed hormones in May 2012.
In June 2012 I saw the clinic’s speech therapy specialist for the first time and Dr Lenihan for the second time. I left the meeting somewhat disappointed, however, that I had travelled all that way at great expense to myself and the rigorous interview at my previous two appointments had not been repeated. In fact, it seemed like I had gone to great lengths for nothing much more than a cursory chat!
However, I still left the meeting feeling I was on the right path and things were progressing smoothly if slowly – something Dr Lenihan seemed to confirm in her last letter to me.
However, in August 2012, after my hormone dose had been increased, I had a realization I was lying to myself – I did not identify as a woman (trans or otherwise) but as something outside of the binary gender model. Thus the progress towards forming a female body could not ever be satisfactory. That it in fact was increasing my gender dysphoria rather than settling it. Thus I decided to stop taking hormones and I wrote to Dr Lenihan and my GP later that month informing them both of my decision to stop taking hormones.
I did not receive a timely reply to that letter and, as time was getting ever nearer to my next appointment, I decided to contact Iffy Middleton as I had been present at one of her presentations and concluded from that that she was a good person to contact on this matter.
She informed me that she had passed on my letter to her to Dr Lenihan and thus I awaited a response.
In the meantime, I received a letter from Charing Cross GIC in October 2012 that informed me that my GP had been asked to take blood tests for my hormone levels(!) thus making it clear that there was a serious time delay in the clinic’s administration resulting in the clinic asking my GP to take blood tests for hormones I had stopped taking a month before the letter was typed and which, when my GP received it, would’ve been outside of the timescale being asked for in the letter my GP received even if I was still on hormones!
Thus I subsequently wrote to Iffy Middleton informing her of this and my dismay at the clinic’s inefficient service.
However, in Dr Lenihan's last letter to me, she seemed to think something she described as “a typing backlog” is not evidence of inefficiency and, furthermore, that there is no evidence I have had an inefficient service from the NHS at all!
Then as fate would have it, I had a phone call on the 16th October 2012 from my GP asking me to come in for the blood tests the clinic had asked her to do! So it would seem that it is not only the clinic who is unable to keep up with events – even when they’re brought to their attention directly by myself!
So I decided to write to Dr Lenihan taking issue with her comment that there is no evidence I have had an inefficient service from the NHS and received a very apologetic letter from the practice manager (countersigned by Dr Lenihan) promising, amongst other things, that the typing backlog would be addressed. However, I know from my friends who go there, that the typing backlog is as great as it ever was.
However, on the plus side, I feel I have learned a great deal from the last 3 years and I now feel sure in my own mind who/what I am and what I want out of life and it has nothing to do with “the gender reassignment pathway” or Charing Cross GIC.