I think I’m trans: now what?
If you’re reading this section, you’ve probably already done a considerable amount of soul-searching, thinking and reading about your gender identity. The following section is going to be about the medical treatment of gender dysphoria in the Cambridge area, so if you’re wondering where to go next, read on. If on the other hand you feel that the medical route isn’t right for you at the moment and you’d just like someone with a friendly ear to listen, then feel free to email the trans rep or come along to one of our coffee meets.
Counselling can provide you with the space and opportunity to talk in confidence about your gender identity and the implications of transition for your life. In the University, colleges have counsellors, and counselling is also available through the University Counselling Service (http://www.counselling.cam.ac.uk/). GPs can also refer you to counsellors. Privately, Pink Therapy (http://www.pinktherapy.co.uk/) has counsellors who are specially trained in working with the LGBTQ community.
Alternatively, if you’d like to talk to someone trans, the trans rep is available at the following address: email@example.com
The GP, your local CCG, and Gender Identity Clinics
Getting medical treatment as a trans person means that in all likelihood you’re going to see multiple different health professionals. The treatments available range from counselling to hormones and surgery, and different individuals will choose to have different treatment(s) depending on their personal needs.
Your first port of call is probably going to be your GP. From personal experience, it’s a good idea to have a very clear idea about what you want from your GP before you go to your appointment! It’s also a good idea to be very direct about what you want from them, for example, referral to a Gender Identity Clinic (see later). Most GPs will not have much or any experience with trans issues, and you may have to guide them through the referral process! If your GP is not very helpful, the best thing to do is to swap to another one (you don’t need to give a reason).
Your GP will refer you to a psychiatrist for an assessment of gender dysphoria. In Cambridge, these assessments are generally conducted by psychiatrists at Union House in Chesterton, the community facility for adult mental health. Depending on the outcome of your assessment, you may then be referred to a Gender Identity Clinic. Gender Identity Clinics are few and far between: the Cambridge Clinical Commissioning Group (CCG) refers to Charing Cross (formerly West London Mental Health Trust) GIC in London (http://www.wlmht.nhs.uk/gi/gender-identity-clinic/).
If at any stage of the process you are unhappy with the conclusions a medical professional has come to, you can ask for a second opinion. In the event that you are not treated with respect or have another reason for complaint, you can look to the NHS Patient Advice and Liason Service (PALS).
Not everyone opts for the NHS route. While the NHS has the huge advantage of being free, there are long waiting times for referrals. If you go to a private clinic, for example Gender Care UK (http://gendercare.co.uk/) or Trans Health (http://www.transhealth.co.uk/) you’re more likely to have more control over your treatment and timescales, although it is obviously much more expensive.
What kind of treatment is available at GICs?
GICs can provide you with counselling and hormone therapy. They are also able to refer you for gender confirmation surgery. http://www.wlmht.nhs.uk/gi/gender-identity-clinic/what-we-do/
There are many good resources on the web that discuss the effects of hormones and the different kinds of surgery available. You can find a discussion of these at the following addresses: http://www.nhs.uk/Conditions/Gender-dysphoria/Pages/Treatment.aspx
Please note that the following NHS guides are now out of date due to the recent changes in the clinical guidance. Most of the changes are fairly minor and the overall pathway is still the same. (I shall try to update this once I find a decent copy of the new guidance)
Specific Policy covering Cambridge: http://www.eoescg.nhs.uk/Libraries/Policies_Docs/Gender_Dysphoria_Commissioning_Policy_V13_final_Sept_2012.sflb.ashx
An NHS guide for young trans people: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_074252.pdf
An NHS guide to Hormone Therapy: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_081582.pdf
NHS guides for doctors:
If you want to hear real people talking about transition, there are a huge number of video diaries and blogs online run by people who are undergoing or have undergone transition, which range from the fun and frivolous to the serious and instructive. Some of my personal favourites are:
Juliet Jacques’ (MtF) Guardian column: http://www.guardian.co.uk/lifeandstyle/2010/jun/02/transgender-journey
Ayden and Kylie’s upbeat, silly, and occasionally harrowing video diary of Ayden’s FtM transition. (If you only watch one, take a look at ‘People Gone Wrong’.) http://www.youtube.com/user/AYDENandKYLIE
Maki’s channel. An intelligent video diary from an utterly cool trans femme musician in the UK! http://www.youtube.com/user/mercuryneedle
My own humble contribution (that’s Harry, trans rep 2011-2012). Watch me as I make slow progress through treatment on the NHS. We’re in this together. http://www.youtube.com/user/harrylukas7