I am writing this amid a pandemic when all of our lives are upside down. We all know our GP’s are very busy so this page aims to give quick but accurate info to GP’s who may be confronted with an adult trans patient and considering the best route for treatment.
There are more of us than perhaps you realise, and as society begins to accept trans people as part of life’s diversity, more of us will “come out.” Coming out to a GP takes a lot of courage, and many GP’s refer trans patients to Gender Identity Clinics (GIC’s).
Many trans people have issues with this, though. Waiting times at GIC’s are very long with anecdotal evidence of up to six years. This is much longer than the NHS target of 18 weeks and waits of this length are not acceptable.
Because of this waiting time, there is very significant evidence that trans patients mental health issues significantly deteriorate, potentially causing self-harm and in worse case scenarios; suicide.
Whilst some trans patients may in due course require surgery and GIC referral becomes inevitable; many trans patients are happy to just say they are trans or ask for hormones. GP’s do have the authority to offer trans patients hormones, and there is some help available to GP’s who decide to go this route.
NHS Wales recently introduced two online training modules for GP’s. This is a HUGE step forward and sincere thanks to Dr Sophie Quinney for this GP lead initiative. Click HERE for the introduction. Click HERE for module one (Gender Diversity) Click HERE for module two (Transgender Health).
The GMC also offers advice – please click HERE to see it.
The Royal College of Physicians offers this course – click HERE to see details.
The BMA also produce information about trans care. Entitled “Managing patients with Gender Dysphoria” – click HERE to see it.
Regarding endocrinologyendocrinology https://en.wikipedia.org/wiki/Endocrinology Endocrinology (from endocrine + -ology) is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. It is also concerned with the integration of developmental events proliferation, growth, and differentiation, and the psychological or behavioral activities of metabolism, growth and development, tissue function, sleep, digestion, respiration, excretion, mood, stress, lactation, movement, reproduction, and sensory perception caused by hormones. Specializations include behavioral endocrinology and comparative endocrinology., the UK boasts a world-class ‘trans specialist’ endocrinologist in Dr Leighton J Seal, who in 2015 put information regarding trans patient care online. Click HERE for details.
STRICTLY FOR GP’s ONLY the London Gender Identity Clinic offers a hormone advice line now (YAY!) – the number is 020 8938 7369
I would also urge you to possibly consider working with GenderGP as third party (“Shared Care”) experts subject to your patient having funds to “go private.” Many people in the trans community very much love GenderGP, and I hear countless stories from people often saying they would not be here without them. Details of GenderGP “GP Guidance” can be seen by clicking HERE. Other private gender specialists are also available though, such as Gendercare who is based in London.
Trans healthcare in the NHS is badly broken – and I am convinced this is much to do with GIC waiting times.
While GIC’s do have a part to play in some trans patients care, it must be recognised that when a trans patient arrives at a GIC for an appraisal (often after a wait of several years) – they are well versed (thanks to social media) how to present, what questions they are going to be asked and what the “correct” answers are to those questions. What is the point?
Many countries now accept that ‘Self-id’ is an established method of someone identifying as trans and whilst WPATHWPATH World Professional Association for Transgender Health https://www.wpath.org “Standards of Care” must remain the benchmark for the healthcare of trans patients GIC referral is often not the best course of treatment for trans patients.
Trans people are everywhere, working alongside you as supporters and indeed colleagues. The BMA are committed to improving trans healthcare and have passed a motion in support of Self-id (click HERE and HERE for details).
Many GP’s are not aware of NHS publication “Guidance for GPs, Other Clinicians and Health Professionals on the Care of Gender Variant People” which though written a few years ago is still reasonably valid today. Please note that as of 2019 neither the World Health Organisation nor the NHS considers Gender Dhspyhora as a mental health issue. Click HERE to see a copy of this publication.
Trans people in the UK thank you for your support!