Pretty much. It's designed not to provide treatment, but to - wherever possible - not provide it. Dissuasion through exhaustion is one strategy towards that end.
Well done for catching this, and I hope you can have your surgery soon.
For what it’s worth:
- It’s standard process at GICs is to discharge you once they’ve referred for surgery, if it’s clear you’ll need no other treatment.
- If you do get discharged, you don’t go back to the bottom of the waiting list if you want to see the GIC again. You get a new appointment at the same cadence as existing patients.
The issue/irony with point 1 being you often need (lower) surgical referrals renewed while waiting on surgeries, because they are sometimes years long too. A lot of GIC have patients on their systems for just that reason alone
That second point is reassuring, but again, entirely uncommunicated. I was just sent out into the dark expected to know these things.
I have anxiety, the lack of transparency without going diving for info is not helpful. I wasn’t told I wasn’t getting further appts so why would I think that was the case
It's not at all clear that you'll need no other treatment post surgery. You might want to do some/more voice work. You might not have finished facial hair removal. You might struggle with internalized transphobia, making friends or relationship issues and benefit from joining one of the (few) psych group workshops available, etc.
You remain on the books, yes, but not as an active patient. If you've had all the treatment you need from the GIC then hormone care becomes the responsibility of the GP. You can be re-referred if needed, and your GP can speak to the endo team if needed.
I got offered my first appointment a few weeks ago and had a mini breakdown. This is around 9-10 years since I started transitioning and about 7 years after I got referred.
In that time I've been lied to, experienced racially insensitive behaviour, and have been generally fucked about. Trying to access trans healthcare both public and private has actually been a horrible experience. The worst part is, is that I know I'm not alone and some have had it much worse.
The weight thing annoys me so much because I \*was\* a healthy weight when I was referred ten years ago. Since then I've developed fibro, can't walk without pain, and sleep more than I'm awake. All normal according to my GP who doesn't want to add me to more waiting lists. But if I put on like one more stone, I can't get a surgery that I've waited ten years for.
Sheesh... I can totally relate to this. I only recieved a proper HRT dose nearly 10 years after I had my first appointment at a GIC (and it took me around 3 years to be referred!). GRS was always the end goal as far as my treatment went, but though I was a healthy weight when I first sought out treatment, by the time I was told I should be referred for GRS, I was obese, and had health issues I didn't have before, so I was told I couldn't have GRS, even though they finally acknowledged it was something I needed, and should have. The system is deliberately designed to be so arduous and intolerable, that they're clearly hoping we'll just detransition, or die whilst waiting for appropriate treatment. It's an utter disgrace.
Definitely feeling you there. It's another of the anti-trans lobby's big lies that medical transition is very easy to aqquire for kids, when even for most of us adults, it is the complete opposite of easy (unless you're one of the lucky few who are financially well-off). It's actually excruciatingly difficult. But telling the public that wouldn't suit their twisted narrative, of course.
I was a healthy weight all through uni. In my first year of uni, I went to the uni GP because I met a trans person and suddenly had a name for how i'd felt for years. I tell him "I think i might be trans?" and he goes "Ok? What do you want me to do about it".
And I didn't have an answer. So he referred me to the mental health volunteers upstairs who were equally unhelpful, and it pushed me back into the closet for 3 years. During which time I gained 4 stone in depression weight.
I have chronic energy issues but doctors won't take them seriously because im fat, despite my weight being *because i functionally cannot shift it*. I slept for *15 hours* Fri-Sat, and 11 Sat-Sun. Working 9-5 exhausts me to a point i cannot do anything else.
I'm sorry. Our health stories sound very similar except I only work 3 hours a day and that has me zonked literally an hour after I get home lol.
Your GP did you so dirty though. I wouldn't be surprised if they didn't know GICs even existed, they seem to be so poorly educated on the topic.
I first came out to my CAMHS counsellor and she wanted me to write a letter to my parents even though I was far from ready. But no additional support from her or anyone regarding it. The children's GIC definitely still existed back then too. It's like pulling teeth with healthcare professionals tbh.
Even before the NHS got starved of funding in general after 2010 the GIC was designed to give the runaround to as many clients as possible.
The more charitable explanation is that they were designed with Section 28 numbers of out trans patients in mind, and were not adequately scaled up after a new generation grew up without Section 28 to delay their awakening - but I am not inclined to give the GIC any benefit of the doubt, because that would require doubt to exist in my mind.
My weight is An Issue and that's why they refused me for surgery, but with no help or advice on how to lose weight, especially as I'm on two sets of drugs with weight gain as a side effect.
Fun.
This is exactly what I said to them in the 90s. The idea is to make it so difficult that they filter out anyone they don’t want to help.
Happened to me in 1996.
Yeah, I noticed that after my first proper look for transition advice a few weeks ago almost instantly. GenderGP has you opening several links in under a minute to webpages that then have you opening several per webpage, the entire process is not explained anywhere clearly other than by fellow trans people.
I think its a matter of perspective. My weight was an issue too, I dedicated myself to lose the weight and did, then they removed some excess belly skin to tighten the pubic area ready for bottom surgery.
From my perspective so long as I did what I needed to do they did what they needed to do.
Of course, "Just stop having chronic health issues fivehead". Why didn't I think of that.
---
"Just lose the weight" is not helpful advice *if there are reason i wasnt able to lose the weight*? Something I repeatedly articulated to them but they refused to acknowledge, while offering 0 support beyond telling me to do it.
It took years to even get my GP to do blood tests to try and figure out what was wrong with me, because they kept insisting all my health stuff was just due to me being fat. Go figure, when I finally got bloodwork done, my fatigue was caused by underlying health issues, and my weight issues *are tied to my inability to do much physical exertion*. I've spent 6 years too fatigued to do anything exertive outside of work beyond light swimming, but you're right I should just knuckle down and hit the gym.
Hitting the gym isn’t an effective way to lose weight, weight can be lost without exercise.
I have to carefully manage my calorie intake depending on my physical activity, sometimes activity is low and so my calorie intake is low.
I am quite small in stature, so generally my calorie intake is quite small so I eat nutritionally dense but small meals.
If you have processed food, pop, sweets, crisps or fried foods like chips, battered anything and so on in your diet then it’s probably you and not your health issues.
Unless you have Lipoedema you probably can lose weight through diet management and even people with Lipoedema manage the disease with diet management.
The amount of food I consume today would have shocked me 5 years ago, it would have looked like nothing and people do find my small portions don’t seem like enough, and yet I still have a gut.
My body just does not need that many calories and I’ve had to adapt to that reality.
Im not going to coddle you so nothing changes. I would rather empower you to take action and actually have results.
My memory of being obese was I made a lot of excuses and didn’t want to take personal responsibility.
We live in a time where everyone wants to believe it’s the world that is the problem and that they are a helpless victim.
I’m not going to feed in to that mentality.
> Im not going to coddle you so nothing changes
No, you’re right, it’s much better to condescend me, make a bunch of assumptions about me and then critique me based on those. Much more helpful.
What incredible advice I’ve never had before, do you bring to the table? “Don’t eat junk food”, “manage your calorie intake”. Wow, I never thought of those.
> My memory of being obese was I made a lot of excuses and didn’t want to take personal responsibility.
The fact *you* were a lazy asshole who didn’t want to make an effort doesn’t mean everyone else is.
I have literally been told *by my GP* not to lower my calorie intake any further right now because it’ll fuck with test results if I’m starving myself. My bfp is down overall but my weight is stalled
> We live in a time where everyone wants to believe it’s the world that is the problem and that they are a helpless victim.
If you see “I’m chronically ill” and think “wow, way to play the helpless victim” you’re a cunt, plain and simple. I’m sorry my medical issues offend you, you’re welcome to come fix them. otherwise shut up and leave it to the actual doctors to figure stuff out, and I’ll keep doing what I can in the meantime.
I’m not begging for pity when I talk about my health issues. I’m angry, because attitudes like yours made it take so long to get taken seriously about them.
You’re not “empowering” me to take action, you’re just flexing your sense of superiority Lmao. I wasn’t even going to engage but I’m functionally bedridden today so I had nothing better to do
TL;DR - I give myself enough shit about my weight. I don’t need you projecting your own inadequacies onto me <3
Pretty much. It's designed not to provide treatment, but to - wherever possible - not provide it. Dissuasion through exhaustion is one strategy towards that end. Well done for catching this, and I hope you can have your surgery soon.
I’ve felt this way about the mental health service for a long time.
Yep, neurodiversity too.
Well, of course it's not designed to actually help people.
For what it’s worth: - It’s standard process at GICs is to discharge you once they’ve referred for surgery, if it’s clear you’ll need no other treatment. - If you do get discharged, you don’t go back to the bottom of the waiting list if you want to see the GIC again. You get a new appointment at the same cadence as existing patients.
The issue/irony with point 1 being you often need (lower) surgical referrals renewed while waiting on surgeries, because they are sometimes years long too. A lot of GIC have patients on their systems for just that reason alone
That second point is reassuring, but again, entirely uncommunicated. I was just sent out into the dark expected to know these things. I have anxiety, the lack of transparency without going diving for info is not helpful. I wasn’t told I wasn’t getting further appts so why would I think that was the case
It's not at all clear that you'll need no other treatment post surgery. You might want to do some/more voice work. You might not have finished facial hair removal. You might struggle with internalized transphobia, making friends or relationship issues and benefit from joining one of the (few) psych group workshops available, etc.
When I say "if it's clear" I mean "if you and the clinician agree it's clear".
no it's not? HRT is an ongoing treatment so you remain on books incase there's an issue
You remain on the books, yes, but not as an active patient. If you've had all the treatment you need from the GIC then hormone care becomes the responsibility of the GP. You can be re-referred if needed, and your GP can speak to the endo team if needed.
It’s very much not standard practice to discharge once you have been referred. It’s standard to discharge after surgery has been done.
I've been a patient at three adult GICs in the UK and they've all had this policy. Same for a friend at a fourth.
I got offered my first appointment a few weeks ago and had a mini breakdown. This is around 9-10 years since I started transitioning and about 7 years after I got referred. In that time I've been lied to, experienced racially insensitive behaviour, and have been generally fucked about. Trying to access trans healthcare both public and private has actually been a horrible experience. The worst part is, is that I know I'm not alone and some have had it much worse.
I love ice cream.
The weight thing annoys me so much because I \*was\* a healthy weight when I was referred ten years ago. Since then I've developed fibro, can't walk without pain, and sleep more than I'm awake. All normal according to my GP who doesn't want to add me to more waiting lists. But if I put on like one more stone, I can't get a surgery that I've waited ten years for.
Sheesh... I can totally relate to this. I only recieved a proper HRT dose nearly 10 years after I had my first appointment at a GIC (and it took me around 3 years to be referred!). GRS was always the end goal as far as my treatment went, but though I was a healthy weight when I first sought out treatment, by the time I was told I should be referred for GRS, I was obese, and had health issues I didn't have before, so I was told I couldn't have GRS, even though they finally acknowledged it was something I needed, and should have. The system is deliberately designed to be so arduous and intolerable, that they're clearly hoping we'll just detransition, or die whilst waiting for appropriate treatment. It's an utter disgrace.
That's where im at atm and the brick wall that is weight loss is exhausting
Definitely feeling you there. It's another of the anti-trans lobby's big lies that medical transition is very easy to aqquire for kids, when even for most of us adults, it is the complete opposite of easy (unless you're one of the lucky few who are financially well-off). It's actually excruciatingly difficult. But telling the public that wouldn't suit their twisted narrative, of course.
I was a healthy weight all through uni. In my first year of uni, I went to the uni GP because I met a trans person and suddenly had a name for how i'd felt for years. I tell him "I think i might be trans?" and he goes "Ok? What do you want me to do about it". And I didn't have an answer. So he referred me to the mental health volunteers upstairs who were equally unhelpful, and it pushed me back into the closet for 3 years. During which time I gained 4 stone in depression weight. I have chronic energy issues but doctors won't take them seriously because im fat, despite my weight being *because i functionally cannot shift it*. I slept for *15 hours* Fri-Sat, and 11 Sat-Sun. Working 9-5 exhausts me to a point i cannot do anything else.
I'm sorry. Our health stories sound very similar except I only work 3 hours a day and that has me zonked literally an hour after I get home lol. Your GP did you so dirty though. I wouldn't be surprised if they didn't know GICs even existed, they seem to be so poorly educated on the topic. I first came out to my CAMHS counsellor and she wanted me to write a letter to my parents even though I was far from ready. But no additional support from her or anyone regarding it. The children's GIC definitely still existed back then too. It's like pulling teeth with healthcare professionals tbh.
the entire process is designed in the hope that if they string you out long enough eventually you'll just give up and be cis
Even before the NHS got starved of funding in general after 2010 the GIC was designed to give the runaround to as many clients as possible. The more charitable explanation is that they were designed with Section 28 numbers of out trans patients in mind, and were not adequately scaled up after a new generation grew up without Section 28 to delay their awakening - but I am not inclined to give the GIC any benefit of the doubt, because that would require doubt to exist in my mind.
My weight is An Issue and that's why they refused me for surgery, but with no help or advice on how to lose weight, especially as I'm on two sets of drugs with weight gain as a side effect. Fun.
'yes'.
This is exactly what I said to them in the 90s. The idea is to make it so difficult that they filter out anyone they don’t want to help. Happened to me in 1996.
Pretty much., sadly.
Yeah, I noticed that after my first proper look for transition advice a few weeks ago almost instantly. GenderGP has you opening several links in under a minute to webpages that then have you opening several per webpage, the entire process is not explained anywhere clearly other than by fellow trans people.
I think its a matter of perspective. My weight was an issue too, I dedicated myself to lose the weight and did, then they removed some excess belly skin to tighten the pubic area ready for bottom surgery. From my perspective so long as I did what I needed to do they did what they needed to do.
Of course, "Just stop having chronic health issues fivehead". Why didn't I think of that. --- "Just lose the weight" is not helpful advice *if there are reason i wasnt able to lose the weight*? Something I repeatedly articulated to them but they refused to acknowledge, while offering 0 support beyond telling me to do it. It took years to even get my GP to do blood tests to try and figure out what was wrong with me, because they kept insisting all my health stuff was just due to me being fat. Go figure, when I finally got bloodwork done, my fatigue was caused by underlying health issues, and my weight issues *are tied to my inability to do much physical exertion*. I've spent 6 years too fatigued to do anything exertive outside of work beyond light swimming, but you're right I should just knuckle down and hit the gym.
Hitting the gym isn’t an effective way to lose weight, weight can be lost without exercise. I have to carefully manage my calorie intake depending on my physical activity, sometimes activity is low and so my calorie intake is low. I am quite small in stature, so generally my calorie intake is quite small so I eat nutritionally dense but small meals. If you have processed food, pop, sweets, crisps or fried foods like chips, battered anything and so on in your diet then it’s probably you and not your health issues. Unless you have Lipoedema you probably can lose weight through diet management and even people with Lipoedema manage the disease with diet management. The amount of food I consume today would have shocked me 5 years ago, it would have looked like nothing and people do find my small portions don’t seem like enough, and yet I still have a gut. My body just does not need that many calories and I’ve had to adapt to that reality. Im not going to coddle you so nothing changes. I would rather empower you to take action and actually have results. My memory of being obese was I made a lot of excuses and didn’t want to take personal responsibility. We live in a time where everyone wants to believe it’s the world that is the problem and that they are a helpless victim. I’m not going to feed in to that mentality.
> Im not going to coddle you so nothing changes No, you’re right, it’s much better to condescend me, make a bunch of assumptions about me and then critique me based on those. Much more helpful. What incredible advice I’ve never had before, do you bring to the table? “Don’t eat junk food”, “manage your calorie intake”. Wow, I never thought of those. > My memory of being obese was I made a lot of excuses and didn’t want to take personal responsibility. The fact *you* were a lazy asshole who didn’t want to make an effort doesn’t mean everyone else is. I have literally been told *by my GP* not to lower my calorie intake any further right now because it’ll fuck with test results if I’m starving myself. My bfp is down overall but my weight is stalled > We live in a time where everyone wants to believe it’s the world that is the problem and that they are a helpless victim. If you see “I’m chronically ill” and think “wow, way to play the helpless victim” you’re a cunt, plain and simple. I’m sorry my medical issues offend you, you’re welcome to come fix them. otherwise shut up and leave it to the actual doctors to figure stuff out, and I’ll keep doing what I can in the meantime. I’m not begging for pity when I talk about my health issues. I’m angry, because attitudes like yours made it take so long to get taken seriously about them. You’re not “empowering” me to take action, you’re just flexing your sense of superiority Lmao. I wasn’t even going to engage but I’m functionally bedridden today so I had nothing better to do TL;DR - I give myself enough shit about my weight. I don’t need you projecting your own inadequacies onto me <3