Private Transition in the UK
This resource is a work in progress, and contains some frequently asked questions about private transition as well as information on the private gender clinics available in the UK. If any information is incorrect or you think something should be added, drop us a message!
If you’re seeing this post via a reblog the master post may have changed: see this link for the original post.
Last updated August 2018.
Frequently asked questions
1. Can I go private for one part of transition and use the NHS for another? (e.g. go private for hormones and get top surgery on the NHS).
Short answer - yes! Lots of people are prescribed hormones via a private clinic whilst on the waiting list for an NHS clinic, for instance. It won’t negatively impact your treatment at the NHS clinic, and the NHS clinic will generally take over any care the private clinic has been providing once you have been through their assessment process.
However, if you have already started having appointments with an NHS clinic, you should check with them before making a private appointment as they generally need you to ‘pick’ one or the other, to prevent getting conflicting advice/treatment from different clinics.
2. Can I use a private referral to get NHS-funded surgery?
No. The NHS will only fund surgery if the referral has come from an NHS clinic. You CAN use an NHS referral to go to a private surgeon though, and pay for it yourself (some people use NHS referrals to go to surgeons abroad, for example).
3. How much do hormones cost privately?
Hormone prices vary depending on the pharmacy, so it can be good to shop around. As a rough guide, the following prices tend to apply.
Nebido: £120 per injection (which would be every 10-14 weeks after the initial loading phase has been completed).
Sustanon: £3 per injection (which would be every 3-5 weeks).
4. Can I pay NHS prices for hormones from a private clinic?
It depends whether your GP is willing to engage in a ‘shared care’ plan with the private clinic - in essence this means that your GP agrees to carry out the day-to-day prescribing, monitoring etc under the instruction of the private clinic. GenderCare’s FAQ gives a good outline of what is involved and what the potential problems can be.
Gendercare’s FAQ is very thorough, and is probably the best way to find out more about the clinic and how it works. However, see below for a brief outline of what you can expect.
GenderCare can help with hormones, surgical referrals, gender counselling, speech therapy, and various medical reports. Who you see and how many appointments you need depends on what you are hoping for from them.
Who you see and how many appointments you need depends on what you are hoping for from them: see their How to use GenderCare page to get started. In general you should plan for at least two appointments. Prices are either advertised on the website or can be found out by contacting the clinician you are interested in seeing.
They see people from the age of 18. They may occasionally see younger people who have already been attending an NHS youth clinic, or agree to see people who are nearly 18 provided treatment doesn’t start until they are 18. If in doubt, get in touch with them to check.
If you need any blood tests in advance of an appointment, they will let you know, and tell you what you need tested (the list is also in their FAQ).
Your first appointment will normally be a full assessment, where they take a history of your childhood, family, relationships, and education. You will discuss your feelings about your body and gender, any physical or mental health conditions you might have, and how you wish to progress with your transition. Dr Lorimer included a list of questions he tends to ask in initial appointments in this article - the procedure is unlikely to vary too much from clinician to clinician, but there might be some differences, and depending on your circumstances - and whether you have anything else you want to talk about! - there might also be other questions. An assessment letter will be written to your GP and copied in to you.
To date (August 2018) Dr Lorimer is the only clinician who has been known to agree to hormones after a first appointment, but these are given as a bridging prescription and you will still be expected to see one of their endocrinologists at a later date. See here for more information.
If you are starting hormones through GenderCare, your second appointment will generally be with an endocrinologist. It will cover some of the same ground as your first appointment, but may concentrate more on physical/medical aspects of hormone treatment. Your bloods will be reviewed, if they haven’t already. An assessment letter will be written to your GP and copied in to you. You may be sent a private prescription, if you haven’t already been given one.
Further appointments will normally be for the purposes of follow-up and monitoring (or for further treatment referrals, if you are going private for surgery and hormones). You’ll be told how to schedule these, and how regularly to send bloods for review if applicable (bloods can be reviewed without making an appointment, but you’ll be advised if you need a follow-up appointment).
If you are going through GenderCare whilst waiting for an NHS appointment, you can stop seeing GenderCare when the NHS clinic takes over your care (typically at the second or third appointment, but it varies from clinic to clinic).
The information below comes from tumblr user charliepa and was correct as of late 2014 (we have made some small edits to remove obviously outdated information). He welcomes questions about his experience with Dr Myskow, and can be contacted here.
elthadriel also submitted some information regarding their experiences with YourGP in late 2016 which may also be worthwhile reading. They also welcome questions.
Appointment 1 with Dr Myskow (60 mins): £250
This is a standard assessment appointment as described for GenderCare. It is helpful to take evidence of living in role, change of name documents etc. to this appointment if you have them. Dr Myskow will ask you to see a therapist, get blood work done, and commence RLE (if you haven’t already) before your next appointment with her in approximately 3 months’ time.
Second opinion appointment with Dr Kennedy (60 mins): £230
This appointment is necessary unless you have been diagnosed by a psychiatrist with ICD-10 Transsexualism F64.0. Dr Kennedy acts as a second opinion for treatment referrals/recommendations. The appointment is much like the appointment with Dr Myskow, but your thoughts and feelings about transition will be covered in greater detail.
Bloodwork (30 minutes): £270
This is done by either a doctor or paramedic at the clinic (paramedics are cheaper). The results only take a few days to come back, so provided Dr Kennedy has sent Dr Myskow a copy of your assessment, you can make an appointment with Dr Myskow for the following week.
Appointment 2 with Dr Myskow (60 mins): £230 (+£130 nebido injection if agreed)
This appointment would normally occur no sooner than 3 months after your initial appointment with Dr Myskow, and would comprise a discussion of your progress in that time, results of blood tests done following previous appointments, and discussion of the next steps you wish to take in your transition. If hormone treatment is agreed at this stage it can be obtained and administered by Dr Myskow at this appointment. She generally prefers to prescribe nebido. She will ask you to get bloodwork done at either your second or third shot (3-6 months after your first injection).
Appointment 3+ with Dr Myskow (60 mins) £230 (+£130 nebido injection)
This would generally be a follow-up appointment after six months. For those who went private whilst waiting for an NHS clinic e.g. the Sandyford, you can expect to have been seen there by this time and so this will likely be your last private appointment.
Private blood test and hormone costs:
Initial blood tests: around £270
Monitoring blood tests: around £54 excluding consultant fee, which will be between £70 and £100
London Transgender Clinic - London
We have limited information on this clinic at the moment beyond what is available on their website. See below for what information we do have:
Anon message with some information on how they work.
Tumblr user @cluttered-fandoms is happy to answer questions.
If you have attended this clinic, please do get in touch!
Harley Street Gender Clinic - London
We currently have no information about this clinic beyond what is available on the website - if anyone has attended the clinic, please do get in touch!