#shared care

[ukftm]

Hi. I went private for my prescription. Today I was told by my GP that he will no longer support my decision. He had previously been all for it and had even signed off on shared care. But the pharmacy and the surgery won't allow it.

Today I was told I had to cancel my subscription for my prescription as I won't be able to get my hormones anywhere. I was told by my GP that if I did get my hormones elsewhere, I would no longer be able to be seen in that surgery. They will not help me with any kind of illness.

I don't understand why. I had been given the green light all the way through this. Until now. I have wasted hundreds to go private just for my surgery to say it's all to waste.

I'm honestly just so tired of all this. I spent a year on the wait list after being referred by my doctor. Turns out he hadn't actually referred me to the gic. So I got a new doc, he did it instantly. It's been 3 years and nothing has happened.

I'm sorry for the rant. I'm not out. No one knows I'm trans. I keep it a secret. My family know. But everyone else just think I'm a cis man, this is for my safety.

Hi Anon,

Your GP should not be treating you like this especially when you had an agreed plan in place.

I would recommend putting in a formal complaint about your GP. Highlight the process you have been through and your GPS change of mind. Talk about discrimination and wanting to know why your GP is now refusing to help you. Use words like “discrimination on grounds of gender identity” and “refusal of access to care”.

Complaints can be daunting, but they can get things investigated properly and your GP would have to give reason, other than their personal prejudice for not allowing you access all of a sudden. Also add to you complaint that your GP didn’t put in your referral which is another act of deliberately stopping your access to appropriate healthcare. I would also note in the complaint that your GP had also said they will not help you with any illness if you go elsewhere for hormones. A GP cannot refuse you help or access to healthcare when you present at your GP surgery for help. This is unethical and goes against the NHS code of practice.

If you do not have a supportive GP, you may want to consider changing your GP and GP surgery. These drs are acting out of their own personal bias and prejudice towards trans people and are often doing this because they lack the knowledge of appropriate trans healthcare. This however does not give them an excuse for poor treatment and medical negligence.

Try the complaints procedure as this means they have a limited time to respond and then this will put pressure on them to answer for their actions. But if these are the problems you are having at this stage, you will definitely not want to continue with this GP for the rest of your process.

[ukftm]

*urgent* how do I get my GP to agree to shared care? I’ve asked and he said that he wouldn’t be able to because it should be gendercare’s responsibility. Apparently when he’s had trans patients before charing cross did all the prescriptions and everything so he wouldn’t need to. He also said that he wouldn’t feel comfortable because the hormones might not be approved for him to prescribe. What do I say?

There’s a section on Gendercare’s FAQ called “My GP refuses to prescribe. What should I do?”. This has all the information you’re likely to need.

~ James

[ukftm]

Urgent - I'm seeing my gp tomorrow to ask about shared care and I'm getting quite nervous. What exactly do I say? Do I just say would you agree to shared care with gendercare or do I have to be more specific and say would you be willing to prescribe under instruction of this private doctor etc?

Explaining exactly what you want them to do might be the best option.  Explain that Gendercare will assess you, review your bloods, and instruct them accordingly on the dosage and frequency.  All they need to do is to agree to take the bloods and issue the prescription.

~ Alex

[ukftm]

so i want to get bloods done before my appointment with gendercare but i have no letter, so my pratice is funny about doing it (its a very small town with limited resources so they want to do everything upon request from a doctor), should I just email gendercare asking for one? i was also told in feb im on the waiting list for an appointment in may but have heard nothing as of april. should i email about this too

As a first step, you could show the information on blood tests on Gendercare’s FAQ page to your doctor. If that doesn’t help, then yes, contact Gendercare and they should be able to help.

~ James

[ukftm]

My GP won’t provide shared care nor a blood test! I have an appointment with gendercare in May and wanted to get all 11 blood done before is there any other way I can get my bloods done for all gendercare have requested?

You will need to get the blood tests done privately. I’ve known people use Medichecks (https://www.medichecks.com/how-it-works) and Nuffield (https://www.nuffieldhealth.com/pathology-direct) but followers might have other recommendations.

In the longer term, if you haven’t already, it might be worth asking Gendercare for some documentation to support the request for shared care. GPs aren’t obliged to provide it, but Gendercare do have resources to help you inform your GP if the issue is more about them being uncertain than it being a matter of policy that they don’t work with private providers. If this is part of a wider pattern of your GP being unhelpful, you could also look into switching to a GP practice that is more prepared to work with consultants on things like shared care.

~ James

[ukftm]

How do you go about arranging blood tests through your gp if I’m going through the private route for hormones?

The short answer is you’ll need to talk to your GP about having a shared care arrangement - where your GP takes responsibility for prescribing and ordering blood tests, following the instructions of the private gender clinic.

I’m not sure which private clinic you’re with, but Gendercare’s FAQ has lots of information on shared care that will be generally applicable to all private/NHS shared care arrangements. If you’re not with Gendercare, you can speak to your own private clinic for details of their shared care preferences.

~ James

[ukftm]

I'm sorry to ask this after you've answered variations of this question hundreds of times but I was hoping to get a clear answer in one if you can help me. If I go to my gp soon and ask for a referral for gic and get put on the waiting list is it possible to just go private for testosterone to speed up the process for myself seeing as it sounds like referrals take 2 years for the place I'm looking at. After the nhs take over does that mean they pay for the testosterone going forward? Thank you.

Yes, it is entirely possible to go private for testosterone while waiting for an appointment at an NHS Gender Identity Clinic.

If you see a private clinic while you’re waiting and they recommend testosterone your GP may be willing to work with them on a “shared care agreement” and prescribe the testosterone on their recommendation.  This would mean that while you would pay to see the private clinic and get their recommendation and guidance for testosterone, your GP would write you an NHS prescription for the testosterone and perform blood tests on the NHS.  Not all GPs will do this but the vast majority will.

Once you are able to begin seeing an NHS GIC then they would take over care of your testosterone monitoring and write to your GP instructing them to prescribe you testosterone.  If they are not already prescribing testosterone on a shared care basis with a private clinic then they would start prescribing testosterone on the NHS at this point.

With an NHS prescription it may either be free or you may be required to pay the NHS prescription charge (currently £8.80).  This is the same as all other prescriptions.  Prescriptions are free for those in Scotland, Wales, Northern Ireland, in full time education, have medical exceptions, or are low income.  You can check whether you need to pay for prescriptions here.

~ Alex