It took us 2.5 hours to get through the application but it’s done! We’ll be getting our ‘passport/visa’ photos done on Wednesday and sending away at the same time. We laughed at a few of the questions and there are just several pages left completely blank as the “if you have checked no or yes please jump to 7.5″ things that just didn’t apply to us or our process. I need to give a massive shout out to ournewestchapter for letting me know about the fees to visa holders after April 6 you really helped us to get a move on!! :D 

Do you live in England?
Are you interested in NHS Gender Identity Services?
Register as a NHS England CRG Stakeholder NOW!

Register on the NHS England website at: tinyurl.com/crg-register

UK Trans Info’s Quick Guide to Completing the Form

Page 1: Fill in your name and email address
Page 2: Tick Mental Health
Page 3: Tick Gender Identity Services (GIS) which is about half way down the list.
Page 4: Tick ‘Individual participation’ (unless you are registering as an organisation or a professional)
Page 5: Choose the option that matches the level of involvement you would like. If you are unsure then we suggest choosing ‘informed stakeholder’ if you would just like newsletters or ‘consulted stakeholder’ if you would like to be more involved.
Page 6: Select the area that you live.
Page 7: Leave blank unless you are representing an organisation
Page 8: Click submit!

Hey! My names Rosy and I’m 19 ❤️. I suffer Post Traumatic Stress Disorder. Sadly, I can’t get treatment on the nhs, so my only choice was to go private. I’m seeing someone on the 2nd of April, but it’s going to cost a lot of money. My family had run out of money, so I’m asking if you could make a small donation to help. £5 could make a huge difference, so if you could, please go to http://www.gofundme.com/fundrosysrecovery anything big or small will help ❤️.
Thank you so much! Please reblog this to spead my message.
http://www.gofundme.com/fundrosysrecovery

Fantastic news!

UK Trans Info have managed to get the NHS to confirm that GIC patients actually do have a legal right to be treated by GICs within 18 weeks of being referred!

UK Trans Info welcome that NHS England have finally accepted the true legal position. We recognise that it will not be quick or easy to bring the excessive waiting lists back down to within legal limits, but the first step to fixing a problem is to acknowledge it’s existence. The letter states that NHS England will first be focussing on reducing the waiting times for genital reconstructive surgery. It says that “Area teams have been asked to initiate discussions with providers as a matter of urgency about potential options to expand capacity and […] progress with moving towards and sustaining the standard will be the subject of routine performance and exception reporting.”

Important - A request for all UK followers

I don’t believe in using OhMyBritain to promote my own agenda, political beliefs or otherwise as I started it solely with the intention for it to become a tumblr where people could find nice images of different parts of England, Wales and Scotland. However this is incredibly important, if Britain loses the NHS and our health care becomes privatised it will be a colossal mistake. The US’ private health care has failed millions of Americans who need access to healthcare but cannot afford it or their insurance won’t cover it, this could be the future for the UK if we don’t act. I feel very strongly about this issue and if you live in Britain and can’t afford private health care, you should too.

Please sign the petition. You will need to put in your postcode, therefore only those with UK residency can sign it but every signature counts. If you can’t sign the petition, a reblog would help just as much. Thank you.

Petition that the NHS and World Health Organisation Shouldn't Class Female Genital Piercings As FGM

This is the link to the petition against female genital piercings being recorded as FGM by the WHO (World Health Organisation) and by the NHS.
PLEASE SIGN IT.

Not only will this hopefully mean that women with genital piercings won’t be labed victims and reduces the risk of piercers being charged with an act of FGM, but it means the true victims of FGM won’t be lost in a data base full of women who consented to genital piercings. That way the database will only record the true victims of FGM so we can start to try and help those who have suffered as a result.

PLEASE SIGN AND SHARE!

http://epetitions.direct.gov.uk/petitions/75889

The End of Endo Taboo

March is Endometriosis Awareness Month, but we still don’t seem to see or hear much about the chronic illness that affects many women throughout the UK. Are people still too afraid to talk openly about all the unpleasant things that their own bodies do, or are they justuninformed due to a lack of primary knowledge from professionals?

35-year-old mum of two Sally Altass fromBarnsley in South Yorkshire opens up to Parallel about her long-term struggles with endometriosis, discussing which treatments have and haven’t worked, what other kind of support is available, how it affects her family life, and what gets her through the worst days.

Can you tell us a little about endometriosis?

Endometriosis is, in layman’s terms, when you have your period you don’t just bleed down and out, you bleed in and around. No one quite knows why this happens, but basically on the outside of your uterus you start to get little legions of endometriosis which look like little blisters.

There’s four stages of endometriosis, there’s Stage One being minimal, Stage Four being everywhere inside your uterus, around your pelvic system, and around your reproductive system, but it depends. Each stage of endometriosis you have doesn’t reflect the level of pain you may feel. A woman with Stage Four endometriosis may not feel any pain, whereas someone with Stage One could be crippled when she ovulates because it’s about where the endometriosis is. If it’s on a nerve ending – imagine a blister being on your foot and just rubbing continuously, you can cushion a blister on your foot, you can’t cushion a blister that you can’t see inside of you so its constantly rubbing against that nerve ending and constantly sending pain.

How does endometriosis affect you on a daily basis?

It makes your body bloat. When I had my periods I could put on half a stone in weight just from the sheer bloat, I could go from a size 12 to a size 16 and back down again. When you have your period your lining thickens and then it comes out, so that lining is thickening everywhere else as well because it’s behaving exactly the same as the lining of your uterus. It’s really gross, and normally when I talk about it people just normally go “NOPE! That’s enough! That’s enough!” so its weird to actually be able to talk about it and no one going “euurgh!”

It just builds up and builds up because there’s nowhere for it to go once its inside your pelvic system and it causes adhesions, so it can cause your uterus to stick to your bowel and your bladder, and also your ovaries can stick to stuff, it can stick to your fallopian tubes so it can cause infertility. It’s one of the leading causes of infertility, but if a gynaecologist says to you that you have endometriosis it does not mean that you are infertile, it means that you may be at some stage and it could lead to it if the endometriosis isn’t treated properly.

What kind of treatments (if any) have you had for it?

I’ve been on the pill for pretty much half my life. I was put on the pill at age sixteen because of how ridiculous my periods were even then, I’d only had periods for two years at that point and I was put on the pill to try and control them. Of course at sixteen that’s a massive stigma because people think you’re going to be sleeping around and stuff like that, whereas it had nothing to do with that.

I’ve been put on a hormonal treatment called Zoladex which puts you into a temporary chemical menopause. It’s also a treatment that’s used in chemotherapy for breast cancer patients, and so they are given, along with the Zoladex, Hormonal Replacement Therapy so that they don’t have too many horrible side effects. With endometriosis, because it’s trying to stop the hormones, we can’t have the HRT. So I’ve known people who have had Zoladex for sixth months, every six months, for three or four years and they’re only in their early twenties. It can make your hair get thinner because it’s stopping your hormones and oestrogen. It’s a horrible, horrible treatment, and I was on that for three months. It can also give you osteoporosis because it can make your bones weaker.

I’ve had two surgeries called laparoscopies which are used to diagnose and also treat endometriosis. The first one was in 2004 when I was diagnosed with endometriosis, the second one was in 2013 and they said they couldn’t find any endometriosis, which was a little bit strange. I’ve also had the Mirena coil (IUS) in for five years which is supposed to stop your periods, but I still had my periods and I still had them irregularly.

Last March (2014) I had a hysterectomy to remove my uterus because of the amount of bleeding that was happening – even with the coil in, and the hormonal treatments I was on. That was great because I was no longer bleeding, but a hysterectomy is not a cure for endometriosis if the endometriosis isn’t removed from the places outside your pelvis that it can get to because it can be found on your lungs, brain, bowels, kidneys and bladder.

In January this year when I went back to the gynaecologists they agreed to have a look inside me again to see if they needed to remove my ovaries. They did remove my ovaries because they had cysts on them, which I’ve found out since was a mild case of polycystic ovaries (PCOS) and it took twenty-one years to find that out; its ridiculous. But since I’ve come out of the surgery I’ve had a bit of recovery pain, but at the moment – touch wood - I‘m not in pain, though I have had a very low dose of HRT to try and make it a bit easier on the hot flushes and the memory loss, but if it goes up in dose it may encourage any endometriosis patches that have been left to flare up again, and if so they will reproduce their own hormones and just basically cause me havoc again. So basically at the age of thirty-five I’m having the menopause and having to put up with it because otherwise I’ll just be in a state of being in pain all the time, and I’ve had two years recently of being in pain every single day, so right now I’m loving not being dosed up on morphine, its great!

Are there any alternative treatments?

People say to treat endometriosis you can treat it with diet – you can’t treat it with diet. I went from a size 20 to a size 10 because I was controlling my diet so thoroughly because I was scared of a flare-up, but I was still in pain. I still couldn’t get up in the morning. I still couldn’t go to the toilet without crawling. I still couldn’t take the kids to school because I was in so much pain.

They also say that pregnancy is a treatment for endometriosis – it isn’t. I got told before I had Devon that I was infertile because I had endometriosis. I got pregnant with Devon within the year. The couple of years in between having Devon and having Morgan was fine, it wasn’t too bad, but then since having Morgan it got worse so I got the coil put in because it started to get bad again. But the coil just ended up not helping me at all, it was like I didn’t have a coil in. I had to have a bucket of salt water to put my bed sheets in every other day because my bleeding was that bad, and there’s no way to control it. So that’s not a treatment.

People say you can treat it with exercise, because you know when you get a bad cramp they say go for a run; go for a walk it will help. The problem is with endo’ pain, if you can stand up you’re lucky. And if you can stand up and move two steps without puking up because you’re in so much pain you’re lucky, so exercise ain’t gonna help it because you can’t physically move anyway because you’re in that much pain! So all the holistic approaches, I’ve tried them and – for some women if it works for them that’s great, if they’ve got mind over matter that’s great. But if the endo’ is on a nerve ending, going for a run isn’t going to help because it will just inflate it more and rile it up more so… no. Not holistic.

What gets you through your bad days?

Sewing started getting me through my bad days when I was getting to the point where I couldn’t concentrate for long enough to write or I couldn’t concentrate on the TV for long enough because I was just in too much pain. Weirdly, for some reason I could concentrate on sewing because it was so intricate it completely took my mind off it. I’d prick my hand with the needle every now and then and go “Ouch… Oh that’s nowt!” And just carry on with that, so it’s been positive in that aspect, but before the sewing I used to colour in really intricate doodles, like geometric designs and art therapy things, and before that I would try and write, which went alright for a bit, but then I sort of realised that going to gigs was getting impossible because I’d just end up puking on someone’s head if they happened to just pass me as I was having a flare and it would look like I was drunk so that went out of the window.

Within the endo’ community its very much split by those who are told they’re infertile and believe it, and so they hate everybody with children. Every single pregnancy announcement is like a slap in the face personally to them, and between those who – like me – have been told they’re infertile and have gone on to have children, so I try and say never say never. But in a lot of groups if you mention that you’re struggling to look after the kids because you’re in pain, you will get jumped on. You will get told, “I can’t believe you’re so selfish, that’s such an inconsiderate thing to say when I can’t have children and I would give anything to have children, and children would make me get through my day!” Yes, I know I’m lucky to have kids, but it doesn’t stop me being in pain. I can’t just go up to bed and pull the duvet over my head and cry because I’m in pain because I’ve got them two [children] to sort out.

So the community is supportive on one half and envious on another?

Yeah, its like one person said on Mother’s Day, “It’s like everyone who is announcing that they got presents from their children is personally insulting me.” I’m like… okay? So we’re not allowed to celebrate our children, and the fact that we have got children even after most of us were told that we would never have children? So to have children is an amazing thing, and if we celebrate that we’re insulting you? Hmmm.

I try and think of [the children] to get me through the day and the fact that I am lucky to have them, but it doesn’t stop me from being in pain. Some people would be saying to me, “Just think of the kids, that should be enough to get you through any bad day.”

It’s like if someone chopped your leg off, and you’ve still got kids to look after but you’re missing a leg, having kids isn’t going to magically make it grow back again is it?

Yeah exactly! That’s it absolutely exactly. And sometimes as well, I’ve seen some ladies have partners who aren’t very understanding because endo’ hurts when you have sex, and even when you’re not due on your cycle you tend to bleed afterwards as well so its not very often [my partner and I] can be intimate. It’s so taboo talking about it, you get a lot of women’s partners saying, “Oh for fucks sake, you’ve got pain again?” Whereas he’s been so understanding. He knows when it’s hurting, he knows when I’m in pain, so he knows when to just be there for a cuddle and never puts me under pressure. So that gets me through as well, knowing that I have a really understanding partner, because its better than a lot of women with this condition have. So that does help me get through, even the days when he’s doing my nut in I’ll just sit there and think: well it could be worse!

What advice would you give to anyone with endometriosis or to anyone who suspects they may have it?

I would advise them to go to their GP – this is especially if they suspect they have endometriosis – they need to sit down and tell them everything that’s been going on with their periods. Provide a timeline if they can proving that the pain is cyclical, but also it has peaks and troughs. Endo’ pain isn’t just a bad period, it’s more than just a bad period. Go to the doctor, ask to be referred to the gynaecology team, but to make sure that it’s a specialist endometriosis gynaecology team because I was told by different gynaecologists different things.

My first gynaecologist told me that I would never get pregnant, then when I did get pregnant he told me I was cured. When I went back to [the hospital] to have another laparoscopy they completely missed obvious endometriosis, and I know that they missed it because after my hysterectomy my new gynaecologist showed me the pictures of the endo’ that was really obvious on my uterus.

I’d also recommend going to endometriosis-uk.org because they have a brilliant website giving information and they list all the specialist centres in the UK. For anybody in the Barnsley area I would recommend going to Jessops in Sheffield, they are specialists. They know what they’re doing, they know what they’re looking for and they know how to treat it properly as well.

I would recommend them to – just before they agree to be put on the hormonal treatment – actually ask for a couple of days to research the different hormonal treatments available. As I said earlier I didn’t realise with Zoladex when I was given it, I asked what it would do and all they told me was that it would put me into a temporary menopause and I had the injection there and then. It was afterwards when I came home that I actually realised that its used as a cancer treatment for chemotherapy and it wouldn’t stop my periods for at least a month, so I bled for that whole first month when I was expecting some sort of miracle cure. So fully research any treatments that they offer you.

A hysterectomy isn’t a cure. There is no cure for this disease. It goes into a sort of remission state, but if you have the wrong hormone treatment it can just flare up again and it can start to feed itself. It isn’t cancer, but it acts like a cancer. It’s not a cancer because it doesn’t mutate, but it does grow and feed itself and reproduce itself like a cancer would. So that’s why it’s always overlooked because people say things like, “Oh it could be worse; it could be cancer!” And it’s like… I’m still in pain? That doesn’t make me feel any better. You can’t take away the fact that I’m still in absolute agony. Endometriosis can increase the risk of ovarian cancer in small cases, but when women are diagnosed with it and they’ll Google it they will see that in big capital letters flashing at them! It’s very, very rare that it happens.

Google or search on Facebook for endometriosis groups. For the first ten years or so I was diagnosed I felt like no one understood. No one understood me when I said “I can’t come out tonight, I’ve got a date with my hot water bottle, or with the toilet,” whereas I’ve found these support groups online. Yes a few have got divas who think the whole world revolves around them, but you’re going to find that anyway in any community. It happens in the autism community with Morgan, it happens anywhere. Just find a group you’re comfortable with, get to know the people in the group, and ask questions because these women have been through it. They know more than the gynaecologists most of the time as well. I’ve still got friends with gynaecologists saying that they’re cured when they’ve got pregnant, and it breaks my heart because I know its not true, but they’re not going to listen until they experience it. The people that we trust are lying to us because they don’t know enough about it. So, more education for gynaecologists!

Words and photographs by Roseanna Hanson

Links:

Up to 20% or 2 in 10 women and girls worldwide have polycystic ovary syndrome (PCOS), a complex hormonal disorder for which there is no cure. The silent killer as we call it. While the name may be deceiving, PCOS is not a gynecological issues it is an endocrine disorder affeting many systems in the body.  If left untreated PCOS can be a precursor to many life threatening conditions including type II diabetes, hypertension, cardiovascular disease, stroke and kidney problems. This means PCOS contributes to some of the leading causes of death and disability in women today. For many diagnosed with PCOS,  Awareness and education have played a key role in helping them learn to live and deal with Polycystic Ovary Syndrome and ultimately live a healthier life. That is why PCOS Awareness has to happen now to ensure women and girls do not have to go through another day, month or year of silent suffering and to ensure they are educated on how to live a healthier life with this syndrome. What PCOS is, and what it does to women who have it, is complicated to explain as symptoms and severity of the syndrome can vary from person to person. Some of the classic symptoms are drastic weight gain, hair loss, depression, fatigue, thyroid problems, high cholesterol, panic attacks, headaches, dizzy spells, poor memory or muddled mind, sleeping disorders, constant thirst, extreme cravings, insulin resistance, cystic acne, cystic ovaries, menstrual cycles without ovulation, irregular cycles, severe mood swings, high testosterone levels, infertility problems, excess facial and body hair, not to mention a seven times greater risk than an average woman for four major health concerns affecting women in the UK today including heart disease, diabetes, endometrial (womb) cancer and stroke. Because PCOS can cause so many physical and emotional complications, it is important for early detection, treatment and support. I was diagnosed at the age 14 and was given a leaflet and told i would never have children  This petition is not only raising awareness and gaining support, it is giving women, their families and supporters of PCOS awareness a voice, a strong voice that will hopefully inspire and invoke change for better health, treatment and support of this syndrome.

PLEASE sign this & share this, it would mean the world, seriously. It is so important to us, and we need so much more support! I think PCOS gets put on the backburner and doesn’t get the press it needs! Much loves! x

Leak reveals truth behind the biggest NHS privatisation yet

A leak has revealed deeply worrying details of one of the largest NHS privatisations yet - the proposed privatisation of cancer care in the Staffordshire area.

A secret “Memorandum of Information” - published exclusively here by OurNHS openDemocracy - sets out details of what will be in the £700million, ten year contract.

The document - which is labelled ‘commercial in confidence’ - was obtained by Kate Godfrey, Labour parliamentary candidate for Stafford.

The leaked proposals include handing all responsibility for commissioning cancer services for 800,000 patients to a ‘prime provider’ - which can be a private company - who will then sub-contract services to companies of their choice, after an initial 2-year handover period. The first tranche of patients to be handed over to new companies will be breast, lung, bladder and prostate cancer, with others added later, we learn today.

The most worrying thing about the leaked plans is their lack of accountability or redress and their shocking vagueness.

The document sets out “The commissioners do not intend to specify in detail how outcomes should be achieved” preferring instead “the use of high level outcomes”. It sets out how the contract will be based on nine outcomes set out by Macmillan such as “I can enjoy life” and “I want to die well”.

During the first two years the main responsibility on the company will be to develop a more detailed set of ‘service outcomes’ - the criteria that they will be measured against for the remaining eight years.

This, Godfrey says, is a unique arrangement - deciding ‘most of elements of contract design’ such as performance standards and targets, after the contract has been awarded. The company writes its own rules, effectively, and decides what it will - and won’t - do.

But there are clues. There is an emphasis on patients being expected to “self-manage at home”. There is talk of a “stable and managed change environment where providers of care know what is expected of them…this will require disinvestment for (some)”.

Experienced health campaigner John Lister of Health Emergency has described the arrangement as ‘no more than a blank cheque for whichever private firm is most ruthlessly willing to cut costs to shore up their own profits’

And if the ‘prime provider’ company does fail the tests they have created for themselves, there does not appear to be any provision for a break clause for the NHS to get out of the contract. OurNHS understands that - on the basis of what is set out here - it would be legally very difficult if not impossible for the ‘prime provider’ to be sacked for failings which they could blame on their sub-contractors.

The shortlisted ‘prime provider’ bidders are all both controversial and well connected. They include United Health (through its subsidiary Optum), the former employer of new NHS boss Simon Stevens; Virgin Care (who have been warned about service standards by inspectors), CSC Computer Sciences (who were paid £12bn by the UK taxpayer for an IT project that failed to deliver anything that worked) and Interserve Investments (chaired by former Conservative policy chief Lord Blackwell).

Two NHS trusts are also shortlisted, those that currently run respectively Stafford and Stoke University Hospitals, and Wolverhampton hospital. But Godfrey has been advised that “this contract seems to have been designed expressly to exclude them” through clauses about financial arrangements “which seem to have been specifically written with a private company in mind”. There are also extensive clauses setting out competition requirements which appear to weigh most heavily on “current providers” (ie the NHS).  This might explain why, when Valerie Vaz MP asked local health boss Andrew Donald (chair of Stafford CCG) “Just tell me, is the University hospital happy with this process?” he replied simply “No, the chief executive is not.”

It seems more likely that the NHS may - or may not - become a sub-contractor to the company that now holds the NHS purse strings, fundamentally inverting the power balance and making NHS hospitals dependent on decisions by private companies for income - and survival.

Godfrey has prepared a full briefing on key points of concern, published here by OurNHS openDemocracy. She says “even I have been taken aback at quite how far project managers have taken the freedoms granted to them in the Health and Social Care Act.”

The Memorandum of Information - which Godfrey has been advised is legally enforceable - has been prepared by cancer charity Macmillan, whose involvement in the plan has been heavily criticised - and by the shadowy ‘Strategic Projects Team’. The latter have overseen many of the most controversial (and botched) NHS privatisation plans, including Hinchingbrooke (where the private operator Circle withdrew the day devastating care failings were exposed by CQC inspectors) and older people’s services in the East of England, where over a million pounds was wasted on tendering a huge contract only to discover no private company could provide services better than the NHS could.

Wendy Savage of Keep Our NHS Public pointed out in a letter to the Guardian, “Now we have groups of GPs, with no training in epidemiology, oncology or commissioning, making plans to spend millions on an untried system with private companies, who have no experience in cancer care, eagerly waiting to make profits from these sick patients.”

Even Chris Ham of the Kings Fund - often reluctant to criticise government health ‘reforms’ - admitted to Valerie Vaz MP that this plan “is a risk to take with taxpayers money.’. The Kings Fund has also pointed out that whilst simply handing over the responsibility for spending large amounts of NHS money to a private company is “simple for commissioners to manage”, it also raises “Concern over management of co-morbidities and other boundaries”.

What happens to the radiology department who are dealing with both cancer and non-cancer patients? What happens to the cancer patient who is being treated by the NHS for other conditions such as diabetes? What happens to patients who live on the geographical margins of the area? Does the contract even cover all patients in the area? To what extent will existing services be provided? What standards are expected to be met?

It seems these are treated as minor details to be worked out - after the £700m contract is awarded.

Satisfaction with the NHS has grown year on year.
— 

George Osborne, during his budget speech, 18/03/2015.

Except that public satisfaction with the NHS fell from 70% to 58% in the first year of this parliament, rose to 60% the next year, stayed at 60% the following year and is currently at 65%, still 5% lower than when the Tories took office. [source][source]

So, more blatant lies from George Osborne today.

anonymous asked:

Hey! I was wondering if I could trouble you for advice? Basically, I'm dfab and agender and going to talk to my GP this week about the idea of a referral to a gender identity clinic about getting just top surgery. What would be the best things to say and have for a backup in case they end up being transphobic/binarist/horrible in some way? Thanks :D

Hello! :)

(Disclaimer for future enbys: I wrote this advice in Feb 2015.)

1. Take the interim protocol for GPs re: gender dysphoria

"Hey doc, I’m transgender, could you please refer me to a gender identity clinic?"

First of all, most GPs have a very out of date referral protocol for patients with gender dysphoria. Their protocol says they should refer to a Community Mental Health Team (CMHT) who would assess you and refer you on. This protocol was updated in 2013; there is now an interim protocol, published by the NHS, that your GP should follow. The new interim protocol says that GPs should refer directly to a gender identity clinic (GIC), with no need for a psychiatric assessment.

I strongly advise all people going to their GP to check out this page on the NHS website and download and print the attached PDF to take with you. The PDF is the interim protocol, and if your GP can have a quick read through and refer you straight away it will save you weeks (if not months) of waiting, following up, being asked unnecessary and intimate questions, etc.

Your GP, if they are particularly rubbish, may try to offer you a counselling service or a referral to the CMHT instead of a GIC referral. Accept whatever else you want that you feel will help, but do not leave that office without a referral. (Ask to be CCed - see point 2.) If they refuse to refer you immediately, and they don’t give an explanation that satisfies you, it’s time for a new GP.

Waiting lists are really long. Really really long. You have a legal right to treatment within 18 weeks of referral, but four of six GICs in this PDF are failing to follow that law. My GIC Charing Cross (London) is the oldest and most well known, and it’s one of the worst; I had a gap of six months (26 weeks) between referral and first appointment in 2011. In 2014 it was more than twice that (56 weeks). My initial referral to the CMHT added 6 months to my wait. (More on my timeline here.) That’s why you should insist on a referral even if you’re not sure; you can ask to be removed from the list later on, but if you’re not sure and you delay your GIC decision you can’t jump the queue.

You are allowed to choose your GIC, if you’d like - though it’s fine to trust your GP to refer you to whichever they think is most appropriate. I’d like to advise you on which GIC to choose, but I only have experience of Charing Cross and the national nonbinary GIC situation is changing fast. If you don’t mind the risk of getting a GIC that might suck or need educating and you’re up for travelling, you can ask to be referred to the one with the shortest waiting list (currently Daventry or Exeter). You could also ask around to see which clinics nonbinary people are attending and how it’s going, and for that I recommend the /r/nonbinaryUK subreddit and the NBSW forums. I’m sorry I can’t be more help on that!

2. Ask to be copied (CCed) on your referral and all correspondence with the GIC

This is a common request and your GP should have no problems agreeing to it and following it. It’s no trouble for them either so don’t feel bad about asking.

It’ll be evidence that you have in fact been referred, and if you don’t hear from your GIC you’ll know who to chase up with. It’s just a really useful thing to have in your records.

Plus it’s always good to hear what your GP is saying behind your back. It’ll let you know how they handle the pronoun issue, for example. (I have learned to be wary of the people who decide to avoid pronouns altogether, because in my experience they slip up a lot.)

3. Pronouns (optional)

If you have settled on some pronouns, take an A4 sheet with notes on your gender identity and pronouns. Give it to your GP, tell them aloud that you want them to use these new pronouns from now on in person and in records, and tell them to put that sheet of paper in your records for future reference.

Even if you’re going with “they”, throw in an example sentence that uses lots of pronouny goodness (including the reflexive, “[pronoun]self”) - gender-inclusive and neopronouns are very new and unfamiliar to a lot of people, and even smart people need a little hand-holding.

"Cassian has their dentist appointment today; they will drive themself there."

(I feel honour-bound to tell you that I don’t drive. o.O Thanks, brain.)

4. Record-keeping (optional)

This can be done by post at any time. It’s just writing to your GP and asking them to change your title and gender on your records. @just-one-mx wrote a great blog post with a letter template.

TL;DR

"Hi Dr Geepee! I’m transgender, I want a double mastectomy, I’ve got buckets of gender dysphoria. Please refer me directly to [my favourite gender identity clinic] as per the interim protocol published by the NHS that I have here. Also, copy me on the referral, and here’s my new pronouns."

And if they’re really snotty: “If you’re not referring me directly as per the interim protocol I’ll be making a formal complaint and switching GP.”

I’m slowly realizing the state this country is in. I’m unable to get doctors or hospital appointments for my wife or my son within a fortnight and when we do get seen the surgery can’t get a booking for the referral to a hospital. They reckon they can’t keep trying for us and we have to do it ourselves online now. Log on and no bookings are available. I’m thinking Maybe if the surgery wasn’t full of bloody foreigners we might get a look in. I’ve had enough I’M VOTING UKIP