And we immediately went to our current GP practice I foolishly thought, of course, theyll help us immediately and I was, I was horrified with what we were faced with. So they referred us straight away to the Gender Identity Service which was good. Led us to believe that that would be quite quick process. When wed spoke to the Gender Identity Service they said it’s gonna be at least an 18 month wait before you even get seen. So we went back to the GP. Id done lots of research, looked at the GMC guidelines that encouraged GPs to provide bridging medication if they felt able to. And that was the important bit, because that’s a get out clause for them all.

Well, We don’t feel experienced enough to be able to do thi. So I had many a discussion with our current GP felt they were very condescending I complained, I wrote letters of complaint to the practice itself to the GMC, to NHS England, to the CQC, to our local commissioning group. And pretty much felt like I was getting nowhere. But, I think the attitude of that particular practice was just not acceptable. They were dismissive. They were condescending and I didnt like it at all and so Id been talking with a friend and she said, there is another practice in another village that’s kind of the other way from the first one. And she said, they, you know, theyre really nice, well run practice. Why don’t you try there? So I went to them and I said, Are you transgender friendly? I’m not moving if I’m gonna end up in the same position. Oh yes, yes, we are. So made an appointment and went in with [name of participant’s child] and again, the first thing we were told was, No, we, we cant provide you with any bridging hormones at all. So I found myself going down the same route again of complaining to the world wide news, only I went to my MP this time as well and said, This is wholly unacceptable. You know, at that time we had started with a private service, internet based service, because it was the only way we could get some kind of help. And probably took about three months, I think of having assessments, you know, psyche assessments and stuff for [name of participant’s child] to get her first hormones. But at least then she felt like she was on a bit of a, bit of an even keel because I think the hormones that were going on inside her body were kind of matching how she identified. But a, above everything her big concern was that she was losing her hair. Her hair was receding and that had to stop. Waiting 18 months, I mean, she could have been half bald by then. I mean, it was just unacceptable that you know, they didnt, they didnt respond to that, the health professionals. So I wrote to the lead partner in the practice and said, You need to, you need to think about doing this. This is not acceptable. So she invited us in and I took all the guidance I could find, all the information I was trying to be as reasonable and a, as balanced as I could in presenting that to her. Because I said, if something happens to my child because you will not treat her, I will hold you responsible. And I said, I feel like you’re not treating her out of either prejudice or you’re choosing not to, you know, when youve got the opportunity. And, she wasnt, she didnt like me saying that at all. She took offence at that. So I kind of had to just be, you know, I didnt want to get into a conflict situation with them. I was genuinely trying to persuade them to provide assistance. So she said, Well, weve got a practice meeting, well discuss it there. And we got a letter after that that said, no, we will not treat [name of participant’s child].

What was the reason they gave you?

They just said, well they said because we were using an internet service they wouldn’t provide monitoring bloods for that. And they didnt feel they had the expertise to actually take over the prescribing, even though they are prescribing HRT for women, all day, every day. And it’s essentially the same. So I was continuing to complain to all the bodies that I could complain to. And I wrote back to them and I said, this is a list of everybody that I’m complaining to about your practice. I would urge you to reconsider your decision and they did reconsider their decision. So she called us in and said, We genuinely don’t feel able to do the prescribing ourselves, but what we will do is we will refer your child to an endocrinologist. Let them come up with a prescription and then well take over the bridging medicatio and that’s exactly what happened.

They [GPs] are the first point of contact, usually. They can, I think their initial reaction can, could be really reassuring or it could be really dismissive. Again, I say, for younger kids. I don’t think for my child she doesnt need to see a psychologist and certainly she doesnt need to see a psychologist after like a two year wait. So, I think if the initial contact with the GP was just accepting of gender diversity, I think that could really reassure parents whore really, really scared of getting it wrong. And I think if the initial contact with the GP – and, and there are some GPs who are enlightened. And I think that initial contact with a GP can make such a difference, cause if the GP can say, oh yeah, some kids are gender diverse and particularly the message that is standard in other countries at that first point of primary healthcare, the message that’s in the policies and recommendations from like you know, the Australian and the American Healthcare Service is they say to the parents at that point: it’s not about predicting a destination, it’s about making the child feel fully secure and accepted where they are right now. And it doesnt matter how they feel in a year’s time. It doesnt matter where they eventually end up. It’s about making them feel valid and normal and accepted as they are right now. And that’s a really clear message that parents can understand and can go with. ‘

I contacted the GP and, to be fair, I was expecting the GP to be not great. But she was really good. She we’d written to her first so that I could give some background without having to go through it all in ten minute appointments. So she had some of that background. And, obviously, she’d had previous letters from CAMHS and so on which had used his male name. But she was a lot better than I expected her to be. I was expecting it to be, to have to try and change GP. But she immediately wrote to CAMHS and got us that referral back in she prescribed my son the pill. She was fine. She didn’t make, she didn’t make specific reference to it to the fact that he’s trans. But that was fine, actually. That was fine because she just treated him as the person sat in front of him, rather than it all being about him being trans. So, actually speaking to the GP was fine, yeah.

And our current GP is really, really good. She’s been really supportive. She gave us a letter to get our passport updated, which the gender clinic had refused. The gender clinic had said, We cant update passports till after puberty, because she might change her mind about her identity, which is just, I don’t think they understand like even if she did feel differently in the future, why does she have to have a passport that makes her sad now like it just strange, their priorities are unintelligible to me. But the GP was like, Well obviously, she’s a girl she’s, her passport should say she’s a girl and so the GP gave us a letter and we got her passport updated and she was really happy about that. So yeah, the GP’s currently really nice and in a different world, I would be looking to see whether our GP would be willing to work with private healthcare, because in other scenarios that should be possible. And I think our GP would be really up for that. I think our GP understands the problems in the gender clinic service and she understands that other countries do it differently. And she understands that it would be, that there’s harms in following the current gender clinic specifications. So I think as an individual GP she would be quite up for working with private healthcare. But I think her ability to do that is influenced by the guidance from like there are Royal College of GPs. And their recent guidance that came out like yesterday was just really negative and really did not give, does not encourage GPs to support their patients, it discourages GPs from supporting their patients, which is again, disappointing.

I think fundamentally that we’ve been really fortunate that our GP the whole practice has been exceptionally supportive of us. And that we managed to secure a shared care. But I’m acutely aware that not everyone is in that situation that either their GPs don’t self fund it or don’t do shared care or that actually that they’re not supportive in the way that our GP is. And it’s made a huge difference to not only the way that when I take my son in for his blood test or his injections, the way that they greet him that the way that they’ve organised appointments so he can. Practiorning. But what she does is she has this movable slot for him, so you know, on the day that he needsce nurse usually has like emergency triage appointments in the first thing in the m to be, he’s able to come in first thing to get his injection and then he can go straight to school. You know, that, they will do things. They will ring up to say, the blood test results are in and giving paper copies of it. They’ll, you know, we can have conversations on the phone and stuff like that. But they’ve been amazing and it’s fundamentally made a huge difference to us. And I think that’s the thing that I would like this for, for if only, if all GP practices were like that it would be, it would make so much difference I reckon.

I think there’s a number of barriers. One of them is prejudice so I think there’s a lot of that within general practice. One of them is around experience, so they don’t think they have the experience. And there’s possibly something that can be done about that. If they, you know, if theyre given the guidance that they would prescribe in the same way as they prescribe HRT then maybe that would be sufficient for them to feel like they can to feel like they can provide this bridging medication. Education, there’s a lack of education for GPs around what transgender is and what care they actually need. So, I think there’s a sort of awareness and maybe some patient pathways that could be could be drawn up that would say, well, actually, if you don’t feel like you can do this, you could refer in this way and that may possibly also help, and funding as well. So one of the arguments I had with our first practice was that they said, We are not funded to provide your child with blood tests. As did the second GP practice actually. We are not, we are not funded to provide you with blood tests to monitor your, you know, monitor her hormonal parameters. And then in the next breath I was seeing a social media post from the second practice that was saying, Ah, free blood tests for everybody. And I was like, ah, yeah, the select few potentially, not for everybody. And I actually put that, It’s very rare I would put something on Very rare I would put something on you know, social media that’s not, you know, that kind of meaningful in that way. And they put a comment on it to say, This is not the forum for that, for this. And I replied to them and I said, Well actually, it is, because you wont listen to me in any other way. And it’s from that point that’s when they started to listen. So, yeah, funding is another one. Oh, and guidelines, sorry. The GMC guidelines are quite clear around providing bridging medication, but it gives them a get out. So, the minute they feel like theyre unable to prescribe or unable to help they can just throw their hands in the air and say, No, I’m sorry you’re just gonna have to wait for the, you know, the gender service. And I think that’s wrong. So, I think GPs should have to take a level of responsibility for looking after their transgender patients without having that kind of get out. So, those guidelines need to be a little more prescriptive.

We also went to the GP and asked him to make a referral. That was an awful experience. He was quite obviously unsupportive of our difficulties. He told us that he wouldn’t make the referral because the protocol was to refer to CAMHS. And CAMHS would then refer on if they diagnosed a gender identity disorder, which I knew to be incorrect. He wouldn’t, he wouldn’t listen to me. So I then had to leave the doctor’s surgery. My son said to me, He doesn’t wanna help us, does he mummy?’ And I said, I don’t think he does today. But I’ll make sure he does the next time I see him. don’t worry about it. I’ve got it. And but then we had a battle with the GP to get the GP to make the referral.

When the GP refused to refer us, I contacted Mermaids who had sent me all of this information. And they said that they would refer us. So they did that, as I understand it. And I also made a complaint about the GP, to the GPs surgery about the treatment that we had had he didn’t even look at my son during the consultation. He didn’t speak to him once. It was really, it was really bad. And he obviously didn’t understand the process. He also, because we talked about hormone blockers in that consultation, he also said to me, in front of my son, This is potent medication. This is a cancer treatment. You know, this isn’t, not just any medicine. This is a cancer treatment’, which it is used for certain treatment, certain types of cancer, but it’s also used for to stop early pubertal development and you know, therein obviously for the purpose that we were asking about it for my son. So, I made a complaint about all of those things and the fact that the GP had been, had been mistaken in terms of the process that he should have followed. And as a result of that complaint, a referral was made then. But it took a lot of time.

It’s more around and it’s really hard to really hard to articulate. But it’s the way they look at us. And the tone of voice that they use and the look in their eyes and I know, you know, it’s it might sound daft, but actually to be sitting there under the kind of gaze that almost feels like it’s bordering on ridicule is very, very uncomfortable. You know the first the first GP you know, very nice, soft voice and everything, but you could just see in his eyes it was just, it was not something that he was comfortable with at all. You know, he was keen to make the referral and just kind of get us out of there. And was keen not to really have, to have any involvement in any kind of bridging care for [name of participant’s child]. And then the clinical lead and so he suggested, Well if you know youve got a problem with this I suggest you write into the clinical lead. They gave me the name of the clinical leads. I wrote into that clinical lead. And he questioned why I was even bothering writing to him, because he hadnt, in this, the letter it said, I havent seen your child for half a decade. It was like trying to make it sound better, that he hadnt seen my child for such a, such a long time. But that wasnt that the practice hadnt seen her. He personally hadnt seen her. So yeah, it, they almost didnt take our concerns very seriously at all. You know, had I been writing in about something else, I don’t know having not dealt with a broken arm correctly or what have you. I do feel they would have taken that far more seriously than the fact that I was writing in about transgender care.