Gender Care

GenderCare

UK SPECIALISTS IN GENDER THERAPY

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Frequently asked questions

SERVICES
TIMESCALES
COSTS
WHO WE SEE
MAKING AN APPOINTMENT
APPOINTMENTS
STARTING HORMONES
GETTING HORMONES
SURGERY
GENDER RECOGNITION CERTIFICATE
MIXING PRIVATE AND NHS
CONTACTING US
GIVING FEEDBACK
FURTHER INFORMATION


SERVICES
What services do you offer?
The services we offer are listed here: http://gendercare.co.uk/index.html.

Can you assess me by telephone, Skype or email?
All of Dr Seal's assessments are in person, so you'd have to travel to London for a face-to-face appointment. All first assessments with Dr Lorimer are face-to-face but, after that, he's sometimes prepared to carry out review assessments by telephone (the cost is the same: £130). At the current time, neither Dr Lorimer nor Dr Seal do assessments via Skype or email. That may change in the future.

Can you provide counselling via telephone, Skype or email?
Dr Christina Richards provides counselling by Skype and face-to-face in Nottingham. Her details are here: http://gendercare.co.uk/christina_richards.html. You can also contact her directly by email: contact@christinarichards.com.

TIMESCALES
What are the waiting times for GenderCare?
It varies. Dr Lorimer's clinics are usually less booked up than Dr Seal's or Dr Richard's. There's a lot of demand for Saturday appointments, but if you're able to make an appointment on a Friday, Dr Lorimer may be able to see you sooner. Also, if you're able to make appointments at short notice, let us know: people drop out at the last minute and we frequently offer those appointment slots a day or two in advance. If you have a particular deadline to be seen, let us know.

How long after the appointment before my letter arrives?
Usually, it's at least two weeks. Dr Lorimer sends a draft copy of your letter by email, you get back to him to okay this and then the paper copies go out to you, your GP and any other doctor involved (Dr Seal or Dr Richards, for example, or a surgeon). Dr Seal usually dictates his letters in or just after the appointment and they're typed and sent within two weeks. Sometimes, if blood results have to be discussed or if it's a holiday period, it can take longer for a letter to go out.

How long before I'm started on hormones?
It depends on your particular situation but, if your blood results are normal and Dr Lorimer agrees to "bridging hormones", you could be started on hormones maybe a month after your appointment with him. If your situation's more complicated or there's an abnormality in your bloods, you might need to have more tests, and that would take longer. Sometimes, Dr Seal might want to see you in person before starting hormones, so you'd have to wait until your appointment with him.

COSTS
How much does it cost to get started on hormones?
Costs are here: http://gendercare.co.uk/fees.html. As a rule of thumb, you should budget for two appointments, one with Dr Lorimer (£220) and one with Dr Seal (£220) i.e. a total of £440. It's becoming more common for us to start "bridging hormones" after just one appointment with Dr Lorimer – so following just one payment of £220 – but that's on the understanding that you attend the later appointment with Dr Seal.

How much does it cost to see you after starting hormones?
It depends on your individual situation but you should plan for a shorter review appointment with Dr Seal 6 months after starting hormones, to review dose, etc. Dr Seal's review appointments cost £170. There is more variation with Dr Lorimer's review appointments, depending whether you need to see him, but he might want to see you for general review 6-12 months after the first meeting. Dr Lorimer's review appointments cost £130. Dr Lorimer is sometimes prepared to carry out review appointments by telephone (same cost: £130).

Many people use GenderCare while on the waiting list for NHS gender services. Depending how soon you're likely to be seen within the NHS pathway, you might not need any review appointments with either doctor.

What's the monthly cost?
There isn't a monthly fee; we charge for individual appointments with a clinician. The overall cost will vary depending on the number of appointments. In between appointments, we're happy to answer email or other queries at no extra cost.

Are there any ongoing costs?
There isn't a monthly fee; we charge for individual appointments with a clinician. The overall cost will vary depending on the number of appointments. In between appointments, we're happy to answer email or other queries at no extra cost.

Are there any hidden costs?
No. The assessment cost includes your time with the clinician, a summary sent to your GP and other relevant medics/surgeons, passport letters and private prescriptions (if required). Also included is the time taken in responding to email or other queries.

Do you charge for private prescriptions?
No – although you'd have to pay the pharmacist the cost of the medication itself.

How do I pay?
Cash, cheque, bank transfer (and, in Dr Lorimer's case, PayPal) – more or less anything except card payment. Dr Richards accepts cash on PayPal. We can supply bank or PayPal details on request. Please note that payment should be made in advance or at the appointment itself.

Will my medical insurance pay?
Some types of medical insurance may pay for gender dysphoria related assessment and treatment. Dr Lorimer, Dr Seal and Dr Richards don't deal with third parties, though, so you would have to pay them yourself and then claim the cost back from your medical insurer. We're happy to send you an invoice to help with this.

Can I pay in instalments?
Yes, but you would have to have completed payment by the day of your appointment, for example, you could pay in advance by several bank transfers but you'd have to have paid the complete cost by the day of the appointment itself.

Are there discounts for students or those on benefits?
At present, no, we don't offer discounted rates. This may change in the future.

WHO WE SEE
I'm a teenager. Will you see me?
Although we have some training with children and adolescents, GenderCare is an adult service, so we see ages 18 and upward. There have been occasional exceptions to this – for example, when we've seen slightly younger teenagers who've already been assessed by child & adolescent specialists at the Tavistock & Portman NHS gender service – but our general rule is 18-and-older.

I'm the parent of a teenager. Will you see my child?
We will see ages 18 and upward. There have been occasional exceptions – for example, when we've seen slightly younger teenagers who've already been assessed by child & adolescent specialists at the Tavistock & Portman NHS gender service – but our general rule is 18-and-older.

Please note that we require a short written statement from the patient themselves before we can offer an appointment date. Once we've taken them on as a patient, confidentiality issues apply: we need their written permission to discuss details of their medical care with you.

I'm an OAP. Will you see me?
Yes, depending on your physical fitness, we have no upper age limit.

I am a non-UK citizen. Will you see me?
It depends what the treatment is and how it's to be dispensed. We do have non-UK patients, but our standard way of working is to make recommendations to a general practitioner (GP), who then prescribes. If you're not registered with a UK GP, then the options are more limited. If you have a doctor in your own country, who is willing to prescribe on our recommendation, then that can work.

Dr Lorimer and Dr Seal can provide private prescriptions themselves but prefer not to do this in the long term.

I'm being treated by another gender practitioner. Will you see me?
It depends on the situation but, generally speaking, we prefer not to take over your care if another gender practitioner has started you on hormone treatment. This is partly because we prefer to do our own assessments and blood tests first and, if you're already on hormones, this may no longer be possible.

I'm being treated by another gender practitioner but am unhappy with their care. Will you see me?
Generally speaking, we prefer not to take over your care if another gender practitioner has started you on hormone treatment. Any doctor who starts you on hormones has an ongoing duty of care to you, meaning they're responsible for following you up and addressing any problems caused by those hormones. If they're unable or unwilling to do that themselves, ask them to refer you to a specialist who can.

If you're unhappy with any doctor's care, you can make a complaint through their complaints system or, more formally, to the GMC. You can do that online, here: http://www.gmc-uk.org/concerns/23339.asp.

I'm already paying for private prescriptions from another doctor but want to receive my hormones from the NHS. Can you arrange this?
Generally speaking, we prefer not to take over your care if another gender practitioner has started you on hormone treatment. Ask the doctor who is issuing the private prescriptions to talk to your GP about receiving hormones within the NHS.

MAKING AN APPOINTMENT
How do I make an appointment?
Contact us by email (enquiries@gendercare.co.uk) with the following information:

  1 What name do you prefer to be known by (for example, when we meet you)?
  2 How old are you?
  3 Are you with other gender services, private or NHS?
  4 Are you living, day to day, as you'd like to live, gender-wise? If not, what needs to change?
  5 What's your objective in approaching GenderCare – what would you like from us?

None of these is a trick question; we ask them to get a better sense of how best we can help.

Can someone else make an appointment on my behalf?
It's not unusual for parents, partners of friends to contact us, but we also need a statement from the person actually wanting to see us. It's helpful for us to have the following information:

  1 What name do you prefer to be known by (for example, when we meet you)?
  2 How old are you?
  3 Are you with other gender services, private or NHS?
  4 Are you living, day to day, as you'd like to live, gender-wise? If not, what needs to change?
  5 What's your objective in approaching GenderCare – what would you like from us?

None of these is a trick question; we ask them to get a better sense of how best we can help.

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APPOINTMENTS
Do I have to see both Dr Lorimer and Dr Seal?
It depends what you want but, usually, yes. In most situations, Dr Seal wants to see an assessment from Dr Lorimer before he'll make a hormone recommendation. Dr Lorimer is open to recommending "bridging hormones" before you see Dr Seal, but that's on the understanding that you still attend the later appointment with Dr Seal.

Separately, you might see Dr Richards for Psychotherapy or Counselling Psychology.

Can I see Dr Lorimer and Dr Seal on the same day?
Yes, you can – the original idea of GenderCare was that you could have both assessments on the same day or, at least, without too long a gap between. There's a longer wait for Dr Seal's clinic than Dr Lorimer's, though, so you're likely to have a longer waiting time overall. Your best bet is to arrange the Dr Seal appointment first (you can contact his secretary on paulinewhite1961@btinternet.com) then contact Dr Lorimer's secretary (enquiries@gendercare.co.uk) about seeing him on the same day.

Where are you based?
Details of Dr Lorimer's and Dr Seal's clinic locations, including maps and directions, are here: http://gendercare.co.uk/location.html. Dr Richards is based in Nottingham.

What should I wear to my appointment?
Wear whatever you feel comfortable wearing.

What should I bring to my appointment?
Your address
Your GP's address
Relevant letters relating to past or current treatment
Your name change document (if you've changed your name)
A list of current medication
Proof of age (passport, driving license)
A supportive friend or relative, if you wish
Payment

What pre-hormone blood tests do I need for my appointment?
Ideally, bloods are fasting (blood is taken first thing, before you've eaten) but this isn't absolutely necessary.

FtM/AFAB/NB Transmasculine:
LFTs, lipids, glucose, vitamin D, prolactin, FBC, LH, FSH, SHBG, oestradiol, testosterone, dihydrotestosterone, prostate specific antigen. (Some labs won't do the last two; they're not essential, so don't worry too much).

MtF/AMAB/NB Transfeminine:
LFTs, lipids, glucose, vitamin D, prolactin, LH, FSH, SHBG, oestradiol, testosterone, dihydrotestosterone, prostate specific antigen. (Some labs won't do the last two; they're not essential, so don't worry too much).

I haven't had all of the blood tests. Should I still attend my appointment?
Yes, do still come to your appointment with Dr Lorimer or Dr Seal. Some labs won't do all the bloods, but they're not all essential. You can discuss it with the clinician.

I haven't had any of the blood tests. Should I still attend my appointment?
Yes, do still come to your appointment with Dr Lorimer or Dr Seal. You can email the blood results later.

What happens if I'm late?
We will generally do our best to fit you in nonetheless but can't guarantee this. If you're very late, we may be unable to see you that day.

What happens if I miss the appointment?
We generally trust people to attend their appointments. If you don't turn up or cancel on the day itself or at very short notice, we may ask for up to half of the cost of the missed appointment before offering another one. We might also then ask for advance payment of any further appointments.

Dr Richards charges the full cost of an appointment if you cancel with less than 24 hours' notice.

What happens at the appointment?
The clinician asks questions about your background, current situation and future plans; they want to know how best they can help you. Dr Lorimer's appointment is more general and diagnostic while Dr Seal's is more medical. The aim is to try to get you closer to what you want to achieve.

Dr Richards' Psychotherapy and Counselling Psychology appointments are more to create a structured space in which you can explore your current thoughts, feelings and situation.

Will I have to undress?
Dr Lorimer's and Dr Richards' assessments are entirely interview-based; they don't examine you at all. Dr Seal's examination is more medical, and he might have to examine you if there's something unusual in your blood results or if he thinks there might be abnormal development of your chest (very rare) or external genitalia (about 20% of people). If he needs to examine you, it's always with a female chaperone present.

If there's no clear "baseline" blood test (for example, if you began taking hormones before a full set of bloods was carried out), it's more likely that Dr Seal will need to do a physical examination.

What happens if I don't agree to be examined?
It depends on your individual situation, and Dr Seal's specific reasons for needing to examine you. He only asks to do an examination when it's absolutely necessary, when you feel comfortable consenting and when there's a female chaperone present.

What do I have to do after the appointment?
Wait for your assessment letter to arrive. Dr Seal sends his through the post. Dr Lorimer sends his in draft form first, as an email attachment, so check your inbox (and junk mail/spam filter) a couple of weeks after the appointment. You need to check over Dr Lorimer's draft letter and let him know you're happy with it, and then he sends the paper version through the post.

STARTING HORMONES
How many times will I need to see you to get started on hormones?
It depends on your situation but you should plan for two appointments, one with Dr Lorimer and one with Dr Seal. It's becoming more common for us to start "bridging hormones" after just one appointment with Dr Lorimer, but that's on the understanding that you attend the later appointment with Dr Seal.

How many times will I need to see you after starting hormones?
It depends on your situation but you should plan for a shorter appointment with Dr Seal perhaps 3-6 months after starting hormones, to review dose, etc. There is more variation with Dr Lorimer's shorter appointments, depending whether you need to see him, but he might want to see you for general review after 6-12 months.

Many people use GenderCare while on the waiting list for NHS gender services. Depending how soon you're likely to be seen within the NHS pathway, you might not need any review appointments with either doctor.

What are "bridging hormones"?
The original idea with GenderCare was to start hormones after two separate assessments, one with Dr Lorimer and one with Dr Seal. There is now a longer time-gap to wait for Dr Seal's clinic, however, so we quite often "bridge" that gap by getting you started on hormones after seeing Dr Lorimer and before seeing Dr Seal. This depends on having a full set of normal blood results and both doctors being in agreement.

How do I get started on "bridging hormones"?
You should arrange the necessary blood tests, through your GP, and have the results ready when you see Dr Lorimer. At the appointment, Dr Lorimer will take a copy of your blood test results and discuss them with Dr Seal. If your blood tests are normal and both doctors are in agreement that it's reasonable for you start hormones, Dr Lorimer will start the process before your appointment with Dr Seal.

GETTING HORMONES
Do I have to be living full time to get hormones?
No. Both Dr Lorimer and Dr Seal are interested in how you interact with the world and what your plans are for the long term, but everyone's situation is different and they're happy to work with you on that.

Do I have to have changed my name to get hormones?
Not necessarily. Both Dr Lorimer and Dr Seal are interested in how you interact with the world and what your plans are for the long term, but everyone's situation is different and they're happy to work with you on that. For some people, name change isn't possible or isn't relevant.

I have mental health problems. Will that stop me getting hormones?
Usually, no – although both doctors will want things to be as stable as possible and might need to communicate with your mental health specialists about this. Your mental health might be relevant to the type of hormones recommended, for example, if you're bipolar and are seeking testosterone, a gel might suit you better than an injection.

I have physical health problems. Will that stop me getting hormones?
Usually, no; there are very few medical conditions that are an absolute no-no for starting hormones. In some cases, Dr Lorimer and Dr Seal might need to communicate with your medical specialists. Your physical health might be relevant to the type of hormones recommended, for example, if you've previously had a stroke or a heart attack and are seeking oestrogen, a gel might suit you better than oral tablets.

Some of my blood results are abnormal. Will that stop me getting hormones?
Probably not – there are very few medical conditions that are an absolute no-no for starting hormones – but starting hormones might be postponed if Dr Seal thinks you need to repeat the blood test first, or to have other investigations to check out the abnormality.

I'm a smoker. Will that stop me getting hormones?
Smoking is an issue with oestrogens and also with testosterone, and you're likely to be delayed in starting hormones if you haven't stopped smoking by the time of your appointment, ideally three months before any hormones. E-cigarettes are okay.

After you okay me for starting hormones, where do I get them?
We prefer to work with your GP on a "shared care" basis where we're responsible for making a hormone recommendation and your GP issues the actual prescription, administers the hormones and carries out blood tests and other monitoring on our instruction. Most GPs are happy to work in this way but some – maybe 5% – are not. It's a good idea to discuss it with your GP beforehand.

What do I have to do after the assessment letter arrives?
The assessment letter usually contains instructions for your GP – for example, arranging blood tests or prescribing hormones – but you may need to prompt them to follow those instructions. Make a GP appointment and bring your copy of the assessment letter along to show them.

If you okay me for starting hormones, does my GP have to prescribe them for me?
The bottom line is: no, your GP can refuse to prescribe you hormones. NHS GPs aren't obliged to prescribe on the recommendation of private sector specialists; they usually do, as a sort of favour, but they can't be forced to prescribe if they don't want to. It's a good idea to discuss it with your GP beforehand.

My GP says hormones aren't licensed for gender transition. Is that true?
Only one hormone is licensed for gender transition, Sustanon, as "supportive therapy for female-to-male transsexuals" (see here: http://www.medicines.org.uk/emc/medicine/28840). Doctors actually prescribe a lot of medication "off-license" – for example, the combined contraceptive pill isn't licensed for suppressing heavy menstrual periods but GPs often use it for that purpose.

My GP will prescribe but wants you to write the first prescription. Can you do that?
Yes. This happens from time to time; GPs are happier continuing a prescription that another doctor's started. If this is your GP's position, then Dr Lorimer or Dr Seal can write the first prescription.

My GP will prescribe but wants you to give the first injection. Can you do that?
Yes, although it can take a little time to arrange. GPs are quite often happier continuing a prescription started by another doctor but it's rare for them to also refuse to administer the actual injection. If this is your GP's position, we can usually arrange for an experienced nurse to give you the first injection. It'll mean you travelling to London, though, and there's a cost of £25 for the nurse's time.

My GP refuses to prescribe. What can I do?
The bottom line is that your GP can quite reasonably refuse to prescribe you hormones. NHS GPs aren't obliged to prescribe on the recommendation of private sector specialists; they usually do, as a sort of favour, but they can't be forced to prescribe if they don't want to. It's a good idea to discuss this with your GP beforehand.

Sometimes, GPs want a "shared care agreement" before prescribing. This is a sort of written contract, laying out the responsibilities of the gender specialists, the GP and the patient. If your GP asks for a "shared care agreement", we're happy to provide one.

Sometimes, GPs agree to continue a hormone prescription if another doctor starts it off. In those situations, we're happy to give you the starting prescription.

Sometimes, GPs are unaware of recent guidelines from NHS England and the General Medical Council, encouraging them to prescribe hormones.

NHS England's guidelines are here: http://shsc.nhs.uk/wp-content/uploads/2016/04/SSC1620_GD-Prescribing.pdf.

The GMC's guidelines are here: http://www.gmc-uk.org/guidance/ethical_guidance/28859.asp.

There's also a letter from the GMC, explaining the situation further: http://www.gmc-uk.org/Susan_Goldsmith_to_Chaand_Nagpaul_BMA_GP_committee.pdf_66389596.pdf.

More recently, Welsh health services issued a Health Circular, giving similar guidance to GPs in Wales: http://gov.wales/docs/dhss/publications/160927whc040en.pdf.

Sometimes, GPs just point-blank refuse to prescribe, and the best option is to try to find another GP who's more open to prescribing. It may be worthwhile approaching other doctors at the same practice, or talking to the practice manager. In extreme situations, it may be appropriate to make a formal complaint to the GMC. You can do that online, here: http://www.gmc-uk.org/concerns/23339.asp.

In some situations, the most practical option may be to register with a different GP practice altogether. Trans masculine support organisations like TMSA-UK (http://www.tmsauk.org) might be able to give word-of-mouth recommendations for trans-friendly GPs and Transfigurations has a directory of trans-friendly doctors: http://transfigurations.org.uk/trans-friendly-doctors/.

Can you provide a prescription, rather than me getting it from the GP?
Yes. We're able to provide private prescriptions for up to three months' supply of hormones, and these can be collected from any UK pharmacist. We'd have to inform your GP that we were treating you, and you'd have to see us for regular review. You'd also have to pay the cost of the medication itself – and some types of hormones are quite costly. We prefer not to issue private prescriptions in the longer term.

What are the differences between NHS and private prescriptions?
Any doctor can issue you with a private prescription, and it can be collected from any UK pharmacy. It's different from an NHS prescription in that you have to pay the cost of the actual medication. For example, if the prescription was for three testosterone injections and those injections cost £5 each, you'd pay the pharmacist a total of £15.

Can you send me a private prescription?
Yes, that's possible. We'd want to review you at regular intervals, though.

Do you charge for private prescriptions?
No. You'd have to pay the pharmacist the cost of the medication itself but GenderCare doesn't charge you for the issuing of a private prescription.

I'm already paying for private prescriptions from another doctor. Can you take over?
It depends on the situation but, generally speaking, we prefer not to take over your care if another gender practitioner has started you on hormone treatment. This is partly because we prefer to do our own assessments and blood tests first and, if you're already on hormones, this may no longer be possible.

I'm already paying for private prescriptions from another doctor but am unhappy with their care. Can you take over?
Generally speaking, we prefer not to take over your care if another gender practitioner has started you on hormone treatment. Any doctor who starts you on hormones has an ongoing duty of care to you, meaning they're responsible for following you up and addressing any problems caused by those hormones. If they're unable or unwilling to do that themselves, ask them to refer you to a specialist who can.

If you're unhappy with any doctor's care, you can make a complaint through their complaints system or, more formally, to the GMC. You can do that online, here: http://www.gmc-uk.org/concerns/23339.asp.

I'm already paying for private prescriptions from another doctor but want to receive my hormones from the NHS. Can GenderCare arrange this?
Generally speaking, we prefer not to take over your care if another gender practitioner has started you on hormone treatment. Ask the doctor who is issuing the private prescriptions to talk to your GP about receiving hormones within the NHS.

SURGERY
I have a tight deadline for surgery. How soon can you see me?
Dr Lorimer's clinics tend to be booked up quite solidly but, if you need to be assessed within a particular window of time, he'll do his best to accommodate that – particularly if you're able to make a Friday appointment.

I want chest surgery before testosterone. Will you see me?
Yes, it's increasingly common for us to see people who want to do things in that order. There are pros and cons to having chest surgery first, and we'd want to talk about those with you.

I want chest surgery but not testosterone. Will you see me?
Yes, it's increasingly common, especially with non-binary, for us to see people who want chest surgery without testosterone. Every situation is different and we'll assess you individually. Although it's usual to reach a decision in one appointment, in some cases – with younger adults or where there's significant mental health history, for example – you might be asked to see more than one clinician.

Can you okay me for testosterone and chest surgery in the same appointment?
Usually, no, there isn't time to cover both in one appointment. Depending on the order in which you want to do things, Dr Lorimer would cover either testosterone or chest surgery in the first appointment and arrange a shorter review appointment (possibly by telephone) at a later date, to discuss the other.

I'm having my surgery abroad. Can you provide a referral?
Yes, Dr Lorimer is recognised as an established gender specialist and has made referrals to various surgeons all around the world.

GENDER RECOGNITION CERTIFICATE
Can you provide a GRC report?
Yes, both Dr Lorimer and Dr Seal are included in HM Government's list of approved gender specialists (details are here: https://formfinder.hmctsformfinder.justice.gov.uk/t493-eng.pdf). If they haven't met you before, the clinician would need to see you for a longer assessment, costing £220, including the report itself.

I'm already your patient. Do I need to pay for a GRC report?
Our written assessments are detailed, and the Gender Recognition Panel will often accept them as the specialist part of the application; this means you don't need a separate report and won't have to pay any extra fee. If in doubt, discuss it first with the Panel (advice available here: GRPenquiries@hmcts.gsi.gov.uk). If you do need a separate report and the doctor is able to write it based on your notes, they'll charge £50.

Do I need a GRC to change my passport?
No, all you need to get a passport in the correct name and gender is a letter from a doctor stating that, in their opinion, your gender identity is stable and permanent. Any doctor can write a passport letter but your GP likely won't have done it before and might charge you a fee. Dr Lorimer doesn't charge for passport letters and can provide you with one after he's met you and seen your change of name document.

MIXING PRIVATE AND NHS
I'm one of your NHS patients. Can I contact you through GenderCare?
No, GenderCare is specifically private sector. If you want to ask a clinician questions about your NHS care, you should do so through NHS channels – for example, you can contact Charing Cross gender clinic here: http://www.wlmht.nhs.uk/contact-2/.

Can you refer me to an NHS gender clinic?
Not directly, no. Referrals to an NHS gender clinic have to come through an NHS pathway. In England, your GP can refer you directly (for example, to Charing Cross NHS gender clinic, using the form on the clinic website - http://www.wlmht.nhs.uk/gi/gender-identity-clinic/how-to-refer/). In Wales, there is a more complex system of "gatekeeping" but seeing your GP is still the starting point.

I'm on the waiting list for an NHS gender clinic. Can I use GenderCare?
Yes, many of our patients are waiting for a first appointment at an NHS clinic. Using GenderCare won't jeopardise your NHS care. You're not "locked into" using private care by using GenderCare. If in doubt, get in touch with your own NHS gender clinic and ask their advice.

I'm attending an NHS gender clinic. Can I use GenderCare?
It depends where you are in that gender clinic's care pathway. At Charing Cross gender clinic, for example, you can continue using the private sector until your second appointment; at the second appointment, you'd have to choose either NHS or private from that point on. Other gender clinics operate slightly differently. If in doubt, get in touch with your own NHS gender clinic and ask their advice.

Can I start hormones with GenderCare then get them from the NHS?
Yes, that's how we prefer to do it. We work with your GP on a "shared care" basis where we're responsible for making a hormone recommendation and your GP issues the actual prescription, administers the hormones and carries out blood tests and other monitoring on our instruction. Most GPs are happy to work in this way but some are not. It's a good idea to discuss it with your GP beforehand.

I'm already paying for private prescriptions from another doctor but want to receive my hormones from the NHS. Can GenderCare arrange this?
Generally speaking, we prefer not to take over your care if another gender practitioner has started you on hormone treatment. Ask the doctor who is issuing the private prescriptions to talk to your GP about receiving hormones within the NHS.

What's "shared care"?
It means that responsibility for your care is shared between GenderCare and your GP. Often, it might involve a "shared care agreement", a sort of written contract laying out the responsibilities of the gender specialists, the GP and the patient. If your GP asks for a "shared care agreement", we're happy to provide one.

If I go private for hormones, will I have to pay for surgery in the future?
No, it's very common for people to use the private sector for starting hormones and later seek surgery through an NHS gender clinic.

I'm having my surgery through the NHS. Can you provide a referral?
No, if your surgery is being funded in the NHS, then the referrals have to come from gender specialists in the NHS, and GenderCare is private sector. We could provide a referral but it wouldn't be accepted in terms of NHS funding.

CONTACTING US
What's the best way for me to contact GenderCare?
Always email: enquiries@gendercare.co.uk. The GenderCare telephone is mainly for text messaging, and conventional mail is collected from the PO Box address only once per week. We can be much more responsive by email.

What's the best way for my GP to contact GenderCare?
Always email - enquiries@gendercare.co.uk. – or, if they prefer, conventional mail to the PO Box address. It is, by contrast, difficult for us to return telephone messages.

Can we talk over the telephone?
Both Dr Lorimer and Dr Seal are full-time NHS consultants and Dr Richards is a full-time Senior Specialist Psychology Associate, so it's difficult to arrange a telephone call. We far prefer to answer queries by email, and can usually respond quicker to a short email question. The email is enquiries@gendercare.co.uk.

Why haven't you returned my telephone call?
The GenderCare telephone is mainly for text messaging, and it is difficult for us to take or return telephone calls. We can be much more responsive by email: enquiries@gendercare.co.uk.

Why haven't you returned my email?
Email is the best way to contact GenderCare but we're a relatively small service with part-time admin, so we do sometimes get snowed under. We'll generally get back to you within a few days but it can take longer during especially busy periods or during holidays. Try not to send multiple emails; we'll do our best to respond as soon as we can. If you're trying to get in touch with Dr Seal's secretary Pauline, she can be emailed direct on paulinewhite1961@btinternet.com.

The contact form on the website isn't working. How can I contact GenderCare?
Usually, the contact form is a good way of getting in touch with us, but sometimes it can be slow or glitchy. If in doubt, email us: enquiries@gendercare.co.uk.

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GIVING FEEDBACK
I'm not happy with GenderCare. What can I do?
If you've had a negative experience with us (and this FAQ hasn't helped), let us know; we may be able to resolve the issue. If not, we're able to involve systems beyond GenderCare in the handling of your complaint.

I'm very happy with GenderCare. What can I do?
If you've had a positive experience, let us know; we love receiving good feedback!

I have a suggestion for improving GenderCare. What can I do?
If you can think of ways to improve our service, let us know; we value all feedback.

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FURTHER INFORMATION
The GenderCare website
http://gendercare.co.uk/index.html

Dr Lorimer’s GenderCare page on Facebook
https://www.facebook.com/drstuartlorimer/

UK FTM Information
https://ukftm.tumblr.com

Trans Masculine Support + Advice UK
http://www.tmsauk.org

Transfigurations register of trans-friendly UK doctors
http://transfigurations.org.uk/trans-friendly-doctors/

Email us!
enquiries@gendercare.co.uk

 
   
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