"Support with Gender transition"

About: Leeds and York Partnership NHS Foundation Trust

(as the patient),

I am a post op transsexual, though I do prefer the term woman. I progressed through the care pathway at Leeds GIC.

Initially the service was very good, frequently monthly-ish support during diagnosis, then early in the 2 year real-life test good help with hormone support, facial hair removal, planning for grs surgery.

But relatively soon into the real life test support gets increasingly sparse, down to every 6 months if that for the 2nd year and next to no support due to finding cuts after surgery. Too much emphasis is put on grs surgery been the cure-all when it is just one piece of the jigsaw. For those people who are not suitable candidates for laser hair removal and who need electrolysis, 8 sessions is worthless when a full beard can take upwards of 200 sessions. I was fortunate to be in the pathway before a lot of the recent pct changes and cuts so was able to be funded for about 60 sessions, but after all that pain and hours travelling from Scarborough to Leeds I am left with 3/4's of a beard (partially clear top half of face, about 30% reduced lower half of face and untouched from the chin down).

At the end of the day when my beard has grown through-out the day and when my make up and wig comes off I feel like I have an action-man head on a barbie bodies. This makes me feel completely unable to have any kind of romantic/intimate relationship as it is greatly distressing and leaves my self confidence at rock bottom. After progressing through the care-pathway initial plans for changing my birth certificate were scrapped at the last appointment again due to funding cuts. No support after my surgery and complications I suffered. Basically just discharged from the service and recommended to visit my gp. Counselling referral offered but misses the point with regards the distress, nothing will fix the distress of being a beard woman except for removing said hair.

The 2 years real life test puts on a lot of pressure and encourages hiding and bottling of difficulties due to the gate keepers barring access to surgery if they see fit. The entire service misses the point on so many things. I am very grateful for the help I was given but I do feel kind of abandoned after the surgery when my transition feels far from complete.

Not enough effort was made to listen to which bit of the transition was most important to my quality of life, as I said too much emphasis places on grs surgery. I must stress this is down to the system and not the staff. How can you argue with a system that considers a transwomans beard as cosmetic!

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Response from Leeds and York Partnership NHS Foundation Trust

I am very sorry to hear that you feel there has been increasingly sparse support, once you began the six monthly contacts with the service.

When clients are progressing with surgery it is normal practice for lead professionals to see clients for 6 monthly contact appointments. We have found this to be an appropriate amount of time between appointments as clients are often ready to disengage with the service and move forward with life outside the gender service.

The Leeds Gender Identity Service does pride itself on working with the client to explore realistic/unrealistic expectations of surgery. Many clients can feel what we describe to be the “post-surgery blues” following GRS. Positive change can also be stressful and many clients can become low in mood in the following months of adjusting to their new body.

When clients have completed surgery they are funded to be seen for up to 12 months which usually encompasses 2 post-operative appointments to assess hormone care and overall well-being. Recommendations are given to the GP at discharge if we feel the client requires more support so that you have a continuation of care and support is provided in your local area.

We appreciate that recent funding cuts can impact greatly on our clients. It is a positive that you received 60 hair removal sessions considering the new funding allowance of up to 8.

Unfortunately the service is no longer commissioned to do GRC appointments unless already booked in the diary. We would be more than happy to provide you with a link to help you look into applying for this privately. Alternately, your GP may be able to contact your local GRC to see if funding can be agreed. The service could then see you for a one off GRC pending there is capacity.

Again we are sorry you feel abandoned now you have completed your journey of gender reassignment. We are encouraged to hear you report that you found the Leeds Gender Identity Service and its staff very good in the first two years of your care with us.

We would like to thank you for your honesty and for sharing your experience. We sincerely hope that you are able to move forward locally with areas you feel we were not able to be provided due to funding.

Kind Regards

Jo Walkinshaw: Clinical Manager

Leeds Gender Identity Service.