"I am really unhappy about the delays to my treatment"

About: West London Mental Health NHS Trust / Gender Identity Clinic

(as the patient),

I am very disappointed in the care I have received so far from Charing Cross GIC. Although the staff are all lovely, I feel that they are not giving the treatment I need and they have not been clear with how my treatment will progress.

I had my first appointment in November for an initial consultation. I was already taking estrogen privately, but I could no longer afford private treatment, in fact because of the long wait I sacrificed a lot to be able to start hormones, using money from Student finance. I then had to wait until April for my next appointment for the second assessment where I was put on decapeptyl. I was offered a follow up appointment another 5 months away in September, which I was not happy about, but was told that was the earliest appointment. Today I received a letter that they had to cancel that appointment with no explanation why for over 2 months later in November, which I find completely unnacceptable. So that means I would have waited over 7 months between appointments which I find unethical and I feel completely neglected. So in a whole year at Charing Cross GIC, the only medical treatment I have received is a recommendation for decapeptyl. I am really unhappy about this. Before coming to Charing Cross I was already living full time in my gender role as a woman for a long time, and had changed all my documents to my new name. I function as a woman in work and in university. I had already started estrogen in the private sector, so there really is no excuse for such a dissapointing outcome.

I have not been kept in the loop about my treatment, to date my doctor has received only one letter from Charing Cross which is problematic in itself. I have not been given the space to ask questions in my medical treatment and there has been absolutely no mention of surgery, despite me being on hormones and living full time in my gender role for close to 2 years. I have not heard anything back about voice therapy or hair removal either. I feel completely failed at this point by Charing Cross and I feel that the equal treatment that all NHS patients should receive is completely ignored here and I believe it is malpractice. Not to mention I had to wait over a year for an initial appointment which goes against NHS protocal of a maximum waiting time of 12 weeks for treatment. I demand to know why my september appointment has been changed to november and what GIC is doing to improve, as since I have been a patient here the waits are longer. I demand to be kept informed of my treatment and the route I will take to get to Sex Reassignment Surgery. I feel that I am discriminated against and receive unethical wait times in treatment because I am transgender. I demand the treatment that I deserve such as any other citizen.

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Response from Lee Wroth, Service Manager, West London Mental Health NHS Trust

Dear Norah

Firstly, let us apologise for the delays that you are experiencing in accessing the treatment that you are attending the clinic for, and additionally for making you feel neglected. We certainly never intend for either of those scenarios to be the case, however the second is often the bi-product of the other

We are a very busy clinic and do - on occasion - have to reschedule appointments. That said, we always try to minimise these where possible. Sometimes - try as we might - we are unable to and have to impact on our service users.

For the future, we are now recruiting additional staffing on both the clinical and admin fronts - however these are not quick processes - to help us do two things: reduce the wait times between appointments, minimise the occasions on which we have to reschedule appointments.

We recognise that all of our patients want to be seen in the timeframes of the 18 week Referral To Treatment, however, to date within gender services this has been extremely difficult to achieve, we have a plan in place with NHS England to address our long waits, as do all gender related service providers to be achieving those goals by the end of October 2018. Whilst this seems a long way off, there has historically been a level of funding that has not kept pace with the demands on gender services, which in this financial year is being addressed by NHS England, hence the recruitment that we are now undertaking.

Moving forward with your particular case, we will add you to our short notice cancellation listing, we ask that you advise us of a timeframe that you could come into the clinic within were we to call with a cancellation appointment?

Secondly, we are concerned that you feel you are not involved in your treatment planning and would encourage you to contact us directly with full details of: your appointments to date, who you have seen and when, so that we can review your file and address these issues for and with you including your additional referrals.

Lee Wroth

Service Manager

WLMHT Gender Identity Clinic

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