Medical pathways for trans people in Oxfordshire

    So, you've come to terms with being transgender and you're easing the closet door open. What now? Perhaps you're happy with part-time gender expression, maybe you want to go further. You could even want to live full-time in your preferred role and never look back, having hormones and surgery to  align your body as closely as possible with your new life.
    Whatever your path there is one very important thing to bear in mind.

There is no 'right' or 'wrong' course in all of this. Do what feels right for you, take your time, and do not feel pressured into any particular path by anyone but yourself.

    If you feel you need to seek medical help then it is as well to know what to expect, this page attempts to provide some pointers for Oxfordshire-based transgender-identified people.
    As a general and much-simplified overview, the medical part of the process of transitioning from one gender to another takes several years. After a first consultation with a doctor, you will be referred to psychiatrists who will go over your life story and give you a diagnosis of gender dysphoria if that is appropriate. If you wish to change gender permanently you will then be required to prove your ability to live a normal life in your chosen role, so called Real Life Experience or RLE. British NHS patients will normally be prescribed hormone therapy by an endocrinologist after a few months of RLE, then referred by their psychiatrists for genital surgery if they wish it after a further two years. With the effect of NHS waiting lists the whole process can be stretched out over quite some time.
    This page however deals only with the very early part of the process, what to expect from your local medical establishment  here in Oxfordshire.
    It is worth pointing out that all patients in the UK have a choice of private or NHS treatment. Most of the information here relates to NHS treatment, but if you have enough money (about the cost of a medium-sized executive car for MtF patients, all things considered) you may prefer the private route. Private gender specialist clinics in the UK include http://gendercare.co.uk/ and http://www.transhealth.co.uk/.
    As an NHS patient, your first port of call should be your GP. Tell them you have gender issues, and they should refer you to a local psychiatrist for a first diagnosis. In Oxfordshire, depending where you live you may be referred to the Barnes Unit at the John Radcliffe Hospital or to a roving NHS psychiatrist who visits GP practices. Neither of these are gender specialists, but the JR have seen far more of us than any other psychiatrists in the county so know much more about the subject. Ask your GP to refer you to the JR if at all possible. By coincidence all of us who are in the system saw the same psychiatrist at the JR, Dr. Christopher Bass.
    If your GP has not had any trans patients before you might also find it of use to give them a copy of the GIRES guidance for GPs.
    The job of the first psychiatrist is to screen patients to ensure that they are suitable for referral for gender treatments. You will see them at least twice over a period of about six months, and they will probe your life story and ensure that your gender issues have their root in gender dysphoria and are not caused by other more complex psychiatric problems.  It is a necessary part of the process and though it may seem like an unnecessary delay it is not arduous and does provide a useful opportunity to discuss your condition with a professional.
    Once you have been passed by the local Oxfordshire psychiatrist you will be referred to an NHS Gender Identity Clinic, or GIC. These are regional specialist gender clinics that take the patient through the whole transition process. In most cases our local GIC here in Oxfordshire is the West London Mental Health Trust Gender Identity Clinic, often known as Charing Cross after its former location. In most cases your first GIC appointment should come between six months and a year after referral.
     Upon reaching the GIC you will be given two assessment appointments with different doctors a few months apart. They will both go over the same ground, as they require two medical opinions for a diagnosis. Once you have passed those two steps you'll be on your way, able to access whatever services they can offer you.

    Good luck!

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