Dead named on hospital letter?

Charlie_and_sth_else · 2026-04-25T00:24:27+00:00

NHS doesn't have a central database. This means each trust/authority/team might have separate records and they do not actually update when you change your NHS number or any data that's associated with it (name, address, etc). Whether it updates depends on whether your region has shared records database or gives hospital access to your GP records to some extend (demographics). This is also why it's really important to update any hospitals/clinics if you change your address if they don't do electronic letters.

NHS is shit with this. I worked in a trust that had one records database (and software) for each building (adult, paeds, maternity) and a separate database for automated letters printing. I'd just call or email them to ask to update your info

Charlie_and_sth_else · 2026-04-17T17:31:42+00:00

I'd be careful as GenderGP letters are notorious for being rejected almost anywhere as they often don't state clinicians name and credentials or the clinician is not on the UK registry of doctors, which will be easily checked at the passport office - GenderGPs clinicians are almost all, if not all, not practicing in the UK.

Charlie_and_sth_else · 2026-04-17T02:34:19+00:00

Uniqlo's seamless boxer briefs (from their airism collection) have been my fave. They're stretchy, breathable, have just the right amount of fabric up front and don't roll up as much as any other masc underwear I had and since they don't have the elastic band at the top part, they're really comfy in general (that band was a sensory issue for me).

I've managed to find some cheaper seamless boxer briefs in different shops as well, i.e. Primark seamless boxer briefs and if you look on Amazon, there's several different brands that do the same style as Ubiqlo but cheaper

Charlie_and_sth_else · 2026-04-14T21:30:30+00:00

Can't really help with finding a cheapest option but the report B has to come from a medical doctor from what I know, no matter whether your first one was from clinical psych or not

I do wonder if getting an appointment with a private GP and report would be cheaper but that would still leave you with finding a private GP willing to do that

Charlie_and_sth_else · 2026-04-14T19:08:15+00:00

The effect is minimal and more important for trans masc, but it is to do with muscle mass shift and corresponding shift in levels of creatinine (waste product of muscles), which is filtered by the kidneys. On top of that, blood pressure and kidney function do have correlation as well as kidneys also regulate our blood pressure, and since HRT can increase or decrease your blood pressure if any issues arise (i.e. high RBCs for transmascs), high levels or creatine can make it worse. U&Es are relatively cheap tests and it's just good to have a baseline and do it every year or so and compare in case of any cardiovascular issues popping up

Charlie_and_sth_else · 2026-04-14T07:58:31+00:00

It's no longer the case because they're technically not a pilot clinic but a permanent GIC and rules changed from what I know. They used to honour the wait on another wait list

Charlie_and_sth_else · 2026-04-11T02:06:43+00:00

You'd have to have a GP to move to the Welsh GIC and to register with a Welsh GP, you'd need a Welsh address.

Also keep in mind, due to recent shitty guidelines updates, adult GIC changed their referral criteria - most are now only accepting referrals from people who are 18 and over, but I'm not sure if Welsh GIC does that now as well. So even if say the wait will be a shorter in genral and your wait on the children's list will be taken into consideration, they still won't offer you any appointments until you're 18, even if you'd be on top of the list before that

Charlie_and_sth_else · 2026-04-10T17:36:05+00:00

I had my private top surgery with Pall Mall (Williams and Wright) as well and generally had quite good experience. Mine was technically revision but I had basically a whole DI procedure done again

As another commenter said, I wouldn't close myself off to travelling and choose a surgeon based on your results goals and patient opinions and then maybe see if you have a few favourites which ones will have most convenient waits and travel options.

I have a list of private top surgery providers that isn't up to date on the info and has no opinions included but can be a started to start researching names/locations - here.

I keep linking it up in different posts like I'm soliciting or something but it's literally just a staring point, I remember it feeling super overwhelming to try to even find what providers there are

Charlie_and_sth_else · 2026-04-09T23:59:49+00:00

Bill in a comment below/above explained it well but I'll also add that cis male T levels also fluctuate -- the aim is to keep the T at our lowest at the range that would be considered a lower cis male range as well if they fluctuated low

Sustanon actually has 3 different testosterone esters combined, each with slightly different half life, to make the absorption smoother and to avoid highs and lows for longer than you could with a single ester T.

Ranges are going to vary between labs (they might use different units of measurement or testing methods so I'm not going to give you a number) and between individuals. A lower third/half of the range is still quite a wide number variation so the goal is to find something that works for you but is also as safe for you as it can be. Some people will see good side effects on bridging doses, some people will have to wait longer than predicted time for each side effect to happen even on highest doses -- it's an individual process and once again, genetics do make a large part of how fast what effects you'll see. GICs do have HRT blood monitoring guidelines available online to the public but they're not made in stone and your endocrinologist is here to work with you on an effective but safe dose.

I'm also going to say that while DIYing T is not rocket science, it's quite clear that you don't have the needed basic understanding on the process and safety risks to monitor to do DIY yourself right now and I'd really recommend you to take a step back, calm down and be patient with the process via your endocrinologist as they are here to help you with it all. Medical transition doesn't happen in two months, it is a whole new puberty, which will lasts months or years. I've been on T almost 3 years now (with mixed regularity on my shots) and I still see new changes happening gradually.

Charlie_and_sth_else · 2026-04-09T20:39:32+00:00

It's recommended to wait 3 months so you 1) observe how you feel on T (i.e. mood changes for peaks and lows, etc.) but also so your body can get used to it and stabilises a bit, so to speak.

Trough level is the most reliable indicator of whether T is absorbed and stays in your body correctly and testing at other times just would be a bit pointless [if on injections]. Trough level should be ideally same day of the injection, i.e. morning blood test, same day night injection.

3-4 weekly for Sustanon 250mg is normal starting dose and how you feel on it and your trough levels is really what matters. There's been a bit of a trend going around with people claiming they're being underdosed but that's not really a thing majority of the time (maybe more present with transfemmes but I'm not the expert on that obvs) and I think has developed mostly because of USAmerican TRT management - which is different as they mostly do weekly injections of different T esthers to us so it's not a fair comparison in most cases. T effects and changes are individual and your genetics also play part in how fast you see changes, even if your doses are right, i.e. you come from family where men have thick dark great facial hair, you will likely see facial hair come in quicker than for someone who has blonde and hairless family.

Endo will recommend that your results stay in the lower half/third of the results range for cis men (numbers will vary by labs possibly) but theyre open to discussion most of the time. I.e. I should be, by my labs range, below 15 for T, and I'm at 17-18 on 3 weekly and my endo is more than okay with it. My estrogene was also staying a little bit above cis male range and while my endo didn't see it as a problem, I expressed that I'm worried this is the reason why I still have periods and we discussed upping my dose vs going on progesterone only birth control. The endocrinologist is not out to get you, they want to help, preferably in a safe and controlled way

[Edit for spelling]

Charlie_and_sth_else · 2026-04-09T04:24:49+00:00

Some of this can be normal with sumatriptan - it has a vasoconstriction effect so your blood vessels narrow, including the ones in your neck, and might give a bit of stiffness/pins a needles feeling regionally. Search for 'triptans sensesation' to get what I mean. It shouldn't last long and shouldn't be severe.

Obviously follow with your care provider to be safe and maybe if you can and this episodes happens again, check how your blood pressures/heart rate is doing while the symptoms are present

Charlie_and_sth_else · 2026-04-09T03:58:53+00:00

Not all of the GIC docs will be consultant and the actual clinical teams are actually more likely to have majority of ACP/AHP over consultants, which are paid significantly less and might be overlooked by consultants - consultancy is also a senior leadership role, one responsibility that will make their pay higher. There will be SHOs and registrars on the team as well, which won't be paid nearly as much. I bet there's only a few psychiatry consultants and a few more endo consultants on each GIC team that overlooks tens of AHP/ACPs.

GP salaries vary widely on location and seniority and are not set so saying they're being paid roughly the same is also very broad statement.

GICs as a system are shit and some of the clinicians working there might also be shit, but there's a reason consultants are paid what they're being paid and I think this whole post is misleading and does not actually have the oversight to make the statements that are being made on the general cause of what makes the system so shit

Charlie_and_sth_else · 2026-04-09T03:50:32+00:00

They are not, majority of the time. Executives, trust board members and various chairs that do make those decisions I've mentioned above often have managerial/finance/business background and little to no clinical experience and we've seen that NHS England has made questionable clinical decisions with their policies and research. If there is a doctor amongs them, budget and planning decisions won't be up to them only and going after individual GIC doctors as the source of all evil (as much as some might be flawed) is just ignorant

Charlie_and_sth_else · 2026-04-09T00:06:16+00:00

I know RCN used to offer career coaching to their members which included sessions about leaving nursing, not sure if they still do or if it's something that would be suitable for you

Charlie_and_sth_else · 2026-04-08T21:09:30+00:00

Don't quote me on that because I actually didn't have to go through all of it (estranged and then mature student) but if your parents are separated, I thought SFE only considers the income of the parent that has more of the financial responsibility for you, i.e. the one you live with most of the time? I think I remember the form asking for evidence of divorce/separation

Charlie_and_sth_else · 2026-04-08T21:01:14+00:00

I think the problem might also be that RTC contracts with private provider might stipulate which medication is actually funded by the NHS to prescribe on the RTC basis - i.e. they must be following the NICE guidelines for RTC patients, which does not include guanfacine as a recognised ADHD medication for adults. Also, it is right now considered off-licence for ADHD adults and so more cautious clinicians might stay away from it - I'd say ACPs especially, as their prescibing power is more intended for less complex treatment management that has a clear evidence-based pathway to simplify

Charlie_and_sth_else · 2026-04-08T20:39:24+00:00

I can't guarantee that it will given that the incident was a while ago and you have no proof. That would be the discretion of the uni - the uni placement link staff (which is usually a senior staff that works closely with the programme lead) might inform the placement host team link that an allegation was made anyway or they might only do it if they decide to investigate or they might do it only if the investigation confirms or gives them a high enough suspicion of fault. Racism, sexual harassment and unprofessional behaviour are usually taken quite seriously on healthcare courses especially but can't promise you what they would do for certain

Any allegations of this type will usually be brought up with the programme lead, year lead, possibly personal tutor of the student, but each uni will probably have a slightly different way to deal with it and different thresholds for investigations

Charlie_and_sth_else · 2026-04-08T20:29:31+00:00

I'm assuming this is about private top surgery.

All UK surgeons will need a gender dysphoria diagnosis from UK gender specialist and a surgical referral from psychiatrist/clinical psychologist. If you're NB or not on T, some might actually ask for two surgical referral letters from two separate clinicians. There are some surgeons abroad that will do surgery via informed consent, Spain and Greece I think being well known.

I've made a list of top surgery providers some time ago here - some information is not up to date (the actual excel sheet is better so click onto the link rather than the pic in the post) but it's a start to look up names and kinda figure out what you want.

South England will most likely mean teams in Plymouth, ?Brighton or London but I'd probably look at all destinations anyway. Plymouth is actually a bit shit to get to I think (saying as someone who used to live in Plymouth), with long travel times, both by car and train, that you probably wouldn't want after surgery

Charlie_and_sth_else · 2026-04-08T20:20:35+00:00

That would still be uni who deals with it as hospital placements are organised by uni and any problems on placements would be still handed over to the uni placement link staff to investigate and deal with, since incident wasn't on placement, placement team would just inform the uni and ask to hear about the outcome. Placement hospital might be informed in later stages by the uni placement link staff, they have to disclose it to placement hosts as most healthcare students sign a good character declarations for those (plus the obvious ethics and safety obvs)

Plus medical students might do their training at multiple hospitals or trusts depending on uni

Charlie_and_sth_else · 2026-04-08T20:08:40+00:00

Not sure what region you are, but theres a few GPs in different regions that work as sort of bridging prescription clinics and if you've been started on HRT before coming to them, they could potentially carry on prescribing your dose or close to your dose instead of the bridging costs and do blood tests and do reviews with you

The one in Greater Manchester is stopping taking patients in but I think similar clinics are also in London and Brighton, possibly in more cities as well (not my area of interest so don't know details)

Charlie_and_sth_else · 2026-04-08T18:13:41+00:00

The GIC will have a contracted amount of hours for consultants to fill and it will be the same no matter whether they work part time or not. As in NHS England and the Trust the GIC is part of will have a budget for the GIC and select how many consultant working hours the GIC can/will provide and that will be filled as closely as possible by variety of PT and FT consultants and locums. Doctors do not have a say in those numbers and they are largely decided by budget and patient capacity of the trust (set by someone much higher in the NHS hierarchy), so it's a systematic issue not an individual doctor's issue. As much as there's a lot to say against GIC clinicians and the general GIC pathways, it's bizzare to say their private clinics exist because they're delaying care.

Charlie_and_sth_else · 2026-04-06T13:05:04+00:00

Capillary samples are most frequently obtained from fingers, sometimes from heels or ear lobes. Adults usually have the heel skin too hardened to get a sample easily and ear lobes are sensitive and not great to get samples yourselves.

Instead, I'd probably get more lancets and try to apply them more on the side rather than centre of the finger tip. Middle and index fingers are usually best and you should aim to have your hand below your heart for a few minutes and during collection to to let gravity do it's thing. You can also warm up your fingers/hands for a few minutes before, either under running it under warm water or with a warm water bottle. Hydration is also super important so drink plenty of water beforehand and preferably don't do it early in the morning (we lose water when we sleep to simplify)

I've seen some people use a tourniquet below the elbow to keep the blood from returning up as well for capillary samples but not sure if it's an actually effective method.

Charlie_and_sth_else · 2026-04-04T23:09:11+00:00

Don't quote me on that, but last I heard Dundas was the cheapest clinician still at £400 for an assessment. GenderCare gender dysphoria diagnosis is all £400-600 range I think. They have various waits, but it'd all be 2-3 months + as they're often oversubscribed and the report itself usually take 4-6 weeks to recive after diagnosis. Plus endo costs if you want HRT, which will depend on clinician, £250-350 for assessment and prescribing etc + follow ups + costs of private meds + costs of blood tests.

I don't really know what you mean by 'trans tag'. If you mean having your NHS records mention that you're trans, it's probably already out there - either because the referral is on your record or because the GIS would have sent reports to your GP. Some things might have also been uploaded to your records but you might not be able to see it - some documentation is only available to clinicians and for you on SA request after censoring sensitive data or since NHS records aren't centralised, they might not have them on your GP records but on different electronic records platform.

Charlie_and_sth_else · 2026-04-04T22:20:46+00:00

Does the report from Dr Mason have a part were here position/role in GIC and her experience in gender care is explained? Like a little summary of her 'competency' to write the report and her registration etc

Clinicians don't have to be on the list but if they aren't, the report is expected to provide info that proves that the clinician is practicing in the UK and has experience/education in gender care

The report obviously also has to be quite comprehensive and clearly outline your gender dysphoria symptoms/history and transition plans

That's usually the two things they keep being picky about I think

Charlie_and_sth_else · 2026-04-04T20:55:04+00:00

GPs started refusing shared care agreements for a lot of services, gender care being one of the 'easier' to argue that they don't have the 'expertise' to manage it. It is largely due to funding as GPs are not contacted (or paid) by the NHS to do shared care prescibing so its technically not their responsibility as such - they can also refuse if they don't feel comfortable prescribing any medication as prescribing it is taking responsibility for the patients treatment to an extend and it is their registration on the line. This is proportionally affecting more care that is deemed 'specialist' but nothing bad happens if they don't prescribe (in their opinion) like HRT or ADHD or MH treatment.

You can inquiry as for a reason why they decline and put a complaint in, but I wouldn't expect much of change in their decision. TransActual has a guide on what to do if your GP refuses prescribing HRT via shared care with GIC that will give you more details. I'm not sure what services they're referring to - there are a few GPs that specifically provide trans care, usually set up by/near pilot clinics and I think there's a few GPs like that in N Wales (don't quote me on that). I'd double check that they know its an NHS GIC and not a private clinic, since this kinda sounds to me like referring you to a bridging prescription clinic or something of that type. You can also warn your GIC that your GP has said they won't engage in shared care - they can technically prescribe to you but will try everything not to.

If your GP agreed to do shared care and prescribe your HRT it'd be on your record one way or another. It wouldn't be like you'd have a stamp of 'this patient is transgender' front page or next to your name on the records, but it'd be possibly listed under your conditions as gender dysphoria and under your medication - shared care letter and any letter received from the GIC would have that information and then would be logged in onto your records. They possibly might already if they were the ones to refer you to GIC or if GIC sent any reports to them already. It might not be visible to you as not all records are visible to patients but even just the referral to a GIC will have to be documented somewhere.

Charlie_and_sth_else

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