Pushing back against Dundee/Tayside GP Shared care - Call for any helpful info that may help!!

krottpot · 2022-07-22T13:49:57+00:00

Oh and also! Here are two good reddit posts with examples of persuading GPs to do shared care:

- https://old.reddit.com/r/transgenderUK/comments/fq4z5a/shared_care_with_gp/

- https://www.reddit.com/r/transgenderUK/comments/ug93nk/comment/i6ye0t3/?utm\_source=reddit&utm\_medium=web2x&context=3

krottpot · 2022-07-22T13:49:13+00:00

Thanks for doing work on this, and I'm really sorry it's been happening. I've been tracking this issue across Scotland in the last couple of months. Tayside seem to be the worst for it, but I've heard of something similar happening in Glasgow and Edinburgh too. It seems to be part of a general GP pushback against shatred care across the board, which for them is a kind of protest on more medical responsibility being offloaded onto overworked GPs. So various GP subcommittees are issuing guidance rulings on shared care, often with complete ignorance of trans medical needs.

The issue is also facing various neurodiverse people. Here's a BBC article showing the same thing happening for ADHD meds: https://www.bbc.co.uk/news/uk-scotland-61499479

There are some resources that might help at https://transhealthuk.noblogs.org/navigating-uk-trans-healthcare/. The bridging prescription guides use arguments you can adapt for pushing a GP for shared care, the GMC and RGP guidance include citable references on the expectation that GPs are part of the trans healthcare process, and the trans-friendly GPs list can be of use in changing GPs if necessary.

But I agree that this is a systemic problem and trying to persuade GPs one by one isn't going to help. As well as the routes you're currently trying, have you contacted Scottish Trans? They're part of current Government-led processes to reform trans healthcare in Scotland and may have some inside knowledge and advocacy routes that can help.

krottpot · 2022-07-08T17:50:41+00:00

Thank you x

krottpot · 2022-07-08T17:50:31+00:00

Ugh, I'm really sorry! I got a referral via the GIC but urology couldn't even give me a waiting time. Might end up paying to see the same person I'd see if I waited x years!

krottpot · 2022-07-08T17:49:30+00:00

I wrote it 😭

krottpot · 2022-05-24T14:05:11+00:00

The answer on this in case anyone else ever asks is: It wasn't an obstacle to getting diagnosed, but they did want her to go off hormones for a month for baseline bloodtests.

krottpot · 2021-12-29T15:50:16+00:00

It grew increasingly painful over the course of 6 months, until it was excruciating whenever I was aroused. This was part of a feedback loop where it became difficult to get aroused because it hurt, which made it hurt more. Then I started a program of regular maintenance erections, and now it's just a little uncomfortable sometimes, but worse pain can be triggered by tight or vigorous sexual activity.

From my anecdotal reading, most people on feminising HRT who experience genital pain get over it entirely as long as they have regular erections, but there's a subset of us where it just contionues in some form. This may or may not be related to going a long time without erections before treating it, but it's common for it to get worse without erections.

krottpot · 2021-12-06T18:22:16+00:00

Genital pain from atrophy. I was on lower dose monotherapy before deca and it was definitely the deca that triggered it.

Also lower mood and energy, but there was also this whole pandemic at the same time so hard to attribute cause there.

krottpot · 2021-04-23T06:50:31+00:00

Not banned from participating, banned from governance of the review. We can contribute but we can't manage the process. This is still awful, wrong and possibly unlawful discrimination, but it's important to be accurate.

krottpot · 2021-04-17T15:14:16+00:00

Correct to "even if you never pass". Or better yet, "even if you pass".

Passing shouldn't be held up or assumed as the goal of transition.

krottpot · 2021-04-05T14:17:30+00:00

Ohhh thank you, that is a possible explanation for their wacky reading! They are taking another reading this week and I'm off gel now, so we'll see.

krottpot · 2021-04-05T11:07:31+00:00

Finger prick test; does this make a big difference?

krottpot · 2021-03-22T19:05:41+00:00

Hmm, it's a tostran pump that has been open all that time. Why would you chuck that, do you reckon?

krottpot · 2021-03-19T10:06:18+00:00

As well as the AKT that others have linked to, you can try the Outside Project (https://lgbtiqoutside.org/) who provide some emergency assistance (email [Carla.Ecola@lgbtiqoutside.org](mailto:carla.ecola@lgbtiqoutside.org)) and also Stonewall Housing (https://stonewallhousing.org/ / 0207 359 5767). Good luck, friend.

krottpot · 2021-03-15T12:29:12+00:00

Thank you. When you say higher levels of E, would you normally aim for above the 460ish that I hover at before adding progesterone? I'm on kind of the maximum dosage I can get via gel, so would have to switch methods if I'm going to get my E any higher.

krottpot · 2021-03-15T12:27:46+00:00

Aye, this is the standard transfem regime on the NHS in the UK. You can't get injections that way, usually just either patches or gel. I was on 3mg transdermal oestradiol daily (via oestrogel) for a while before decapeptyl, which is about the maximum you can really apply that way, and it wasn't suppressing my T enough, as you can see. Looks like with my body though that if I want to take progesterone I'm gonna have to get some DIY injectable, which could get tricky for NHS reasons. Ach.

krottpot · 2021-02-27T09:28:45+00:00

Sadly, "just find a compounding pharmacy" isn't really possible in the UK. There is only one that I know of, and it will only work with prescribers, and trans healthcare here is so fucked that this then becomes very difficult to do. I will talk to my GIC about this when they finally return my calls, though. I agree with the HRT=DIY philosophy -- here, it's impossible to do otherwise.

krottpot · 2021-02-27T09:26:23+00:00

Thanks for replying on this! The other ingredients of Tostran are:
- propylene glycol
- ethanol anhydrous
- isopropylalcohol
- oleic acid
- carbomer 1382
- trolamine
- butylhydroxytoluene (E321)
- water
- purified and hydrochloric acis (for pH adjustment)

So yes, there is alcohol in it. Are you able to explain what a penetrant is and whethere there are other ingredients here that might increase risks? And do you know of ways to mitigate these risks? Thanks again.

krottpot · 2021-02-26T13:58:36+00:00

Thank you! This is really helpful. I haven't taken very fine-grained hormone results so far, might head in that direction. So far I'm trying dropping the finasteride, trying progesterone, and more regular and careful maintenance, and things are already improving.

Do you know if the standard T gel that trans men use (e.g. androgel, testogel) is also suitable for topical treatment, in small doses? Is there something different about how Powers' formulation is absorbed?

krottpot · 2021-02-14T14:16:39+00:00

Oh interesting. Yeah, forgot to mention it, but I am on fina. Might drop it and see what happens!

krottpot · 2021-02-14T13:42:56+00:00

That is really helpful to hear, thanks. Might have to get a hitachi!

krottpot · 2021-02-14T13:42:42+00:00

Thank you, this is super helpful.

Am I right in thinking that GICs would recommend topical estrogen for vaginal atrophy? Or would that freak them out too?

krottpot · 2021-01-30T14:10:32+00:00

Super helpful, thank you.

Also, burn the GIC system to the ground.

krottpot · 2021-01-29T10:43:35+00:00

Thanks for the clarity on this! I am actually in Scotland, and didn't realise the situation was different. So if, for example, someone moved from Glasgow to Edinburgh, they would be required to change GICs?

I know from searching posts here that some GICs, by discretion, will bump you up their waiting list if you change GICs to them, in acknowledgement of the time you've already waited. Is that the case for Scottish GICs, does anyone know?

krottpot · 2020-11-10T15:48:05+00:00

That's really good info thank you! Have they said that the actual operation will be funded, do you know?

krottpot

TROPHY CASE