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Hey, sorry to bother you but I just saw the tags on your reblog. I’m considering my best options for HRT at the moment, and I’ve read so much about NHS (and doctors in general) gatekeeping trans people and generally being pretty problematic. You said you went outside of the NHS? Could you perhaps tell me more about that, if thats not too much hassle?


It was actually a shitty puppet joke but I did really go outside the NHS for my hormones.

This was back in 2000-2001, when there wasn’t really any method like InHouse Pharmacy (that I knew of) for accessing hormones without a prescription. At the time the NHS was being pretty rigid about requiring trans women to live “in role” for at least three months before prescribing HRT, and the way I looked back then there was no way I would have come even close to passing without hormonal assistance, and the few times I’d attempted to go out “dressed” (wow, look how all the old late 90s lingo comes back to me, all bastardised and filtered through crossdressing culture as it was for people in my area) I’d got into… trouble.

Fortunately I was a student and had a student loan, so I threw £150 at Russell Reid, who was at that point London’s finest source of vaguely-affordable transgender consultation and disturbing flirting. His thing was that if you showed up and said, yeah, I want hormones, he’d prescribe you hormones, on a shitty little slip of paper that you took to the pharmacy round the corner and exchanged for a particular birth control pill that happened to have the right hormone mix to be almost suitable for HRT. He was like a space-age leather-sofa-owning eyebrow-waggling informed consent clinic for people in the late 90s and early 2000s who could afford £150.

I really liked his clinic because the secretary was a trans woman and she was really good at putting nervous young trans girls at their ease and proving that, yes, you too could transition and then work as a secretary in close proximity to a leather sofa.

Note that, as it says on the wikipedia page, because he was in favour of informed consent and patient-first care he was investigated and eventually found guilty of not making the transition process confusing and miserable enough when compared to the SoC.

These days, as a result of this kind of thing, I understand it’s not as easy to get a prescription out of his successor as it used to be, and the NHS process has been slightly improved to be merely incredibly grim. You can still use at least one of the international pharmacies without a prescription, I believe, although I’m not sure which one?

Anyway, the way it worked for me was that after he gave me the prescription I took a second copy to my local GP, who was incredibly nice and helpful and was willing, on the basis of the letter she received from him a month or so later, to convert my private HRT prescription to an NHS one (so I could benefit from cheaper prescription charges). She also got me speech therapy on the NHS, which is why I sound so lovely.

I eventually had to go through the NHS gender clinic system when it came time to get GRS, which was kind of a trial, but I’d already been on HRT and transitioned for about six years when I entered the system. I still had to have an interview with a psychiatrist (who assessed me to see if I was really interested in being a woman; note that I’d come to the interview straight from a workplace where for three years everyone thought I was a cis woman) to get my referral to Charing Cross (the NHS gender clinic in London), but the psychiatrist at CX who was a total dick to me and fucked with my hormone dose has since retired, and the other two—presented with a trans woman who despite having circumvented their preferred system to begin with was clearly getting on with life and just needed GRS—happily rubber-stamped me without any fuss.

For UK residents trying to get started on HRT now I think I would suggest getting yourself into the NHS gender clinic system but also seeing about getting some hormones off prescription in case they slap you with huge waiting times. There are still Russell Reid-style private gender clinics if you’ve got the cash, but you’ll probably have to pay for a couple of sessions before they’ll prescribe these days, because of the hand-slapping Reid got. Possibly worth it to side-step the queues if money isn’t a problem. If anyone has any better information or if I’ve made a mistake, I’ll publish your comment/ask.

(I also hope you don’t mind me publishing this; I’ll take it down without question if you would prefer keeping this private.)

Useless general NHS response (as I have no idea about the treatment process in the NHS now):

I have no idea if he’s accepting patients any more, but there is an endocrinologist in Bristol (at the Bristol Royal Infirmary) by the name of Prof Andy Levy. He had an enormous amount of interest in the ill-researched area of hormone therapy for transgendered people. He did try and set up a GID clinic in Bristol, but don’t think he ever managed to get very far.

He looks after my dodgy liver, and seems a generally sensible chap – and I’m aware he’s got a few transgendered patients in his main clinic. But I’m not sure if that’s very much use to you – especially since I don’t know if he’s still taking people to that clinic – and as always ymmv.