This is a little bit confusing because I filled in the original for on the 28th March, again on 11th April and then for a third time on 16th April.

Is this prescription from the first time I filled in the form or the last time?

Whatever, I need my prescription so I’ve paid the pharmacy and if I receive further prescriptions from filling in the form the second and third time I will be grabbing these as well so I have a stockpile.

I still haven’t received my pharmaceuticals yet and id anticipate this being another week which will means its been over a month since the original request and I will have run out of my previous prescription medications by then.

Sort yourselves out Gender GP!

In the meantime, If you are thinking about using their services, think hard as what was once a great service has been sadly lacking in professionalism recently.

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Today I taken a CLYNXX prescription, which is a digital prescription, to the local pharmacy at Tesco. They have filled my last five prescriptions and when I presented this digital one over she printed my digital prescription out and then questioned the validity of this prescription. Back to validity again!!!!

Apparently, Tesco pharmacy have been told not to fill prescriptions where the prescribing doctor is not a UK doctor.

The pharmacist at my local Tesco is usually very good and she said she would check this because it has come from the CLYNXX system there should not be an issue with filling this prescription but they have been told not to fulfil prescriptions from overseas doctors. No i’m worried!

However I am getting a little bit pissed off with the attitude I get from pharmacies regarding my private prescription and I do wonder why I don’t just buy my drugs on the black market. It would be easier that’s for sure.

I know buying things on the black market is a crapshoot but at least I will not have to put up with all the petty bureaucracy. You know “you can’t do this”, “you shouldn’t be doing this”, “the NHS says this”, etc.

If my doctors actually took over a care of duty towards me that I would not have such a shit every quarter to get my prescriptions fulfilled.

This is a whole can of worms that I don’t want to get into at the moment, as my doctors have metaphorically washed their hands of dealing with Trans issues.

I know some people might say,” oh you should wait for the NHS”

Well I’ve already been waiting 3 years and still haven’t actually seen a consultant yet.

With luck, I might not have to wait more than another 3 years to see the NHS specialist. Then my Doctors might think about taking over care of duty of my prescriptions like they have done for my blood tests.

I sometimes think the NHS would be quite happy for me to go back to being a depressive barely functional human being again!

This isn’t about money, this isn’t about being able to see a consultant, or even getting my prescriptions fulfilled. Its also about the constant changing, and dare I say blocking of trans people’s right to care and prescribing drugs, even when their getting private prescriptions and PAYING FOR THEM THEMSELVES.

I await to see whether or not I can get my prescription fulfilled and in the meantime, yet again, I despair at the medical and pharmaceutical profession!

Time will tell on this one and hopefully I get my prescription fulfilled in a timely fashion.

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After the elation a few weeks ago that my Doctors were finally going to help, this week it’s made me realise than the help is still not forthcoming, and nothing has changed since I started this process.

Gender GP told my GP years ago I would need blood tests done at the minimum of every year.

They have done this once so far and now the doctors will not share the blood test results with Gender GP unless they write to them again and request this. Alternatively, I must collect these results and pass them on to Gender GP.

This has never been an issue when I’ve had private blood test done.

From this point on I’ll be cutting my own GP out of the loop as they’ve had my blood test results each time off my care provider.

My doctors have also told me today my Oestradiol and Testosterone levels are normal? Normal for what?

It took me 20 minutes for them to give me the levels over the phone. 0.9nmol/L for Testosterone and 101pmol/L for Oestradiol. Which is on the low side. I know this because I’ve been paying for blood tests every quarter for the past 3 years and its always been between 142 and 207 for over 18 months.

I was so right not to wait for the NHS and do my own care, and after this fuck up, I’ll be doing the same again next quarter.

Next step is to get my Gender Recognition Certificate completed, my GP to sign it and then once that’s done I can fuck off to a more Trans friendly GP.

The irony of the doctors surgery not willing to help me so now I am self-medicating and thats not supposed to happed under NHS guidelines especially as I am under the care of a Gender Identity service, albeit not an NHS one because the waiting time is not over 5 years from date of referral!

NHS Guidelines

In March 2016 the General Medical Council (GMC) published Guidance for Doctors Treating Transgender Patients. This guidance reiterates the advice previously set   out by NHS England in SSC 1417; and also explains the legal protection against discrimination and harassment given to trans people by The Equality Act 2010 and Gender Recognition Act 2004.

 General Practitioners should co-operate with the specialist Gender Identity Clinics and prescribe hormone therapy (feminising or virilising endocrine therapy) recommended for their patients by the Gender Identity Clinic. The specialists at the Gender Identity Clinic make recommendations for the prescription and monitoring of these therapies but they do not directly prescribe them, or provide physical and laboratory monitoring procedures for patients.

 The decision on whether or not to provide long-term feminising or virilizing endocrine therapy requires the skills of a gender specialist physician, usually working within a Gender Identity Clinic.

 Typical drugs recommended by Gender Identity Clinics include oestradiol preparations (e.g. transdermal oestradiol gels and patches, and oral oestradiol preparations), testosterone preparations (e.g. gels, and Sustanon® and Nebido® injection), gonadotropin releasing hormone analogues and depilatory agents (e.g. Vaniqa®); this list is not exhaustive. Apart from Sustanon®, there are no licensed products with an approved indication for the treatment of gender dysphoria. There is, however, extensive clinical experience of the use of these products in the treatment of gender dysphoria over decades, which provides evidence of tolerability and safety comparable with their use for approved indications. The prescription of licensed products outside their approved indications, often but not always at the recommendation of a specialist provider, is not uncommon in general practice.

 General Practitioners should collaborate with Gender Identity Clinics in the initiation and on-going prescribing of hormone therapy, and for organizing blood and other diagnostic tests as recommended by the Gender Identity Clinics.

 General Practitioners are also expected to co-operate with Gender Identity Clinics in patient safety monitoring, by providing basic physical examinations (within the competence of General Practitioners) and blood tests and diagnostic tests recommended by the Gender Identity Clinic. Hormone therapy should be monitored at least 6 monthly in the first 3 years and yearly thereafter, dependent on clinical need.

 The Gender Identity Clinic is expected to assist General Practitioners by providing relevant information and support, including the provision of guidance regarding the interpretation of blood test results

British Medical Association guide for dealing with patients with Gender Dysphoria

I also love this article, parts copied below, on the British Medical Association website: https://www.bma.org.uk/advice-and-support/gp-practices/gp-service-provision/managing-patients-with-gender-dysphoria

Be mindful of the sensitivity of their condition and of how difficult it might have been for your patient to seek treatment.

Yeah, that didn’t happen!

Be particularly mindful of medical confidentiality, when addressing your patient in person and in written correspondence.

Yeah, that didn’t happen either and my GP are still dead naming me now

Avoid misattributing commonplace health problems to gender.

They refuse to look at me as someone who has had 2.5 years worth of HRT and look solely at me as male.

Assist those patients who wish to change their personal details on their practice medical record. 

Thats the best one. Despite having 2 copies of my deed pool in person and one via emails my GP still dead names me.

Inform your patient of any gender-specific disease prevention and organ screening programmes, including offering information on how to opt out and discuss any future family plans and fertility treatments options.

Nope, nothing!

Refer early to a reputable NHS GIC (gender identity clinic).

You mean like an NHS approved service where the waiting list is many years long? How many people either kill themselves, self harm or give up because they are unable to access Gender services?

Get informed about prescribing medicines that you are not normally familiar with. 

My GP haven’t spoke to me once about this

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It is my understanding that the GMC is again trying to make things difficult for Transgender people by restricting the pharmacies that dispense Synarel for gender clinics!

This is on the Gender GP website:

“Following the Bell v Tavistock ruling, the General Pharmaceutical Council has targeted the pharmacies that dispense most of our Synarel. This has led to some disruption of supplies. We are always investigating alternative providers, and in the meanwhile, any chemist in the UK and EU is able to dispense medication prescribed by us.“

I’m not going to go into the Bell vs Tavistock case but here are some helpful links to help you understand what’s been going on:

• Bell v Tavistock Judgment, Courts and Tribunals Judiciary
• Wikipedia Bell vs Tavistock, whether puberty blockers could be administered to minors
• Transgender issues in the Court of Appeal: Bell v Tavistock update
• Mermaids statement on the Bell v Tavistock appeal

No, no, no good!

This is not good for trans people. If the dispensing chemists, we have been using are being targeted and the supply of Synarel is being disrupted.

I’ve had problems getting my prescription fulfilled and then further prescription supply issues in January and these issues just compound things and cause both anxiety and also withdrawal issues if drugs cannot be sourced.

At this moment I am having to source this drug from alternative suppliers, and I have also had to change my Estradiol prescription because there is also a shortage of this. At this moment, I am unsure of the reasons why this should be in short supply!

This lack of supply is not a good thing and hopefully, these Synarel shortages won’t last long!

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