GPs will be paid for trans hormone prescriptions - Sussex

Why does Sussex so often end up at the forefront of whatever batshittery is going on in a given week? Even things which have nothing to do with local government such as Prof. Stock's harassment seem to gravitate locally.

I don't think any money body should be given hormones to try and change their sex. Too many people are in pain with disease and life threatening illnesses and these are a priority, whilst even if hormones are given people can't change their sex anyway you born male and female with the chromosomes for either male or female. My only exception to this is intersex people who are different and I don't know what help they may require

@Cuck00soup
That would require a radical change in the GMS contract and how General Practice is funded. The core GMS contract covers only a tiny fraction of what a GP practice does and currently the flat sum GPs are paid per patient to provide care (about £99 per patient per year) does not cover even the basics anymore. Primary care does 90% of NHS work for 10% of the budget. The managerial and administrative structure at NHS England itself gets 15% of the budget.

I won’t derail the thread but general practice funding structure is not about paying GPs to get them to do the work they should be doing anyway.

I struggle with GP enhanced services in principle because I don’t agree with incentivising people to do the job they should be doing anyway. That said I have in the past developed local schemes to improve diagnosis - and therefore treatment of - some conditions.

This is Sussex so the public health drivers are relevant.

But unless incredibly well run, there is a risk of enthusiastic prescribing without considering the situation holistically. And 2 and a half hours online training seems barely adequate. The service may be for adults, but it doesn’t mean they are not at risk.

Which could be -
A self disgust at being homosexual
Hatred of body due to sexual abuse
Mental health issues such as bi polar ect
Autistic and feels like not fitting in to society.

Yes and another is simply GNC, and has been told by teachers and/or parents that this means they are the opposite sex, and made a fuss of over their "transness". This is one that bothers me and several other women I know a lot. I would absolutely have been "transed" as a child if I was in the current climate and an in a gender-pushing school. In fact I was a tomboy who grew up to be a happy, and sometimes "tomboy", woman. I did at one point want to be a boy - simply because there were gendered restrictions on me as a girl that I didn't like. It was because I knew I couldn't be a boy that I worked through it. Many kids now literally don't know they can't actually change sex and what they're signing up for is physical damage and pain to a body that will stay the same sex.

Jess I've been on one wait list 35 weeks but led to believe it could be another 2 years at least. One dc waited 2 1/2 years for treatment (now waiting potentially another year for the next step) and another dc has just passed the 18 month wait on camhs (we were seen after 9 months when they agreed therapy was necessary). If we went private for dc therapy we would be taken off the camhs list.

This is where it becomes transparent about the big money Pharma behind this this drive to push transgenderism.

I read a document today that said adults and young people would be included in this.

Also don't forget if the new conversation therapy law went through it would mean that GP would not be able to challenge these people/young people as in ... in fact it would be illegal.

'Why do you feel you are in the wrong body? Can we have a look at any other underlying issues?'

Which could be -
A self disgust at being homosexual
Hatred of body due to sexual abuse
Mental health issues such as bi polar ect
Autistic and feels like not fitting in to society.

We have to really really look at why way more young girls are transitioning than young boys.

And lets not forget these 'hormones' cause so mach damage to the body over time. Kidney failure, osteoporosis amongst many.

So whilst grown adult men are free to take the hormones - although I'd put money on they don't take them as they lose their erections and as we know the vast vast majority of adult men like to keep there penis when they transition.

I am not arsed about adults doing this ( they can pill pop what they want) - its the kids that are following suit we really needed to be alarmed with.

The Government guideline states that the maximum time anyone should wait for treatment is 18 weeks. Yet I have been told that the wait time for my treatment is 4 years. This will hopefully speed it up and make it comply with government guidelines.

At least the 2 1/2 hours online training requirement provides a get out for more ethical GPs. They can simply not do the training.

I wouldn’t be too concerned about this
It’s largely irrelevant as in most areas of sussex it will take years for them to actually obtain a gp appointment to get the prescription.

Just seen in the article there is a new acronym. TNBI. does this mean we will now have LGB and TNBI. This would definitely work better on separating the two groups which have nothing on common and often conflicting interests.

Hear, hear!

Some DSDs have physical health issues. This is about the only sensible part!

This is absolutely not a sensible part. This needs specialist investigation and care.

I'm 100% agreeing with you about how worrying this is though, I'm just trying to explain how this scheme will be positioned as 'business as usual' by NHS England.

"A spokeswoman for Sussex Commissioners said: “Transgender, non-binary and intersex (TNBI) people experience significant health inequalities — something we are committed to tackling.”"

"Hayton questioned the level of psychological support in the scheme. “When I transitioned I had an hour with a therapist every week for months,” she said. “That’s what I needed to understand myself. An annual review is a pale shadow of that.” Doctors will also have to monitor patients and carry out blood tests to ensure they are taking treatments safely."

Those two statements seem to contradict. Do they really experience health inequality?

Mental health services generally are really underfunded. It's very difficult to access appropriate treatment and timescales of any treatment are often limited to short periods such as 6 weeks if/when you do get it. I have a serious mental health condition and often have periods when I am suicidal and I get no support at all. When I do get any support tbh it's pretty useless ime (eg a monthly call from a mental health nurse was the most recent offering - I stopped those as they were completely ineffectual). If you can access a weekly appointment "for months" I would say that's fucking amazing in comparison to support in offer for many other conditions.

I also have ADHD. Untreated ADHD has extremely poor physical and mental health outcomes including limited life expectancy. Yet in many areas there is no diagnostic service at all and where there is a service the waiting times are years long, 4-5 years in some areas. Then when you get an assessment it's sometimes inadequately carried out. So the long wait time for trans people send to pretty on a par with or better than what's being offered to everyone else - it's pretty shit for everyone ime!

Ideally mental health services would be improved across the board including for trans people, but tbh if it was a choice my vote would be to improve the services for children and young people first as CAMHS is particularly dire. Even referrals for suicidal children are declined by the service as they are so underfunded, it's appalling.

So I don't think there are "health inequalities" for trans people. NHS Mental health services are shit for everyone. It's all pretty equal.

Just seen in the article there is a new acronym. TNBI. does this mean we will now have LGB and TNBI. This would definitely work better on separating the two groups which have nothing on common and often conflicting interests.

@MissLucyEyelesbarrow is correct. There are procedures set up for GPs to monitor and prescribe drugs initiated by specialists under what are called Shared Care Agreements. The crucial point though is that this is an agreement- GPs can decline if they feel they cannot do it safely and while that can be frustrating for patients it’s not something the GMC would concern themselves with. The difficulty with GPs prescribing for people, and especially children, who are waiting to see GIDS is that there is no equivalent in which GPs prescribe. The treatments are not evidence based, there’s concerns about ethics and even with additional training this is beyond the scope of GPs unless it’s going to be run by GPs with special interest in the way GPs do other roles e.g prescribing in drug addiction. But that usually requires postgraduate training, exams, assessments and so on not 2.5 hours online learning.

The fact that it’s GPs being put in this position is reflective of a couple of things. Firstly that whenever there is a gap in NHS provision of services the assumption is GPs will plug the gap. I am expected to do all manner of inappropriate tasks or have things passed to me with the expectation I will do it because unlike other departments our contract is essentially open ended and vague so people assume if it’s not their job it must be mine. In addition to this NHSE, governments of any colour and in fact a fair amount of non Primary Care managers, doctors, nurses etc don’t actually know what we do.

Add to the mix that these official bodies have been Stonewalled and it’s not hard to see how this has come about.

In terms of responsibility and what happens if someone changes their mind, detransitions and decides to sue it would be whoever prescribed the drugs, whether under specialist direction or not, who is held responsible. As for whether GPs will do it out of fear of a GMC referral or fear of being called transphobic I don’t know but I don’t think so. The principles of ‘first do no harm’ and not prescribing outwith your competence is so ingrained that I think there may be resistance to taking this on and there are many of us following the GMC’s previous directive on this who are unhappy at being put in the position of working outside our competence and being asked to make a ‘special exception’ for prescribing hormones although as with so many groups there are GPs who’ve already drunk the Kool Aid.

No, it's different because it's an NHS scheme. There are similar arrangements for various specialist drugs: a specialist initiates them, but GPs prescribe follow up prescriptions and do any monitoring required.

But that doesn't seem to be what's being proposed here. It's not doctors being asked to prescribe hormones and do blood tests etc for a patient who has been diagnosed by a specialist clinic which has recommended a particular course of treatment.

What is being proposed here is that the doctors will prescribe the hormones while the patient is on the waiting list for the specialist clinic. Such a patient will not already have a diagnosis and appropriate treatment will not have been recommended by the specialist.

Pisses me off that the taxpayer pays millions for controversial treatments of unproven benefit to treat the self-diagnosed neuroses of confused people but I have to pay privately to fund IVF that I only need because the NHS damaged my womb 😡

I don't know why the post I replied to was deleted. It was a quote from the article
"Setting out its reasons for launching the scheme, Sussex Clinical Commissioning Groups said that research showed “the most frequently suggested action for improving healthcare for trans people was an increase in awareness training within primary care”.

I was commenting on that in asking who was this 'most commonly suggested' by? I'd be very very surprised if it was the GPs that suggested it . . .

And (I'm on a roll, now 😉), if i said I didn't feel I could safely prescribe the RA drug, the patient might complain, but i would be supported by the BMA and the GMC, as long as I had reasonable grounds for saying so.

But the BMA, NHSE and GMC are 100% Stonewalled. I would have no confidence at all that they would back me up if I objected to prescribing for a trans patient on safety grounds. On the contrary, I would expect to have disciplinary action taken against me.