GPs will be paid for trans hormone prescriptions - Sussex

[Igneococcus]

I don't quite get it, supposedly it is “not designed to promote the initiation of hormonal treatment in general practice" but also "The document adds that any decision to start hormone therapy is “at the discretion of the individual GP”.
Also it seems non-binary people also need hormones.

www.thetimes.co.uk/article/eb0eb198-b1f3-11ec-8570-b43daaf58ea1?shareToken=bda8d448f411c2d44f782d823721d844

It says "adults" so presumably 18 and up?

Surely the first step of any medical body is to actually define what it is they are actually treating.

No one can agree on any of it..or define it. There surely needs to be some kind of central criteria so everyone is on the same page.

It says intersex patients as well, why are people with a DSD included in this?

Surely we want them to transition properly, isn’t hormones the start?
You can’t scream “Men in dresses” and then complain when they are started down the track of full transition.

I don't think anyone cares about 'men in dresses'.
The concern is about men saying they are women and using women's spaces.
Also, concern about young people permanently modifying their bodies in ways that negatively impact their health.

But you would still be a male person in a dress with hormones . The only difference it makes is that you are causing damage to your body and becoming a lifeling patient

I don't want people to be given life changing hormone treatments without careful consideration and therapy before considering all options carefully and I very much doubt a GP can provide this kind of care.
I also don't think that taking hormones turns men into women.

Participating GPs must undertake two and a half hours of online training.

Seems thorough

So they're incentivising GPs to prescribe opposite sex hormones?

There's this:

A document, seen by The Times, says that the Sussex scheme is “not designed to promote the initiation of hormonal treatment in general practice”.

And then this:

It says that it aims to provide “interim support” to patients on the gender clinic waiting list and “improve access” to hormone therapy.

It's hard to tell if that means interim, or start of process.

Debbie Hayton thinks it's sub-standard, saying it's nothing like the processes she went through. Which she says are the right ones (longer, more checks).

@MintyMoocow

Surely we want them to transition properly, isn’t hormones the start? You can’t scream “Men in dresses” and then complain when they are started down the track of full transition.

That's the bigger issue.

When here talk about many facets of the while 'becoming Trans' journey. We talk about the realities of the medication, the real effects, or lack thereof, on gender dysphoria; the very real long term health issues medication does cause, the realities of the varying surgeries, the cost financial, physical and emotional; we discuss the differences between varying impetuses to become trans, what being trans actually means, what a "full transition" would actually be. And that is entirely separate from the issues around women's rights.

And yet still we get trite little pops like this. A quick admonishment for not being nice enough, for not caring enough.

Pshaw!

This sounds a bit like they're endorsing Dr Michael Webberley's "shopping list" approach, and not really on board with the concerns of the endocrinologist witness there.

@MintyMoocow

Surely we want them to transition properly, isn’t hormones the start? You can’t scream “Men in dresses” and then complain when they are started down the track of full transition.

If you think that medical professionals without in-depth training should be prescribing cross sex hormones based on a 5-10 minute slot as gold standard trans health, you have just shown you don’t actually care about trans people.

And if you think regulars on this board think there is a problem with a man in a dress, you are also showing your ignorance about what the majority on this board care about. Men can wear anything they want. They are still men though. And why should they need medical treatment to wear that dress?

Surely Minty, you can do better.

It also sounds a bit like a "oh god we need to do something" panic - from central government? because of the upcoming conference? - and this is being abseiled in without keeping up to date with the tribunal and so on.

The GP rep sounds unconvinced/worried about it. If it's just one location (or a few GPs), probably they'll be worried about going first and being overwhelmed.

I can forsee absolutely nothing going wrong here, whatsoever.

I fee sorry for the GPs, instead of investing in more specialised help, the government have pushed it all onto the GP, who will have a 10 minute consultation to deal with the patient.

but they are experimental with no long term study they are already linked to retardation of brain development and crumbling bones and teeth.

what happened to ethics?

And why is the " treatment " exactly the same for a teenage female (18 is still a teen) and a middle aged male.

If 3 people had the exact same cancer, 1 may opt for surgery, one may opt for chemo and the other may choose to max put a credit card and take a trip around Europe instead of taking treatment. And none of the choices reflect on anyones different choice.

But here treatment is seen as validate 1 to validate them all despite being from different stages of their life and different sexes and different circumstances. Uts seen as a personal.atgack on all trans people of one person is denied or decides not to take medication.

"They will also be able to claim an extra £91 a year for providing an annual health check to a transgender, non-binary or intersex (TNBI) patient."

The inclusion of 'intersex' patients suggests ideological capture not clinical thinking. Patients with VSD would not be seen by gender clinics anyway they must be treated by specialists - I'm guessing genital-urinary medicine and endocrinologists. And given the complexity of conditions in VSD how would a 2 1/2 hour online course cover it?

And non-binary? What is that these days?

Sasha Misra, an associate director at Stonewall, said: “With enough capacity and training, schemes like this could ensure trans people can access the specialist care they need in their local community and without the lengthy wait.”

Truly, has this quote been taken out of context? This person from Stonewall thinks that 2 1/2 hours is enough ‘training’ to make these GPs specialists?

I am very concerned for GPs in this. I suspect they are going to get a raw deal. Just as the patient is.

‘Interim support’ with a financial incentive to prescribe hormones, and a yearly check up. Maybe who ever has felt this was a good idea could tell us what is reversible in females with testosterone treatment?

How can prescribing testosterone to females be consider ‘interim’!!!

I am continually astounded by the lack of awareness of just how the treatments are so much more harmful to females. But that is never publicised and never discussed and when directly asked of extreme trans activists, ignored everytime.

Even here on this thread we have some plop something down about men in dresses. Perish the thought they ever think about female transitioners at all!

I guess this is what happens when a religion decides their sacrement is a medication rather than a food.

If you want wine or little biccies, you can just get them from the supermarket, then do whatever you do to bless them, but hormones are a little trickier to source.

Although, got to be careful about for religious bits, as Glinner noted.

@Lovelyricepudding

"They will also be able to claim an extra £91 a year for providing an annual health check to a transgender, non-binary or intersex (TNBI) patient."

The inclusion of 'intersex' patients suggests ideological capture not clinical thinking. Patients with VSD would not be seen by gender clinics anyway they must be treated by specialists - I'm guessing genital-urinary medicine and endocrinologists. And given the complexity of conditions in VSD how would a 2 1/2 hour online course cover it?

And non-binary? What is that these days?

NB now days is wanting to de-sex yourself I'm afraid, its cutting off boobs, dangly bits etc trying to be as much like a sexless toy doll as possible.

A few things to unpick here…

This is part of a move to try and set up services that are acting like satellite services for patients on GIDS waiting list.
Currently there is a referral form to complete for GIDS which asks questions about how and why someone wants to transition/identifies as transgender, what their mental health is like etc. It’s a pain in the arse to complete but is not (in my opinion) designed to be a thorough exploration of the patient’s situation and to be fair that’s not the point of a referral, that’s what GIDS should be doing.
Having recently (and unhappily because I have concerns about GIDS but can’t refuse because that’s the NHS pathway and a fear of being labelled transphobic if I speak up) referred a 16 year old teenager. I have had a reply telling me that there is a plan to set up this service starting in Spring 2022 because of how long the wait is and I may be asked to issue prescriptions. Ironically though they make it very clear that the patient will not be under GIDS clinical responsibility until physically seen.
To add some context to this a few years ago the GMC issued guidance to GPs about providing ‘bridging’ prescriptions for hormones to patients on GIDS waiting list which contradicts its own guidance about prescribing only within our own competence and many GPs were and are very unhappy about it. I’m aware of several colleagues who have had patients who’ve seen GenderGP have letters about prescribing hormones reminding them they can fall foul of GMC guidance on this in an attempt to coerce prescribing.

The funding thing is actually pretty standard. Funding for practices is really quite complicated. GP practices are paid a basic amount of money (around £99) per patient per year to provide all Primary Care services such as medication, appointments with doctors, nurses etc and to pay all the staff costs, utilities etc. Clearly that is not enough money so there is additional funding for non core services. For example, childhood vaccinations are non core, so if you do them you get paid etc. Lots of routine work is funded in this way. In addition to this there are other schemes that practices in some parts of the country are offered because there is a local need for it and practices sign up to offer this work for additional funding but have to demonstrate they have done the work in the contract.
The vast majority of GPs will not do something they think is not good for their patient just because they’ll get paid for it. The biggest worry here for me is that there will be those who will do it because they think they’re doing the right thing or because GIDS tells them it’s the right thing without being aware of the full issue.

@MintyMoocow

Surely we want them to transition properly, isn’t hormones the start? You can’t scream “Men in dresses” and then complain when they are started down the track of full transition.

Surely women transition too? Its not all about MEN

Surely we want them to transition properly

What does 'transition properly' mean? A man will no more be a woman if he takes drugs and has extreme cosmetic surgery than if he simply puts on a gender-nonconforming item of clothing. You cannot change sex.