I’m a boring old peri menopausal female in my late 40s and my GP declined to prescribe HRT without specialist supervision due to family cancer history (even though I’ve been tested for my mother’s BRCA gene fault and definitely haven’t inherited it).
it was a 2 year and 4 month wait from referral to a telephone appointment with an NHS Consultant Gynaecologist working at the regional menopause clinic (yes, 28 months! And yes I started to wonder if I would’ve finished menopause before I saw anyone!) but I wouldn’t want my GP to ever feel coerced to prescribe outside of her competency, for both my physical safety and her professional good standing.
As it happens that two year wait ended with a five minute call (on a Sunday morning!) and me being discharged back into my GPs care with a recommendation letter for HRT (actual HRT, to replace the actual hormones my body once produced plenty of) so it was a massive long wait for what be the shortest specialist appointment on record.
Nonetheless the only part of this system that I have complaint with is the the lack of menopause clinic capacity for the almost entirely predictable numbers of women reaching menopausal age each year - which., save for a little immi and emi gration has been mostly forseeable for nigh on 50 years, unlike trans identity, which has had a weird social-contagion driven spike followed by a continuous but more gradual rise.
Also, gynaecologists and specialist nurses should theoretically be easier to recruit than gender transition staff because gynaecology is taught in medical school and has a recognised pathway to specialism,
Whereas fuck knows what GIC staff are qualified in - a mish mash of eccentric psychiatrists and naive clinical psychologists (who leave as quickly as possible) and a two tier diagnosis and ‘treatment’ system that allows the psychs to blame the endocrinologists and surgeons and the endocrinologists and surgeons to blame the psychs (and everyone to point at WPATH) when the ‘treatment’ does nothing to improve the patient’s long term quality of life whilst destroying their fertility, sexual function and increasing their risk of stroke, heart attack and cancer.
No wonder loads of GPs want nothing to do with it.