I am an NHS GP with a special interest in sexual health and gender care. I am passionate about equality in healthcare and reaching out to those minorities that may face prejudice from healthcare professionals. www.GenderGP.co.uk
The problem with talking about driving lorries, performing open heart surgery and other extreme specialist services is that it dilutes what we are actually talking about here.
Many GPs refuse to refer to GICs, a lot of GPs refuse to share care with the specialist clinics, too many GPs turn patients away because they say they don't know anything about gender care.
It is the small steps of listening, caring, sharing care, referring appropriately that we could ALL do.
And then, for perhaps the more modern thinking GPs, bridging prescriptions or initiating therapy in very easy cases of gender dysphoria will honestly save lives.
My 'crusading zeal' is not trying to persuade you to perform gender reassignment surgery in the car park, but to just do what GPs do best.
Hi, the trouble is that the specialist clinics are bursting and a lot of very simple cases could actually be managed in Primary Care.
Many GPs are currently even refusing to monitor or prescribe under supervision of the gender clinics, for reasons that they 'don't approve' or 'don't agree' with this as a condition. So that could be a very simple step to take - just to agree to shared care.
Some patients are do desperate that they are self-medicating and looking for safe and reliable sources of medication. I am hoping that more GPs would feel able (as the GMC recommends) to offer a bridging prescription while they wait for the GIC.
And then maybe some other GPs would like to do a little more training to take this speciality on a bit further, and offer simple hormone regimes for cross-sex therapy. Many cases are barn-door, simple presentations, and the family GP could be by far the best person to help.
We don't all have to take this on full steam ahead, but if we all did a little bit more than we may do now, then this very rewarding condition could be helped better, and maybe the shocking self-harm and suicide statistics may improve.
We don't have to all become gender specialists, but actually if you read around the subject we can make little steps to make the lives of these gender variant people much happier and healthier.
The issue that we have is that gender care is on a true spectrum, and some of the cases are really very simple. Imagine a person, born male, who has felt female since birth. Secretly always cross-dressed and now, out of desperation, started taking estradiol bought off the Internet to try and make the body match the mind.
All we need to do is listen, care, replace the potentially dangerous drugs with prescription meds and check some blood tests.
The waiting times for the gender identity clinics in some areas are currently approaching 4 years, and with referrals rising rapidly, we should leave the specialist clinics to deal with the complex cases - because many are in fact very simple - and our GP skills are perfect for these desperate patients.