Trans man forced to wait 10 agonising years to start testosterone: ‘I don’t have any mirrors in my flat’
A trans man who’s been waiting 10 years to access testosterone on the NHS was denied the treatment by his GP because of “unacceptable risk”.
Jacob Jones, 30, has been out as trans since he was 12 and first went to an NHS gender clinic when he was 21 and living in London. But in almost a decade, he told the Blackpool Gazette, he’s only been seen three times by a gender specialist – and his GP is refusing to prescribe him testosterone.
The General Medical Council and the Royal College of Psychiatrist’s both advise GPs to prescribe a “bridging prescription” of hormone therapy to trans patients on long NHS gender clinic waiting lists where they might otherwise access the hormones illegally, are at risk of self-harm or suicide, and when the GP can get advice from a gender specialist.
But, like Jacob, many trans people report that their GPs refuse to help, even when those criteria are met. According to a survey of 68 trans patients by private trans health clinic GenderGP, 80 per cent of trans people on NHS gender clinic waiting lists have been refused a bridging prescription by their GP.
Speaking to the Blackpool Gazette, Jacob said: “The dysphoria is horrible. Looking at my body and knowing in your heart it’s not the body I should have is horrible.
“Even in the shower in the morning, even when I’m getting dressed, everything I do is affected. I haven’t got any mirrors in my flat at all, because I can’t bear to look at my body.”
The NHS guidelines state that patients should wait a maximum of 18 weeks for their first appointment at an NHS gender clinic after being referred by their GP. But in many parts of the country, people are waiting three years or more for that crucial first appointment – with no support or treatment in the meantime.
There are seven NHS gender clinics in England and Wales serving an estimated population of 200-500,000 trans people. The longest waiting list is at The Laurels in Exeter, where thousands of trans patients have been waiting for as long as five years for their first appointment.
When Jacob told his GP about the long wait and asked for a bridging prescription of testosterone, he was refused.
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A letter from the partners at the practice read: “We are sorry that we are unable to provide this treatment for you as it is outside of our area of expertise.
“As GPs we must recognise and work within the limits of our competence. We are responsible for our prescribing and should not prescribe where we feel it is unsafe to do so or where there is unacceptable risk.”
Jacob said: “I have been diagnosed with gender dysphoria, which is the criteria for hormone therapy. I’m just very frustrated because I’ve been trying to fight for this for years, and every single time I get knocked back. I feel like I’m going round and round in circles.
“It’s affected my mental health so badly I’ve had to have counselling. That’s coming to an end soon, but the cause of my depression, which is the fight that I’m having to go through, is still going on.”
A spokesman for NHS Blackpool Clinical Commissioning Group (CCG) said: “Prescribers are able to consider prescribing bridging treatment and where this happens it would normally be on the advice of a specialist.
“However, primary care clinicians may not feel confident to undertake prescribing of hormonal medication outside its normal licensed use. It is for an individual prescriber to make their own decision regarding this.”