SleepyCatten<p>Hey folks :TransHeart: </p><p>So, we're going to try to keep this post shortish for our own wellbeing and sanity, as well as yours.</p><p>We will, however, frontload some abbreviations and links:</p><ul><li>EOEGS - <a href="https://ncth.nhs.uk/east-of-england-service/" rel="nofollow noopener noreferrer" target="_blank">East of England Gender Service</a></li><li><a href="https://transactual.org.uk/medical-transition/gender-dysphoria-clinics/" rel="nofollow noopener noreferrer" target="_blank">Gender Clinics</a><ul><li>Aka GIC (Gender Identity Clinic) or, solely by the NHS, Gender Dysphoria Clinic (GDC)</li></ul></li><li>IFR - <a href="https://www.england.nhs.uk/contact-us/privacy-notice/how-we-use-your-information/our-services/individual-requests-for-funding/" rel="nofollow noopener noreferrer" target="_blank">Individual Funding Request</a></li><li>ICB / ICS - <a href="https://www.nhs.uk/nhs-services/find-your-local-integrated-care-board/" rel="nofollow noopener noreferrer" target="_blank">Integrated Care Board</a> / System</li><li>GDNRSS - <a href="https://ncth.nhs.uk/gdnrss/" rel="nofollow noopener noreferrer" target="_blank">NHS Gender Dysphoria National Referral Support Services</a></li><li>GAHT - Gender-Affirming Hormone Therapy</li><li>FFS - Facial Feminisation Surgery</li><li>VFS - Voice Feminisation Surgery</li><li>GP - General Practitioner</li><li>PALS - <a href="https://www.nhs.uk/nhs-services/hospitals/what-is-pals-patient-advice-and-liaison-service/" rel="nofollow noopener noreferrer" target="_blank">Patient Advice and Liaison Service</a></li><li>PHSO - Parliamentary and Health Service Ombudsman </li></ul><p>We have already written up about some of our early experience of trying to get gender-affirming care from the NHS in an <a href="https://transactual.org.uk/blog/2023/10/21/i-have-no-gender-affirming-care-and-i-must-scream/" rel="nofollow noopener noreferrer" target="_blank">article for TransActual</a>, but that was published back in October 2023, so it's more than a little outdated now 😅</p><p>Back in August 2023, we knew it was possible to request funding for gender-affirming surgeries not routinely covered by the NHS via IFRs. These are submitted to your local ICB, who will likely refuse funding unless you've made a really good funding case.</p><p>(It's worth noting here that such gender-affirming surgeries are recommended by WPATH's <a href="https://www.tandfonline.com/doi/pdf/10.1080/26895269.2022.2100644" rel="nofollow noopener noreferrer" target="_blank">SOC8</a>: the NHS just disagrees and refuses to follow the international recommendations.)</p><p>Nonetheless, we mostly just wanted the chance to put our case forward for VFS. A standalone bilateral orchidectomy and FFS were there, but as lower priorities, since it was our voice causing us the most issues.</p><p>(We won't list all of our voice dysphoria issues here, but basically we've been doing voice feminisation training since December 2021 and we're nowhere near even the lowest-end voice goals. Our voice leads to us getting regularly misgendered both on the phone and even in person 😞 We've done our genuine best for years and VFS is very much our last resort.)</p><p>We are going to give selective details of what's happened since, but we'll first cut to key points: the EOEGS (our gender clinic) has been refusing to comply with their responsibilities for approaching <strong>2 YEARS</strong> and no-one within the NHS will hold them to account.</p><p>First they denied responsibility for IFRs and tried to say it was our GP's responsibility. So, we went to our local ICB to ask them and got given the details for the NHS England IFR team, who told us -- in no uncertain terms -- that it was the responsibility of the EOEGS to submit these for us. That was back in very early 2024.</p><p>We forwarded this to the EOEGS, and then followed it up with them at our 3rd appointment (Q1 2024). They still denied responsibility, so we forwarded on the proof again. And waited. 3 months later (Q2 2024), we chased... and waited again.</p><p>Near the end of Q3 2024, the EOEGS <strong>finally</strong> wrote up the notes from the 3rd appointment (~6 months ago), and mailed them to us and our GP in the post (no digital copy or email)... with multiple factual errors :Sighing_Face: 🤦♀️</p><p>So, we scanned the letter, turned it into a PDF, then highlighted and corrected <strong>all</strong> the errors. We then politely emailed it across to the EOEGS, CCing in our GP, along with a clear restatement of outstanding issues and requests.</p><p>As the quarter ended, we got an offer of a 4th appointment (more surgical referral gatekeeping nonsense) next quarter. Then silence, yet again.</p><p>Q4 2024 came around. The EOEGS claimed that the IFR issue was still with its "service lead". We raised it at the 4th appointment. No answers. Only further promises to look into it and get back to us.</p><p>As 2024 ended, we went back to the NHS England IFR team. They confirmed once again that our gender clinic was shirking their responsibility over IFRs. So, we chased the EOEGS for the last time that year. No response ever came.</p><p>As we moved into 2025, we reached out to GDNRSS to ask for guidance and help. They responded quickly, but advised that the only thing we could do was to raise a complaint with PALS.</p><p>So, that's what we did, CCing in the EOEGS, and made it very clear that this was only being done as a matter of last resort.</p><p>By now, as you can imagine, we weren't expecting anything great. However, we hadn't been mentally prepared for the combination of incompetence, lack of reading comprehension, and institutional malice that followed.</p><p>They'd send us a complaint response that didn't show any understanding of our complaint. We'd go back and clarify the issues again, and suggest a call to discuss it. They'd investigate more, say that they'd pass along our request for a call, delay the response, and then send another one which again failed to address the core issues.</p><p>By Q2 2025, we reached the point where they refused to take the complaint forward any further, and just directed us to the PSHO, which is very much biased towards whatever the current government wants.</p><p>In other words, we'd run out of options to hold the EOEGS accountable 😞</p><p>NGL: in combination with multiple other factors, this kind of broke us, and we simply had none of the time, energy, spoons, or motivation to follow up any further.</p><p>After a few weeks, however, we decided on 2 last-ditch options available to us:</p><ol><li>Raise a <a href="https://gdpr-info.eu/art-15-gdpr/" rel="nofollow noopener noreferrer" target="_blank">DSAR (Data Subject Access Request)</a> under GDPR to request a copy of any and all communications mentioning us (directly or indirectly) and our requests by all organisations and individuals involved.</li><li>Reach out to the senior partner at our GP surgery, via the practice manager, to ask if they'd consider submitting an IFR for us for at least VFS.</li></ol><p>On the 1st point, the ticking clock for that started just a few days ago. Officially they have 1 calendar month to comply, but can request up to 3 calendar months if the request is deemed complex. We are under no obligation to agree to this as the data subject.</p><p>On the 2nd point, the senior partner had a call with us over the issues, then asked whether we could compile all the info on everything for him. We said it would be difficult for us, but agreed, so he booked a follow-up appointment for us on 2025-06-09 (yesterday).</p><p>NGL: going through all the emails and documents again, then summarising them into a chronological sequence of events, was very, very difficult for many reasons, but primarily because it meant going back through everything and reliving the cumulative trauma of it :PleadingFace: </p><p>Nonetheless, we finished compiling it all just a couple of hours before the appointment. A "summary" document that spanned 4 sides of A4 and all the relevant "receipts" (digital documents like emails and PDFs), covering from August 2023 to June 2025.</p><p>Whilst the senior partner said it will take him time to go through it all, the key thing is that he agreed to submit the IFR for us.</p><p>It honestly made us teary just to have someone actually care enough to truly listen and be willing to discuss it with us :FaceHoldingBackTears: </p><p>Of course, this is just the beginning of another long, drawn-out process. It's likely going to take at least several weeks until we even get to the stage of working together to put together the best case possible, let alone getting the IFR submitted. It could even be months.</p><p>Even when it's submitted, it'll then be up to our local ICB to review the submission, and they will almost certainly find a reason or reasons to deny the application.</p><p>We're still not expecting this to succeed. We just wanted to have the chance to have at least one request submitted and reviewed.</p><p>The EOEGS and other NHS departments spent a level of magnitude more time, energy, and resources denying us the <strong>right</strong> to even consider submitting IFRs for us because, we suspect, they didn't want to set a precedent of trans patients in England utilising their rights.</p><p>Or maybe just because they didn't want to comply.</p><p>Whatever happens with the eventual IFR submission, at least we'll have tried every way we can think of to get the NHS to fund a basic gender-affirming surgery that would massively improve our daily quality of life.</p><p>If by some miracle the IFR is approved, it'll give us and maybe others a small glimmer of hope.</p><p>But realistically-speaking, at least then we can create a fundraiser for VFS with a clear conscience that we tried everything else we could first 🥺</p><p>If you got this far, thank you for reading this :TransHeart: Feel free to boost it, if you want others to read it too :BoostsOKPrideSymbol: </p><p><a href="https://cultofshiv.wtf/tags/trans" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>trans</span></a> <a href="https://cultofshiv.wtf/tags/transgender" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>transgender</span></a> <a href="https://cultofshiv.wtf/tags/VoiceTraining" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>VoiceTraining</span></a> <a href="https://cultofshiv.wtf/tags/VoiceFeminisation" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>VoiceFeminisation</span></a> <a href="https://cultofshiv.wtf/tags/VoiceFeminisationSurgery" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>VoiceFeminisationSurgery</span></a> <a href="https://cultofshiv.wtf/tags/VFS" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>VFS</span></a> <a href="https://cultofshiv.wtf/tags/VoiceDysphoria" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>VoiceDysphoria</span></a> <a href="https://cultofshiv.wtf/tags/NHS" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>NHS</span></a> <a href="https://cultofshiv.wtf/tags/NHSEngland" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>NHSEngland</span></a> <a href="https://cultofshiv.wtf/tags/EOEGS" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>EOEGS</span></a> <a href="https://cultofshiv.wtf/tags/PALS" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>PALS</span></a> <a href="https://cultofshiv.wtf/tags/IFR" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>IFR</span></a> <a href="https://cultofshiv.wtf/tags/ICB" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>ICB</span></a> <a href="https://cultofshiv.wtf/tags/ICS" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>ICS</span></a> <a href="https://cultofshiv.wtf/tags/GDNRSS" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>GDNRSS</span></a> <a href="https://cultofshiv.wtf/tags/GAHT" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>GAHT</span></a> <a href="https://cultofshiv.wtf/tags/GDPR" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>GDPR</span></a> <a href="https://cultofshiv.wtf/tags/DSAR" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>DSAR</span></a> <a href="https://cultofshiv.wtf/tags/TransRights" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>TransRights</span></a> <a href="https://cultofshiv.wtf/tags/TransRightsAreHumanRights" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>TransRightsAreHumanRights</span></a> <a href="https://cultofshiv.wtf/tags/LGBTQ" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>LGBTQ</span></a>+ <a href="https://cultofshiv.wtf/tags/LGBTQIA" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>LGBTQIA</span></a>+ <a href="https://cultofshiv.wtf/tags/queer" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>queer</span></a> <a href="https://cultofshiv.wtf/tags/GenderAffirmingCare" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#<span>GenderAffirmingCare</span></a></p>