Q.2. I am a trans woman and have been refused referral for surgery by my psychiatrist from the Gender Identity Clinic. This is apparently I have not complyied with the Clinic's criteria. I have been living as my true self for several years. The clinic won't say what their criteria is. I want to challenge this .
Answer: Here are 5 things you can do now - we suggest you do all 5 activities at the same time, as each will lead down different pathways, but most should join up at the end and help you determine what has gone wrong.
It is poor judgement on the part of any clinician to impose ‘extra’ criteria as to suitability for future treatment if patients are not fully informed in advance of any part of any treatment, including assessment.
Extra requirements being put in place, that is changes to your expectations, without being informed about the changes in advance, can constitute an ‘irrational decision’ by a Public Sector body. As such, a judicial review of the decision can be sought. However, judicial reviews can prove to be very expensive, as now government departments and Public Sector organisations tend to argue that if they win the case they will pursue the other side for all of costs in dealing with the case. This can easily be more than £10,000. IN a case like this, it would be at most a small fine,
OBTAIN THE CRITERIA
Firstly, you should ask your GP to write and obtain the details of your Psychiatrist’s refusal to refer you to an appropriate surgeon. Secondly, if the clinic is part of a hospital, you can make a formal complaint by writing to the hospital complaints manager asking for details for the refusal, and seeking an apology. If you are having problems discovering who the hospital complaints manager is, then call the Hospital Switchboard and ask them for the Complaints Office.
Thirdly, you can ask your GP to refer you to another psychiatrist at another, or the same, Gender Identity Clinic for a 2nd opinion.
Fourthly, you can contact your MP, asking them to ask the Gender Identity Clinic or the Hospital for further details of the refusal and a copy of the document containing the Clinical criteria that is being used.
Finally, you can ask at your GP’s reception for details of the Patient’s advisory Liaison Unit (PALS). You can make a formal complaint through them.
Seeking further advice from Press For Change in cases like this.
For PFC to advise you more accurately and possibly argue on your behalf regarding your access to treatment, PFC ask clients to write a short EVENTS diary, but please make sure it contains the following:
1. Which clinic have you been attending?
2. What is the clinics address & phone number?
3. What is the name and address, including phone number and emails of the Clinic Manager?
4. What is the name of your Psychiatrist at the clinic?
5. When did you first attend the Gender Identity Clinic?
6. How many appointments have you had to date at the clinic?
7. Have you any additional health concerns?
8. When was your last appointment with the clinic?
9. Details of when you commenced living permanently in your preferred Gender role?
10. What other status do you have i.e. are you a Student (full time or part time), voluntary worker, or in full or part time employment. etc.?
11. Have you had a letter confirming your refusal,? If yes, please send us a copy of it?
12. If you or your GP have had a letter confirming the Psychiatrist’s refusal to refer you further, please send a copy of it to us here at Press For Change , the TransEquality project. Then provide as short outline of any treatments, including hormone therapy or surgery which you have received to date. Let us know if you have any further information e.g. did you argue with the psychiatrist, or did you feel the psychiatrist was rude to you, or any other matter, which you feel, may have influenced the psychiatrists’ decision?