What Happens at a Gender Clinic?
We’ve covered how you get a referral to a GIC, and a bit about going private, both of which are where you get treatment from, but what happens once you actually get there?
Child Gender Clinics
Child gender clinics are for anybody under the age of 17, not just for kids who haven’t started puberty yet, just so we’re clear.
There are two main gender clinics that treat trans children in the UK – London and Leeds.
Assessment at a child gender clinic takes a while longer than at an adult clinic, normally between 3 – 6 appointments over a period of months, at the end of which a child could be offered a number of things - hormone blockers, therapy or counselling for both the child and the parents, group work, and more.
Misconception – children are not offered hormones straight away like many people assume they are.
It takes a long time, sometimes years, to even get a first appointment at a gender clinic, for both children and adults alike.
Then, it takes a number of assessments or appointments with a gender specialist as an adult (or a team of people for children) to get access to medical treatment. The specialist will try to make sure you know what you want, and also know the effects of medical treatment, both non-reversible and reversible.
Children can be seen by:
A clinical psychologist
A child psychotherapist
A child and adolescent psychiatrist
A family therapist
A social worker
Whereas adults will normally see two specialists - the first is a gender specialist. The second, if an adult is offered hormones, is an endocrinologist. The endocrinologist helps manage the health of the person in question by dealing with prescribing doses of hormones as well as asking for blood tests from a GP, amongst other things.
Children don’t necessarily have to be seen by all the people listed above. It can be a case-by-case basis.
Parents also need to be involved, where the team of specialists will see the child and the parents together, but also separately, to learn as much information as they can about what the child wants and needs from them.
This is an important process in making sure that young people are safe and are given the correct treatment without rushing into anything more permanent. Although the process itself can be frustrating just due to how long it takes, and it’s okay to be frustrated by that.
Assessments by specialists are lengthy and ask about many areas of life to find out if medical treatment would be the right thing to do for the young person.
Blockers
This is where blockers come in.
Children, like I said earlier, aren’t just offered hormones right away. It’s not even easy to get into a gender clinic in the first place, so it’s no surprise that actual medical treatment is rigorously screened before anybody can start anything.
After 3 – 6 appointments at a child gender clinic, the team of specialists may come to the conclusion that blockers are right for the young person.
Blockers usually stop things like periods, pause breast development, and pause facial hair growth, amongst other things.
Like any medical treatment, blockers may have minor side effects like hot flushes or tiredness.
Blockers are 100% reversible. They pause puberty so that the young person has more time to think about their gender identity and how they identify. They will usually have to be on blockers for a minimum of a year before being offered hormones, otherwise known as hormone replacement therapy.
If the young person reaches 17, and wants to pursue hormones, they can be referred to an adult gender clinic.
Adult Gender Clinics
This is the process that I went through.
I was referred to a child gender clinic as a teenager, but by the time I got there I was already on the combined pill, which stopped my periods and made me a lot more comfortable with myself.
It took around a year to get to a child gender clinic, and after months of appointments, it was decided that I do meet the criteria for gender dysphoria, so I was given a gender dysphoria diagnosis.
I was offered blockers. But I was also about to turn 17, and the pill had done what blockers would also have achieved. So, I felt like the next natural step was to start hormones.
My diagnosis of gender dysphoria made everything else happen much quicker. But I know that not everyone has access to gender clinics at a young age, and that I was lucky to have things happen as quickly as they did.
My gender clinic referred me to adult services, and it took just under a year to get my first appointment there.
Being referred from a child gender clinic to an adult gender clinic is much faster than already being an adult and being referred from a GP, which now takes around four or more years to get a first appointment. My diagnosis also made things faster.
Once at the adult clinic, it took two appointments over a few months to be given hormones, as my gender clinic had just changed how they do things, making access to hormones a little bit quicker.
The specialist I saw just asked a little about my history, and made sure that the details they already had were accurate. I had to sign a consent form during the second appointment, basically showing that I understood what I was doing, as well as what the effects of taking Testosterone would be on my body.
I already knew about as much as I could before starting hormones, because I had done years of researching and questioning to figure out if this was what I really wanted.
Spoiler warning – it is! And starting hormones has been one of the best things for my mental wellbeing, even if not every trans person chooses to transition medically.
You can learn all about Testosterone in our post here.
To Conclude
Getting to a GIC takes a while, but once you’re there… it also takes a while to access blockers and/or hormones.
Children go through around 3 – 6 appointments with a team of specialists over a few months to a year, whereas adults see one specialist over a few months or one or two appointments, and both children and adults see an endocrinologist once offered blockers or hormones, so that their health can be monitored appropriately.
It’s a long process, as these things usually are, but worth it once you’re there.
