Dr Lorimer, one of the UK’s leading gender clinicians who operates at Charing Cross and also has his own private practice, issued the following statement on bridging hormones last week:
I’m keen to make people aware of a change in my own way of working, within GenderCare: the introduction of bridging hormones between my appointment and Dr Seal’s.
The original idea with GenderCare was to provide a comprehensive specialist assessment in two parts: general/diagnostic and endocrine. That’s still our model but, as demand has grown, so have our waiting times, particularly for Dr Seal’s clinic. Increasingly, those seeing me then have up to six months’ wait to see my colleague.
We’re piloting various new ways of addressing this, one of which is bridging hormones. How it works is as follows:
When someone arranges an appointment with me, I tell them what blood tests are needed in preparation. At the appointment, I’ll take a copy of the results and discuss those results with Dr Seal. If we’re in agreement that it’s reasonable to start on hormones, I can then initiate that in advance of their appointment with Dr Seal.
One development that makes this is easier is the recent guidance from NHS England and the General Medical Council, explaining the responsibility of GPs to prescribe, particularly when recommended to do so by an experienced gender specialist.
Obviously, I can’t compel GPs to prescribe but the new guidelines do provide much clearer instruction.
I’m happy to provide the GP with links to these guidelines, prescribing information and a shared care agreement, where needed. I can also start hormones on a private prescription, if this is preferred. I have never charged for private prescriptions.
People will still need to keep their appointments with Dr Seal but he’ll already have seen their baseline blood results and his appointment will focus more on dosage, effects, side effects and medical issues.
The downside of all of this is the extra administration, for which I’ll finally be raising the cost of my initial consultation from £200 to £220. The cost of subsequent appointments remains the same, and Dr Seal’s fees are unchanged.
Clearly this has been the result of high waiting lists rather than a grand plan or strategy to introduce bridging hormones, but they could have just as easily just ignored the issue and left us to wait. I also love the fact that it’s super clear how it’s going to operate… Transparency is really useful for someone trying to navigate what can be quite an arcane system from time to time.
Major kudos to Dr Lorimer for implementing this. Securing low friction access to hormones is one of the big 3 issues facing trans people in the UK today and this move will seriously help our community.