Kudos to Dr Lorimer for clear policy on bridging hormones

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.

MYA: You would have to pay me money to have surgery with you

To: Make Yourself Amazing

I’ve been thinking about Breast Augmentation over the last few months. A cis friend recently had hers done by “Make Yourself Amazing”. She was really happy with her result, so I decided to check out your website.

Your page for Breast Augmentation is compelling and makes several points as to why you’d be a wise choice.

Screen Shot 2016-05-15 at 00.47.07

I also noticed that you have a special page for Transgender patients. I was pleased as I imagined that this would be additional information where you would express your expertise and specialist knowledge when selecting implants to accommodate the different proportions that many trans women possess to natal females or perhaps an understanding of how later life breast development might be different or even advise on appropriate timings for this surgery in relation to HRT.

Unfortunately this was not the case. Your breast augmentation page for transgender women is basically a long an irritatingly complex set of documents that they want from you in order to be considered. What absolute bullshit. If I’m a cis woman, you actively pitch for my money; If I’m a trans woman it’s an obstacle course to be allowed to give you thousands.

Screen Shot 2016-05-15 at 00.47.07

Based upon your website alone – you would literally have to pay me money to come to your clinic; Your treatment of trans women is stigmatizing and discriminatory. I get that there are edge cases out there where perhaps a sexually motivated man might attempt this path for some bizarre reason or other, but I think the consultation would throw this up instantly and if you aren’t sure after meeting the person, then a gentle request for a referral letter from a GP or Gender Clinic would be the classier way of playing it.

I contrast this to Dr Kai Kaye of Ocean Clinic in Marbella, who gave me a lovely hospitable warm welcome to his incredibly modern and 21st century clinic. He treated me as any other patient asking me about my aesthetic concerns and desires. I was at no time interrogated about my right to be there or in any way made to feel invalid as a trans woman.

You may not have realised, but cosmetic surgery is a buyers market. I have and will spend a small fortune in this industry during the course of my transition and I can assure you the people I spend money with will treat me very very well. It would be my strong suggestion that you rethink the way that you position yourselves to our community.

Kind Regards

Amy

 

 

 

 

 

11 makeup tips for someone thinking about transitioning

  1. Get some good makeup remover
    When I started playing with makeup in my evenings after work, I used to have to be fastidious about removing traces of mascara and eyeliner (which can be stubborn). I made the mistake of just buying any old eye makeup remover. In hindsight it was terrible. The result was I’d have to keep going back over and over to remove everything, which of course irritated my eyes. I remember once my boss said to me “You look different… your eyes look funny”. It was the leftover makeup.MACNo7 002
    I eventually switched to the wonderful No.7 Eye makeup remover and it just comes right off.These days I don’t have to worry about being in the closet, but it’s a key part of my makeup table. Catch my mascara wand? Eyeliner smudge? One dip of a cotton bud stick and it can be surgically removed. And my going out mascara (the ludicrously named Mac In Extreme Dimension 3D Black Lash) can be stubborn, so it’s just really useful stuff.
  2. YouTube is your friend… Except when it isn’t
    YouTube and Pinterest are full of amazing tutorials from makeup experts and beauty bloggers creating effortlessly perfect winged eyeliner or whatever.Screen Shot 2016-05-02 at 11.19.22

    I found most of them were just so far out of my reach. My hands were too shaky and imprecise because I hadn’t had a lifetime of practice. In reality, I found most of these tutorials to be disheartening rather than empowering. I found a few which were genuinely simple and they helped me.The point is don’t beat yourself up if a beautiful cis-woman with a lifetime of practice can make herself look more beautiful and somehow it doesn’t translate onto your face. Take what you can from all these “Simple” tutorials and don’t worry about the rest.

     

  3. About your skincare routine… Get one
    Living as a man, my skincare routine was occasionally washing my face with shower gel as I washed my body in the shower.If you do nothing else, buy a good Day Cream and Night Cream and use them both every day.When I bought my first good car, my father once told me that’s it’s a nice ritual to wash it yourself as you’re spending time looking every little inch of the bodywork. I think of this occasionally as I moisturise in the morning – it’s a little ritual to care for my face.

    n07_earlydefence

    This is going to look like No.7 product placement central, but I just really like a few of their products. I use No.7 Early Defense Day & Night Cream (though I think as of my next birthday I’m not sure I qualify for “early defense”).

  4. Try different products… But don’t cling onto them if they’re not you
    There are hundreds, probably thousands of beauty brands out there, it’s easy to find one you like and cling to it. It’s not an exclusive relationship… It’s ok to see other people. Just because one brand’s foundation works for you, doesn’t mean that their mascara is the perfect fit.It’s also easy to buy the wrong thing and feel like you need to hang onto it or worse still use it up because you bought it. If it’s not right for you it’ll make you feel uncomfortable with your appearance. There’s actually a healthy trade of people selling makeup on ebay. I also had some amazing customer service at Mac where I’d come away with the wrong shade of foundation, used it a few times and they still swapped it for me. Either way, if it’s not right, get rid of it. 
  5. Do something really scary.. Get colour matched
    When I first started out, I was buying foundation from Amazon.com because I was too scared to go and ask someone. Incredibly I was ordering 2 or 3 from a range based upon the names of the shades. This approach was hugely hit and miss and very wasteful. I suppose I did try lots of brands out (see 4. above).Every time I read a forum post on this – the others would always say

    “just go and ask one of the girls at <insert name> makeup counter to colour match you… honestly they don’t care and will not bat an eye lid”

    The problem is that once you’ve done it, it was the least scary experience, but what these posts don’t acknowledge is that it’s really really scary. You imagine creeping into that fortress of femininity that is the makeup hall, being sniggered at or whatever. It is really scary. Let’s acknowledge that.

    However all of those people that told me that were completely right. I made myself do it. I felt physically sick. I went to the Mac store. It was packed full of women who moved effortlessly between all the bewildering products. I’d promised myself I was going to do it. I asked one of the staff. They asked me a bunch of questions, to all of which my response was “I don’t know”. We decided that coverage was important to me, so they selected one of the foundations, then dabbed two on my neck and was really clear that I was an “NC20” and that was it. It was completely ok. I should call out the staff of Mac, who have always treated me extremely well and been super friendly. Mac is a very trans friendly company.

    Having foundation that I knew was right gave me confidence that I was using the right product.

  6. Get a lesson
    When I first went for my colour match at Mac, I found out they do 90 minute make up lessons for about £50 ($80). The amazing bit is that you get the money back to spend on product. I booked there and then.It was a few weeks later; It was an amazing experience. I was treated really well and with professionalism and discretion. I’ve written about how it made me feel it before.We took all my makeup off and she took me through everything with no presumed knowledge. As we went through the lesson, she noted down what she was using and gave me a sheet with the look that we’d made with the makeup painted onto the paper. I’ve long since lost it, but I used to use it for the next few months.

    Mac personalised face chart

    I bought a pile of new products and brushes, but the real thing I left with was the knowledge and confidence that I was doing it in the right order and that I was using the products in the right ways.

  7. Less = more… Up until a point
    It’s a popular trope that less = more when it comes up to makeup. People are super quick to tell you that “too much makeup doesn’t look good”. I absolutely agree with them. I started of with the thickest foundation and now use the lightest I think they do.The trouble is that a lot of these people telling you this don’t have beard shadow to contend with. So yes, less is more, but if that means that you don’t feel like you have good coverage, it can ruin your confidence for the day.

    There are piles of tutorials and tips for trans women on the subject of beard coverage and I’ll publish mine soon, but the point is use as much as you need to feel confident and no less.

    Also I believe that telling a woman to wear less makeup (whether directly or through a micro aggression) is a colossal invasion. Her body, her decision. Women wear makeup for themselves not others. The choice to wear lots / some / none is a personal choice and nobody’s business but your own.

  8. It’s all in the brushes
    I started applying by hand, then bought one or two of the wrong brushes on the internet, which helped massively. I now have a decent collection of brushes from Mac. It is a substantial investment when each one is about £30, but they all do something different and I love using them. I can’t really explain what a difference having the right tools has done for me, but everything’s just easier now. I’m sure opinions will vary greatly here, but if I could only have three brushes, I’d have a decent foundation brush (that’s appropriate for the type of foundation and the coverage you want which for me is Mac 196), a pencil tip brush (Mac 219) for applying eye shadow and a blending brush (Mac 224) for blending and finishing it. I also love my eyebrow powder angle brush with a spoolie brush on the end. Ok, so that’s four. Oh and I love my little powder brush in my makeup bag… And my blusher brush… Oh and I use a little foundation brush to apply concealer to my chin to cover my shadow. So seven. You need seven. But I did also buy a nice lip brush for applying lipstick… And a foldable one for my makeup bag… Anyhoo – you get the idea… new brushes = new techniques and new ways of playing with makeup that can greatly effect the result you get.It’s worth noting – some people are huge proponents of using your fingers… and I do for some parts of my routine, but it’s my blog and I’m going to just say that those people just haven’t met the right brush yet.

    8a. Bonus tip: Clean your brushes with brush cleaner regularly. Faces are full of oil and bacteria. Makeup brushes can retain lots of crap which can be bad for your skin and also effect their performance. It takes less than a minute: A few drops on a tissue and swirl the brush around on the tissue until the fibres are clean.

     

  9. It’s all in the hours
    OK – forget brushes. Or products. It’s all in the hours. After going full time, I had to do my makeup every day without fail.Hours and hours of practicing. I’ve had days when strangers have complimented my eye makeup; I’ve had days where I’ve caught myself in the mirror and been dismayed at how bad my makeup looks.My routine suddenly collapsed from 90 mins, to 60 mins and now is at 15 minutes if I’m in a hurry.  I’m not a makeup expert by any means, but I think I am now at the level that most women are at… possibly a bit beyond (technically I just became a beauty blogger) :-)If your first few attempts, or even first 50 attempts are objectively pretty average – don’t despair – you will get exponentially better. Just practice every day.
  10. Always keep experimenting
    One of the things I’ve heard cis women (who you’d think have had a lifetime to achieve mastery) say is that they don’t really know about makeup, they just do their thing and that’s all they know. I’ve started falling into this trap. It’s super easy and quick. I try to make the effort to try something different a few times per week. I normally use eyeliner in a pencil, so I’ll experiment with liquid, gel or powder. I’ve started trying other colours recently. I try different brushes. Less foundation. More foundation. No blush. I always make a mental note of what I think of the result. Allowing yourself to play and experiment is a great way of pushing your skills out of the usual routine.
  11. Don’t be afraid to ask or compliment
    Sometimes I’m in a shop and the woman serving me has amazing eyeliner or a lovely shade of lipstick. I’ve started just paying compliments in those situations. Everytime, without fail the person will swell with pleasure and smile back and thank you. I’ve had a few good tips by paying compliments to strangers, but that’s not why I do it. It’s basically just a nice thing to do and I have this theory that we’re all just pretending and it’s a kindness that costs nothing and impacts someone’s day. But perhaps more significantly as a trans person who felt intimidated by this arena of femininity, just allowing myself to have the confidence to start a conversation about make-up is really empowering.


    So that’s my 11 pearls of wisdom for someone embarking on this fun and slightly intimidating journey into the world of makeup and beauty products. I certainly am no expert and there’s lots I have still to learn (I’m talking to you, winged eye liner). Hopefully it is of some help to someone setting out.

    Love Amy x