% Adults

Table of contents
=================

-   [United Kingdom](#uk)
-   [New Zealand](#nz)

United Kingdom {#uk}
==============

Go to your GP and say that you are transgender. Some doctors are
ignorant, so you need to make sure to explain what this means, and that
you wish to transition your gender. Ask to be referred to a Gender
Identify Clinic. Here is a list:
<http://www.nhs.uk/Livewell/Transhealth/Pages/local-gender-identity-clinics.aspx>

Some GPs are assholes. Report them if they are. And report the awesome ones.
----------------------------------------------------------------------------

Even with private care, you'll still use your GP for a lot of things
probably, including blood tests and endocrinologist referrals, unless
you get those privately too. The following external website maintains a
register of good and bad GPs:\
<http://transfigurations.org.uk/trans-friendly-doctors/>

You should get a blood test BEFORE seeing an endocrinologist, and take
your test results with you.

A trans person in the UK who had a bad bad GP spoke to their local
elected MP and got her to write to the government. [This letter from the
UK Government's Department of Health outlines GP requirements and states
that they are required by law to immediately refer you to a gender
clinic when you request gender transitioning
services](/common/gp_letter.pdf).

When you go to that GP, regardless of whether you think it will go well
(most GPs are OK), take a printout of that letter with you just in case.

Thanks go to Gina Denham of the
[Transpire](http://transpiresouthend.org/) support group for sharing
this letter.

Going about the process
-----------------------

If you live in or near London, the Charing Cross clinic is very good.

Be warned that the waiting lists at most clinics is about 2 years on
average, for your first appointment. This is because attitudes have
shifted in positive ways towards trans people, so more people these days
are transitioning; this means that the NHS is under more strain. Funding
hasn't increased much, and the NHS isn't equipped to handle a 500%
increase in people transitioning over the last 5 years.

[Private transitioning services](private-care.md) should also be used
simultaneously, if you can afford it. You can pay for it with health
insurance, or you can self-fund it. You can use private care while on
the NHS waiting list, and then ditch the private care once you are being
treated by the NHS.

You will then later on receive a letter from that clinic. Give your
details to that clinic, and make sure to book an appointment with them.
Then wait for your appointment.

What to expect from UK NHS trans care:

-   HRT (hormone replacement therapy)
-   voice training
-   hair removal
-   surgery
-   therapy

There is gatekeeping on the NHS, but it's light. However, expect *long*
waiting times. You might be waiting 5 years from now, for surgery. And
about 2-3 years for hormones.

We recommend using private care while on the NHS waiting list. Private
services also have (lower) waiting lists, and you can DIY a lot of your
transition before then (or if you can't afford private care). For
instance, refer to our [HRT self-medication guide](hrt-internet.md).

New Zealand {#nz}
===========

Go to your doctor and ask for gender transition services. You can get
HRT prescribed by your doctor in New Zealand. TODO: add more information
about procedures.

