Medical Transition - The Mechanics of it all - Assessments - part 2 -Diagnosis again (private sector)
In Assessments - Part 1 I talked about my first assessment with Dr Stuart Lorimer in March of 2018, this was followed up by a Further assessment in June 2018 with Dr Leighton Seal another member of the clinical network that is Gendercare, Dr Seal is also a medical Doctor, his higher specialist training is in Endocrinology.
One way in which Gendercare varies slightly from the typical path of the NHS services is that your second assessment may be carried out by a Doctor who is, or has a Specialist interest in , Endocrinology. That said Dr Seal appears on the T493 list of Gender Dysphoria specialists that HMCTS maintain for getting clinical reports where people apply for a Gender Recognition Certificate under the current 2004 procedures. The NHS would tend to have two Gender Identity Clinic Clinician assessments (one Medical, one by a Psychologist or Nurse Clinician) and then refer you on to the Endocrinologist for a purely endocrinology consultation.
My assessment with Dr Seal started in a pretty similar manner to my Assessment with Dr Lorimer, asking about my dysphoria, my past history, a bit more attention on physical health topics, and yes some elements of physical examination, in my case this was simply, height weight and blood pressure, although sometimes an examination of the chest or genitalia may be required, chest examination in trans women ( who are cross sex hormone naive or only on low doses might be required for structural issues or if you have pre -existing gynaecomastia ... Genital examination may be required if you are concerned about the normality or otherwise of your genitalia. Given my past professional experience and therefore exposure to genitals of all natures both male and female I felt able to answer the questions fully.
This assessment took around an hour, and I came away from it with
- A confirmatory Diagnosis of Gender Dysphoria.
- A plan to increase my Estrogen dosages and look at the necessity of testosterone blockers in the light of further blood results.
- A reminder that most people in the UK really do need to supplement their vitamin D intake.
- An indication of a target weight to please the surgeons when/if i were looking to have GRS.