My Transition Tube Map - Hormones

After having my eggs frozen in February 2018, it was time to re-start the process of hormone treatment. I had my bloods taken and reviewed (again) by Dr Seal of GenderCare who gave approval for my start of Sustanon 250mg/1ml every 4 weeks on 23rd May 2018.

I continued with this dosage until I had a review by Dr Coxon in October 2019 who adjusted my dosage to Sustanon 250mg/1ml every 3 weeks. Further blood tests were taken and reviewed, and he adjusted my dosage interval to every 17-18 days, at which point my peak and trough levels were considered correct and my dosage was stable.

I continued with this dosage until the end of February 2022, having been discharged from GenderCare at the end of 2021 as I had not booked another review expecting to be seen by the NHS imminently. I finally received a response to my many attempts to make contact with the service on 2nd February 2022.

It turned out I had been discharged in August 2018, when my name reached the top of the list to have a first appointment with a named professional. It seemed my patient details on the internal system contained my previous address, where the NHS Spire system held my updated address as of October 2017, and so because the addresses did not match the service were not allowed to contact me via post. Despite the fact that my GP was unchanged, where first 3 letters of my postcode were unchanged (having moved 10 minutes walk away), they did not contact my GP either. The service phoned the mobile number on file once - on what was day 2 of 3 days out of the country, my only time abroad since being referred to the service in November 2016 until August 2019. No other efforts were made to contact me, and the alert on their system from September 2017 (when we were initially supposed to move) was never actioned, us having told them to update my address on their system on this date - not telling them there was a delay, and assuming the alert was actioned when it was supposed to be.

Self-referring back into the service, with the promise that my referral would be backdated to my initial referral date and I would be prioritised, it was expected that my name would then be at the top of all necessary lists, where there website stated that they were currently offering appointments to people referred in April 2018. However, this was not the case, and I was not added to a 'priority' list for hormone treatment until late October 2022, having a first appointment in April 2023 - over a year after my re-referral.

Even with being given approval to start on Sustanon 250mg/1ml every 4 weeks in April 2023, the administrative team did not send the approval letter to my GP. I chased this in May, being assured a copy would now be sent, in June to no response, in July where I was told they would send a digital copy as well as a physical copy of the letter - but still nothing. By October 2023, 6 months later, my GP said they would accept my physical copy of the letter considering this was a medication I had been on previously and the incompetence of the service was beyond ridiculous at this point.

My hormone appointment in December 2023 was therefore rendered redundant and cancelled, being rescheduled for March 2024 where the doctor seemed confused at my low levels despite me repeating that my previous correct dosage interval was nearly twice monthly so I am not surprised, and I am still experiencing a monthly cycle. The doctor decided not to decrease my dosage interval, putting my low levels down to me not having my dose when I should.

I had a follow-up in August 2024, where my levels were exactly the same (could be that of someone not on T) despite me being able to prove I had had all the necessary doses, and so the interval was increased to every 3 weeks.

My next follow-up was scheduled for December 2024. However, I also had an appointment with my named professional 2 days later, and having both letters with the necessary zoom links sitting on my desk I checked the letter the night before to double-check the time of my hormone appointment and read the wrong time, assuming it to be at 14:00 (the time of the named professional appointment 2 days later) rather than the scheduled 11:00.

The service's policy is to contact the patient via telephone in case there are technical difficulties with the zoom link (as it is not as if we would have another way to easily get through to them to let them know, but our mobile number's are sitting on the screen in front of them), and when they are contacted regarding the failed attendance of an appointment they will reschedule you in the following 2-3 weeks.

I contacted the service via email at 13:30 as soon as I realised my error, but received no response. I did not receive a rescheduled appointment until 4 months later in March 2025 at the chasing from my named professional. At which point, again, the doctor seemed confused at my low levels, but finally listened to me and adjusted the dosage interval to every 2 weeks - which is where my hormone journey is up to now!