Transgender patients say they feel ‘forced’ to switch using hormones purchased via the dark web because the waiting times of NHS are so long.
Some patients spend three years on a waiting list before finally seeing a gender identity clinic specialist, one BBC research has found.
And, desperate to begin the transition to the opposite sex, patients admit to turning to unregulated sources to find testosterone and estrogen pills.
They can seriously jeopardize their health with the DIY approach by taking untested drugs from unknown, unregulated sources, often outside the UK.
But one said she felt she had to choose between gambling on drugs or committing suicide.
NHS England, with an intended waiting period of 18 weeks for a first appointment, said that the demand for gender identity services is increasing and that there are not enough sufficiently qualified doctors.
Transgender patients wait up to three years to make an appointment at a gender identity clinic after referral (Belfast). A Freedom of Information request from the Victoria Derbyshire program shows that patients in Nottinghamshire wait up to two years and nine months (145 weeks). The NHS Highland Gender Identity Clinic in Scotland has the shortest maximum waiting time of 32 weeks. Some countries have target times – that of NHS England is 18 weeks
A study by the BBC’s Victoria Derbyshire program has shown differences in waiting times in the UK.
The longest waiting time for referral to a gender identity clinic was in Belfast, where patients waited up to three years (166 weeks), the target time of one year (52 weeks) tripled.
The second worst was Nottinghamshire, where waiting for two years and nine months (145 weeks) only lasted for an appointment.
This was followed by Northumberland, where people could stand for up to two years and five months (127 weeks). The NHS in England has a target time of 18 weeks.
In Wales, where there is no waiting time target, patients may have to wait up to two years (104 weeks).
The NHS Highland Gender Identity Clinic in Scotland has the shortest maximum waiting time of 32 weeks.
Kara said she was “absolutely petrified” from the effects the unregulated pills could have on her, but felt “forced” to buy them because she waited two years for a specialist
The first gender identity clinic in Great Britain, at the Tavistock and Portman NHS Trust in London, did not provide any waiting time data, but the BBC reported a suggestion that the waiting time could be two years.
A law student who only told her first name, Kara, to the BBCs Victoria Derbyshire program she started buying hormones online last summer to switch from male to female.
She has been waiting for two years for a specialist at a NHS Gender Identity Clinic to ask if the tablets can be prescribed at the NHS. It is not clear where she lives.
But she said she was “absolutely petrified” from the effects that the unregulated pills could have on her.
“I don’t know anything about the tablets [that I buy] specifically, if they are what they say they are, “she said. ‘So it’s a kind of guessing game with your life.
“I was so low before, it actually felt like a choice between suicide or self-medication, because I can’t handle the thought of further masculization.”
Another patient, Lucas, who started the transition six years ago at the age of 29, also decided to use testosterone purchased online.
When his doctor referred him, he was told that he would wait two and a half years for an appointment, so he took matters into his own hands until that time.
A patient known only as Lucas claimed to know at least one person who took his own life because of the “disturbing and dehumanizing” waiting to be seen
“I suspect that a few doses were in fact nothing,” he said.
“For example, I didn’t start growing facial hair at all until I got the prescribed testosterone.”
Lucas claimed that he knows at least one person who has taken his own life because of the “disturbing and dehumanizing” waiting time to be seen.
More than 13,500 transgender and non-binary adults are on waiting lists for NHS in England, according to previous BBC research.
And this growing demand drives more to venture into the dark world of unregulated drugs.
NHS DOCTS OVERDIAGNOSING SEX DSYPHORIA IN CHILDREN AS YOUNG AND THREE
NHS psychologists ‘over-diagnose’ children with gender dysphoria about fear that employees will be branded transphobically if they don’t.
Ex-clinicians fear that dozens of young people may need unnecessary medication that blocks puberty and deforms their hormones every year.
The concern was expressed by six psychologists in December 2019 who have resigned from the gender identity service for children in London in the last three years.
They all claimed that they were under such enormous pressure that they could not properly judge patients in what they fear could be a “medical scandal.”
One of them has admitted that, in retrospect, they may not have given hormone-disrupting drugs to all children who have been diagnosed with gender dysphoria.
A psychologist who wanted to remain anonymous told it Sky News: “Our fear is that young people will be over-diagnosed and then over-medicalized.
“We are very concerned about the consequences for young people … For those of us who have previously worked in the service, we are afraid that we are in the front row for a medical scandal.”
People with gender dysphoria experience discomfort or anxiety because there is a mismatch between their biological gender and identity.
Almost half of the children treated at the GIDS are prescribed hormone blockers that stop puberty.
It is a completely reversible form of treatment because puberty is resumed when the patient stops taking the medication.
This gives children time to consider whether they really want to make the switch to the opposite sex.
But the drugs interfere with natural hormone production and can cause mood swings.
Thirty-five psychologists have resigned since 2016 at the Gender Identity Development Service (GIDS) of London at the Tavistock and Portman NHS Foundation Trust.
Data show that the number of children treated at the service has exploded more than 30 times in ten years.
Many of the websites that sell the hormones are not based in the UK – meaning that they may have been produced outside the strict UK regulations – and require payment via Bitcoin or bank transfer.
It is illegal to sell testosterone drugs, but it is not illegal to buy or own them for personal use.
And many patients can turn to estrogen hormones that are meant for women in transition to get their dose.
There are huge health risks of taking hormones without a doctor’s supervision, experts emphasize.
Those taking estrogen may experience a pulmonary embolism, where a blood clot travels to the lungs and blocks an artery.
Liver damage can also occur if patients are not followed.
They can also feel discouraged if the medication does not have the desired effect because they are actually fake.
The Royal College of Physicians, which represents general practitioners, expressed concern about the consequences of rapidly increasing referrals in 2019.
It reported that gender identity clinics in England have increased the total number of referrals by 240 percent over five years.
In a statement, the RCOP said, “There is an urgent need to increase the capacity of gender identity and clinic specialists and to increase understanding of gender issues throughout the health system.”
It is understood that waiting times are partly due to a lack of medical professionals who want to specialize in trans-health care. For this reason a new ROP process has been set up.
NHS England told the BBC in a statement: “As more people feel able to seek support and treatment, the demand for gender identity services has increased enormously.
“In recent years, we have invested more in responding to rising demand, with staff working hard to support patients to get the right care as quickly as possible.
“From spring a new service will be tested in London that will increase capacity in gender identity services.”
A Scottish government spokesperson, of which NHS Health Scotland is a branch, said that long waiting times for patients were “unacceptable.”
He said, “Gender identity clinics are a highly specialized resource, and while people are waiting to be assessed, they still have access to a full range of mental health and welfare services that suit their situation and needs.”
NHS Wales and Belfast NHS Trust have not yet responded to requests for comment.