#voicedysphoria — Public Fediverse posts

Voice Dysphoria is real...
- So be mindful...

Also TERFs are just bad.
- Those "Karen" types need to find themselves better hobbies than eavesdropping on peoples' phone calls!

#CyberSix #Comic #AdrianSeidelman #Voice #VoiceDysphoria #dysphoria #Boymoding #TERFs #TERF #trans #identity #feelings #feels #IntenseFeels

Voice Dysphoria is real...
- So be mindful...

Also TERFs are just bad.
- Those "Karen" types need to find themselves better hobbies than eavesdropping on peoples' phone calls!

#CyberSix #Comic #AdrianSeidelman #Voice #VoiceDysphoria #dysphoria #Boymoding #TERFs #TERF #trans #identity #feelings #feels #IntenseFeels

Voice Dysphoria is real...
- So be mindful...

Also TERFs are just bad.
- Those "Karen" types need to find themselves better hobbies than eavesdropping on peoples' phone calls!

#CyberSix #Comic #AdrianSeidelman #Voice #VoiceDysphoria #dysphoria #Boymoding #TERFs #TERF #trans #identity #feelings #feels #IntenseFeels

Just finished watching another video by voice coach Renée Yoxon entitled Will My New Voice Ever Become My Default?.

We don't feel like we need or want (let alone even have the spoons!) to do a breakdown of the video like we've done for another video of theirs, but we wanted to share this lovely metaphor Renée used within the video with you all:

Imagine your brain is a giant, overgrown jungle. Your old voice habits are like a well-paved road. Clear, easy and fast to walk down because you've travelled it every day for years. Now you're trying to build a new path, one that leads to the voice you actually want to use. At first, you're bushwhacking. It's hard to find, it's easy to lose, and honestly, you might get discouraged and end up back on the old road. But every time you take the new path, it gets a little easier. A few branches clear, some grass gets trampled. Eventually, the new path becomes more familiar and the old one starts to get overgrown. That's what it's like when your new voice becomes your default.

#trans #transgender #TransVoice #VoiceTraining #VoiceFeminisation #VoiceFeminization #VoiceDysphoria #RenéeYoxon

Before reading any further, if you're currently experiencing any of:

• a negative MH spiral;
• negative self-talk; and/or
• rumination over perceived failures;

... then please, please stop reading here and come back to this later :PleadingFace:

As many of yous will already know, we've been struggling with voice dysphoria and voice training now for many years. We've about this many times in posts like:

• Trans Voice Friday post and a follow-up post about how we used to sound
• RSD and anxiety over first NHS-funded voice training appointment (initial assessment)
• Vent re: survivorship bias in voice training, with a focus on voice feminisation
• Voice dysphoria

Fairly recently, purely by chance whilst looking for something to highlight how awful the VoiceTools app is for voice training, we chanced across a non-binary voice coach and content creator (Renée Yoxon) via their video about how deeply-flawed the VoiceTools app is.

We haven't watched through all their videos, but we wanted to highlight -- and critique and praise -- some hopefully-relevant sections from a recent video they did with their trans+ fem collaborator Tea, entitled How Long Does Trans Voice Training Really Take?.

Renée started off the video decently (but not perfectly) with the below:

So what are some factors that affect when that shift happens? Three big factors.

One, your experience and aptitude. If you're a singer, a voice actor, or just someone who's used to experimenting with your voice, you'll likely progress faster because you already know how to move your vocal dials. So if you're not yet voice training, this is going to seem wild, but do some silly voices and impressions. It can genuinely give you a better starting point.

Not everyone will feel comfortable with doing silly voices and impressions, so we think it's counterproductive of Renée to have added this here, but otherwise yes: some of us simply are not good at or -- for various reasons -- struggle with manipulating our voice. Continuing on:

Two, your relationship to your voice. Some people are super motivated to practice, but others find voice work triggering or overwhelming. And that's okay. Your emotional connection to your voice can help or hinder your timeline, but both are normal. But if it is hard emotionally, name that to yourself and recognize that it may be harder on your progress and results.

This is SOOOOO important and often overlooked. We'd go much further though, but we want to share the third point before going into that.

Three, your time and consistency. This is a big one. Consistent practice. Even ten minutes a day is more effective than long, infrequent sessions. If you can find small ways to integrate voice work into your daily life, that builds momentum over time.

At this point, we actually got quite annoyed at Renée, as whilst they're normally really spot on, this felt like they'd ignored or not identified some major issues here that can all make voice training even more difficult than it already is.

e.g.,

• Being neurodivergent;
• Having mental health struggles;
• Having physical health struggles;
• Having chronic health conditions.
• Finding voice training to be an unfun and even-awful chore.

For those of us who are barely hanging on a lot of the time, plenty of us just don't have the spare spoons for it.

And even if we do have the spoons, sometimes the idea of being perceived whilst doing the task can be overwhelming in of itself 😖

If the video hadn't segued there, we might have stopped watching and downvoted it. However, their trans+ fem collabor Tea stepped in here to save the video.

Hey, so as Renée's longtime collaborator and someone who has chronic issues with my relationship to my voice, as well as finding time and consistency to voice train I wanted to hijack this video for a minute.
I have still not really started organized voice training, and I work with a trans voice trainer. And this is because I find it really emotionally challenging.

This is the experience that a lot of trans+ people have and it's not highlighted enough, as we sadly see the world filtered by those for whom voice training has come naturally or been super successful within a short period of time (e.g., 6-12 months).

She goes on to discuss gradual changes in a way that is much-more grounded.

Now, this may sound funny looking at me, but for the first five years of my transition, I avoided any physical activity like it was the plague.
I associated muscle with masculinity, and as such, any muscle I already had from working a semi physical job caused me a lot of dysphoria and had to be gotten rid of.
But at that five year mark I got sick and tired of well- feeling sick and tired. So I started working out because I wanted to be able to carry my groceries, more easily move my camera gear, and make mundane things easier.
That started small and this is not a joke. I did exactly ten minutes a day. Every day at lunch I would do three exercises with 5 pound weights. I wasn't following some get swole quick routine. I chose three arm exercises that I just assumed would help with what I mentioned.

She then goes on to explain what this felt like:

At first, my arms just always felt tired and sore and it took a couple of months, but I started to see small improvements. Then I thought, well, but this other movement is tough. So I added an exercise for that and so on and so on. And four and a half years later, I look like this. I work out three times a week and I use 25 pound weights. And believe me, I didn't think I would get to 15 pound weights when I started.

This is a fantastic analogy for voice training, especially in terms of the timeframe.

That journey was full of moments where I thought, "Damn, I'm not improving. It's not getting easier. I haven't reached another easily quantifiable plateau." And that still honestly happens to me at points right now.
But here's the reality. And yes, this is tying back into voice training. If I've learned anything, is that human bodies are not machines: muscles, dexterity. and control, which are all involved in voice work, just with very different muscles that aren't as easy to visually identify, do not build linearly.

Exactly this!!! Many of us will reach points where we feel like we're not getting anywhere, and voice training is a form of physical exercise as much as a mental one.

And it's really frustrating. Really frustrating. But what I've learned is that the body loves slow, consistent work. It understands that and will meet you where you are. What it doesn't understand is when you go 0 to 60 instantly. So if you go from no voice work at all to an hour a day, you are likely to hurt yourself because your body thinks you're in a temporary crisis.

Again, this highlights the importance of taking it low and slow, rather than trying to race ahead too quickly.

My point is, you may hear ten minutes a day, or start with a daily warmup and think that's too little. It can't really do anything. But you're wrong. So long as when it gets easy, you take it up that one step further. Now, wish me luck. That I can actually make myself apply that to my voice, too.

This ending point is perhaps the best one. Tea isn't coming from a place of mastery: she's coming from a place of recognising the struggles she's been having and is continuing to have.

And we guess that Tea must have talked with Renée about this video, as Renée then continues on with this amazing bit of wisdom:

Now, what if it takes even longer than you're expecting? If that happens, that's totally normal. Some people take a year, some take five or more. No matter how long it takes, the time is going to pass anyway. As long as you keep moving forward bit by bit, you'll keep progressing.

This is something absolutely fucking pivotal to voice training, and they go further:

Everyone starts in a different place and has a different goal. Comparison is the thief of joy and will only slow you down.

Yes!!! We DO NOT all start with the same inherent abilities and capabilities. If we keep comparing ourselves to others, we will find only despair.

They then give some advice on what to do if you're in a funk:

If you're feeling stuck or plateaued. It might be time to listen back to your old recordings. You're probably doing better than you think.
Revisit the basics with fresh ears. Try adding a new exercise or warm up technique to your routine. Get support from a coach or peer who can offer feedback. Or maybe take a break.

Doing exactly this is what has stopped us from completely breaking from our own voice dysphoria, which we have found to be one of the most-crippling things for us.

Renée ends on a realistic but positive note:

Here's the truth. Your voice won't stay the same forever. As your life. Identity and confidence shift, so will your relationship with your voice. The voice that feels right today might evolve into something slightly different next year, and that's not a failure, that's growth! Remarkable growth.

So, for anyone / anybody& who is also struggling with their own voice, just like us, we want to remind you that you are not failing and you are not a failure.

Anyway, we hope this helps someone / somebody& :TransHeart:

#trans #transgender #TransVoice #VoiceTraining #VoiceFeminisation #VoiceFeminization #VoiceDysphoria #RenéeYoxon

Hey loveliests :NotoEmojiPinkHeart:

We wrote a post back in June, which we recommend reading first for context if you aren't aware of the situation.

In short, the practice manager from our GP surgery emailed us this afternoon with a copy of the response from the local ICB. As expected, it was a "no".

"Regrettably, we cannot approve your funding request as there is no evidence to show this patient is likely to gain significantly more clinical benefit from Glottoplasty surgery than might be normally expected for the general population of patients with the condition or circumstance i.e. gender dysphoria and neurodiversity. Unfortunately, we are not able to take purely psychological issues into consideration."

It's not something we can afford privately or could save up for, for reasons we won't rehash. (We've written some longer update posts back in late April and late May.)

Our only remaining option now is a fundraiser, but we need to work out how to do so without needing to disclose our surname, since we can't have our alias identified with our full name :Sighing_Face:

#trans #transgender #VoiceTraining #VoiceFeminisation #VoiceFeminisationSurgery #VFS #VoiceDysphoria #NHS #NHSEngland #EOEGS #PALS #IFR #ICB #ICS #GDNRSS #GAHT #GDPR #DSAR #TransRights #TransRightsAreHumanRights #LGBTQ+ #LGBTQIA+ #queer #GenderAffirmingCare

Hey loveliests :NotoEmojiPinkHeart:

We wrote a post back in June, which we recommend reading first for context if you aren't aware of the situation.

In short, the practice manager from our GP surgery emailed us this afternoon with a copy of the response from the local ICB. As expected, it was a "no".

"Regrettably, we cannot approve your funding request as there is no evidence to show this patient is likely to gain significantly more clinical benefit from Glottoplasty surgery than might be normally expected for the general population of patients with the condition or circumstance i.e. gender dysphoria and neurodiversity. Unfortunately, we are not able to take purely psychological issues into consideration."

It's not something we can afford privately or could save up for, for reasons we won't rehash. (We've written some longer update posts back in late April and late May.)

Our only remaining option now is a fundraiser, but we need to work out how to do so without needing to disclose our surname, since we can't have our alias identified with our full name :Sighing_Face:

#trans #transgender #VoiceTraining #VoiceFeminisation #VoiceFeminisationSurgery #VFS #VoiceDysphoria #NHS #NHSEngland #EOEGS #PALS #IFR #ICB #ICS #GDNRSS #GAHT #GDPR #DSAR #TransRights #TransRightsAreHumanRights #LGBTQ+ #LGBTQIA+ #queer #GenderAffirmingCare

Hey loveliests :NotoEmojiPinkHeart:

We wrote a post back in June, which we recommend reading first for context if you aren't aware of the situation.

In short, the practice manager from our GP surgery emailed us this afternoon with a copy of the response from the local ICB. As expected, it was a "no".

"Regrettably, we cannot approve your funding request as there is no evidence to show this patient is likely to gain significantly more clinical benefit from Glottoplasty surgery than might be normally expected for the general population of patients with the condition or circumstance i.e. gender dysphoria and neurodiversity. Unfortunately, we are not able to take purely psychological issues into consideration."

It's not something we can afford privately or could save up for, for reasons we won't rehash. (We've written some longer update posts back in late April and late May.)

Our only remaining option now is a fundraiser, but we need to work out how to do so without needing to disclose our surname, since we can't have our alias identified with our full name :Sighing_Face:

#trans #transgender #VoiceTraining #VoiceFeminisation #VoiceFeminisationSurgery #VFS #VoiceDysphoria #NHS #NHSEngland #EOEGS #PALS #IFR #ICB #ICS #GDNRSS #GAHT #GDPR #DSAR #TransRights #TransRightsAreHumanRights #LGBTQ+ #LGBTQIA+ #queer #GenderAffirmingCare

Hey loveliests :NotoEmojiPinkHeart:

We wrote a post back in June, which we recommend reading first for context if you aren't aware of the situation.

In short, the practice manager from our GP surgery emailed us this afternoon with a copy of the response from the local ICB. As expected, it was a "no".

"Regrettably, we cannot approve your funding request as there is no evidence to show this patient is likely to gain significantly more clinical benefit from Glottoplasty surgery than might be normally expected for the general population of patients with the condition or circumstance i.e. gender dysphoria and neurodiversity. Unfortunately, we are not able to take purely psychological issues into consideration."

It's not something we can afford privately or could save up for, for reasons we won't rehash. (We've written some longer update posts back in late April and late May.)

Our only remaining option now is a fundraiser, but we need to work out how to do so without needing to disclose our surname, since we can't have our alias identified with our full name :Sighing_Face:

#trans #transgender #VoiceTraining #VoiceFeminisation #VoiceFeminisationSurgery #VFS #VoiceDysphoria #NHS #NHSEngland #EOEGS #PALS #IFR #ICB #ICS #GDNRSS #GAHT #GDPR #DSAR #TransRights #TransRightsAreHumanRights #LGBTQ+ #LGBTQIA+ #queer #GenderAffirmingCare

Hey loveliests :NotoEmojiPinkHeart:

We wrote a post back in June, which we recommend reading first for context if you aren't aware of the situation.

In short, the practice manager from our GP surgery emailed us this afternoon with a copy of the response from the local ICB. As expected, it was a "no".

"Regrettably, we cannot approve your funding request as there is no evidence to show this patient is likely to gain significantly more clinical benefit from Glottoplasty surgery than might be normally expected for the general population of patients with the condition or circumstance i.e. gender dysphoria and neurodiversity. Unfortunately, we are not able to take purely psychological issues into consideration."

It's not something we can afford privately or could save up for, for reasons we won't rehash. (We've written some longer update posts back in late April and late May.)

Our only remaining option now is a fundraiser, but we need to work out how to do so without needing to disclose our surname, since we can't have our alias identified with our full name :Sighing_Face:

#trans #transgender #VoiceTraining #VoiceFeminisation #VoiceFeminisationSurgery #VFS #VoiceDysphoria #NHS #NHSEngland #EOEGS #PALS #IFR #ICB #ICS #GDNRSS #GAHT #GDPR #DSAR #TransRights #TransRightsAreHumanRights #LGBTQ+ #LGBTQIA+ #queer #GenderAffirmingCare

Feeling simultaneously anxious and dumb over feeling anxious about this 🥺🤦‍♀️

Yes, we know logically that voice training has been a massive struggle for us and invokes a lot of complex feelings, where:

• we've had insufficient success with voice training, despite starting back in December 2021, to overcome voice dysphoria;
• our voice has been causing us increasing anxiety since we plateaued about 2 years ago;
• our RSD (Rejection Sensitive Dysphoria) makes us want to just give up rather than try again, as anything less than perfection feels worthless and we expect to fail, so why even try;
• we feel like we won't ever have sufficient alone time to practice uninterrupted in quiet without anyone being able to hear us;
• we don't want the kind of stereotypical femme voice pushed by (mostly-US) trans fem voice coaches like TransVoiceLessons, whom we cannot stand;

etc., etc.

We know this all rationally, but we still feel DUMB that we're currently in fight or flight mode over the "Speech & Language Therapy" initial assessment appointment at 14:00 BST 😖

We know we should feel grateful that we're getting anything from the NHS related to gender-affirming care, as they only offer the barest minimum of care and it's taken us from late May 2021 to even progress this far through multiple layers of waitlists and gatekeeping :Sighing_Face:

Right now, we'll just trying to keep ourselves calm and trying to avoid overthinking about it, so we don't truly spiral 😵‍💫

#VoiceTraining #VoiceDysphoria #Speech&LanguageTherapy #RSD #anxiety #NHS #EOEGS #NCTH #trans #TransFem #transgender #transition #SilentlyScreaming

Feeling simultaneously anxious and dumb over feeling anxious about this 🥺🤦‍♀️

Yes, we know logically that voice training has been a massive struggle for us and invokes a lot of complex feelings, where:

• we've had insufficient success with voice training, despite starting back in December 2021, to overcome voice dysphoria;
• our voice has been causing us increasing anxiety since we plateaued about 2 years ago;
• our RSD (Rejection Sensitive Dysphoria) makes us want to just give up rather than try again, as anything less than perfection feels worthless and we expect to fail, so why even try;
• we feel like we won't ever have sufficient alone time to practice uninterrupted in quiet without anyone being able to hear us;
• we don't want the kind of stereotypical femme voice pushed by (mostly-US) trans fem voice coaches like TransVoiceLessons, whom we cannot stand;

etc., etc.

We know this all rationally, but we still feel DUMB that we're currently in fight or flight mode over the "Speech & Language Therapy" initial assessment appointment at 14:00 BST 😖

We know we should feel grateful that we're getting anything from the NHS related to gender-affirming care, as they only offer the barest minimum of care and it's taken us from late May 2021 to even progress this far through multiple layers of waitlists and gatekeeping :Sighing_Face:

Right now, we'll just trying to keep ourselves calm and trying to avoid overthinking about it, so we don't truly spiral 😵‍💫

#VoiceTraining #VoiceDysphoria #Speech&LanguageTherapy #RSD #anxiety #NHS #EOEGS #NCTH #trans #TransFem #transgender #transition #SilentlyScreaming

Feeling simultaneously anxious and dumb over feeling anxious about this 🥺🤦‍♀️

Yes, we know logically that voice training has been a massive struggle for us and invokes a lot of complex feelings, where:

• we've had insufficient success with voice training, despite starting back in December 2021, to overcome voice dysphoria;
• our voice has been causing us increasing anxiety since we plateaued about 2 years ago;
• our RSD (Rejection Sensitive Dysphoria) makes us want to just give up rather than try again, as anything less than perfection feels worthless and we expect to fail, so why even try;
• we feel like we won't ever have sufficient alone time to practice uninterrupted in quiet without anyone being able to hear us;
• we don't want the kind of stereotypical femme voice pushed by (mostly-US) trans fem voice coaches like TransVoiceLessons, whom we cannot stand;

etc., etc.

We know this all rationally, but we still feel DUMB that we're currently in fight or flight mode over the "Speech & Language Therapy" initial assessment appointment at 14:00 BST 😖

We know we should feel grateful that we're getting anything from the NHS related to gender-affirming care, as they only offer the barest minimum of care and it's taken us from late May 2021 to even progress this far through multiple layers of waitlists and gatekeeping :Sighing_Face:

Right now, we'll just trying to keep ourselves calm and trying to avoid overthinking about it, so we don't truly spiral 😵‍💫

#VoiceTraining #VoiceDysphoria #Speech&LanguageTherapy #RSD #anxiety #NHS #EOEGS #NCTH #trans #TransFem #transgender #transition #SilentlyScreaming

Feeling simultaneously anxious and dumb over feeling anxious about this 🥺🤦‍♀️

Yes, we know logically that voice training has been a massive struggle for us and invokes a lot of complex feelings, where:

• we've had insufficient success with voice training, despite starting back in December 2021, to overcome voice dysphoria;
• our voice has been causing us increasing anxiety since we plateaued about 2 years ago;
• our RSD (Rejection Sensitive Dysphoria) makes us want to just give up rather than try again, as anything less than perfection feels worthless and we expect to fail, so why even try;
• we feel like we won't ever have sufficient alone time to practice uninterrupted in quiet without anyone being able to hear us;
• we don't want the kind of stereotypical femme voice pushed by (mostly-US) trans fem voice coaches like TransVoiceLessons, whom we cannot stand;

etc., etc.

We know this all rationally, but we still feel DUMB that we're currently in fight or flight mode over the "Speech & Language Therapy" initial assessment appointment at 14:00 BST 😖

We know we should feel grateful that we're getting anything from the NHS related to gender-affirming care, as they only offer the barest minimum of care and it's taken us from late May 2021 to even progress this far through multiple layers of waitlists and gatekeeping :Sighing_Face:

Right now, we'll just trying to keep ourselves calm and trying to avoid overthinking about it, so we don't truly spiral 😵‍💫

#VoiceTraining #VoiceDysphoria #Speech&LanguageTherapy #RSD #anxiety #NHS #EOEGS #NCTH #trans #TransFem #transgender #transition #SilentlyScreaming

Feeling simultaneously anxious and dumb over feeling anxious about this 🥺🤦‍♀️

Yes, we know logically that voice training has been a massive struggle for us and invokes a lot of complex feelings, where:

• we've had insufficient success with voice training, despite starting back in December 2021, to overcome voice dysphoria;
• our voice has been causing us increasing anxiety since we plateaued about 2 years ago;
• our RSD (Rejection Sensitive Dysphoria) makes us want to just give up rather than try again, as anything less than perfection feels worthless and we expect to fail, so why even try;
• we feel like we won't ever have sufficient alone time to practice uninterrupted in quiet without anyone being able to hear us;
• we don't want the kind of stereotypical femme voice pushed by (mostly-US) trans fem voice coaches like TransVoiceLessons, whom we cannot stand;

etc., etc.

We know this all rationally, but we still feel DUMB that we're currently in fight or flight mode over the "Speech & Language Therapy" initial assessment appointment at 14:00 BST 😖

We know we should feel grateful that we're getting anything from the NHS related to gender-affirming care, as they only offer the barest minimum of care and it's taken us from late May 2021 to even progress this far through multiple layers of waitlists and gatekeeping :Sighing_Face:

Right now, we'll just trying to keep ourselves calm and trying to avoid overthinking about it, so we don't truly spiral 😵‍💫

#VoiceTraining #VoiceDysphoria #Speech&LanguageTherapy #RSD #anxiety #NHS #EOEGS #NCTH #trans #TransFem #transgender #transition #SilentlyScreaming

Hey folks :TransHeart:

So, we're going to try to keep this post shortish for our own wellbeing and sanity, as well as yours.

We will, however, frontload some abbreviations and links:

• EOEGS - East of England Gender Service
• Gender Clinics
  • Aka GIC (Gender Identity Clinic) or, solely by the NHS, Gender Dysphoria Clinic (GDC)
• IFR - Individual Funding Request
• ICB / ICS - Integrated Care Board / System
• GDNRSS - NHS Gender Dysphoria National Referral Support Services
• GAHT - Gender-Affirming Hormone Therapy
• FFS - Facial Feminisation Surgery
• VFS - Voice Feminisation Surgery
• GP - General Practitioner
• PALS - Patient Advice and Liaison Service
• PHSO - Parliamentary and Health Service Ombudsman

We have already written up about some of our early experience of trying to get gender-affirming care from the NHS in an article for TransActual, but that was published back in October 2023, so it's more than a little outdated now 😅

Back in August 2023, we knew it was possible to request funding for gender-affirming surgeries not routinely covered by the NHS via IFRs. These are submitted to your local ICB, who will likely refuse funding unless you've made a really good funding case.

(It's worth noting here that such gender-affirming surgeries are recommended by WPATH's SOC8: the NHS just disagrees and refuses to follow the international recommendations.)

Nonetheless, we mostly just wanted the chance to put our case forward for VFS. A standalone bilateral orchidectomy and FFS were there, but as lower priorities, since it was our voice causing us the most issues.

(We won't list all of our voice dysphoria issues here, but basically we've been doing voice feminisation training since December 2021 and we're nowhere near even the lowest-end voice goals. Our voice leads to us getting regularly misgendered both on the phone and even in person 😞 We've done our genuine best for years and VFS is very much our last resort.)

We are going to give selective details of what's happened since, but we'll first cut to key points: the EOEGS (our gender clinic) has been refusing to comply with their responsibilities for approaching 2 YEARS and no-one within the NHS will hold them to account.

First they denied responsibility for IFRs and tried to say it was our GP's responsibility. So, we went to our local ICB to ask them and got given the details for the NHS England IFR team, who told us -- in no uncertain terms -- that it was the responsibility of the EOEGS to submit these for us. That was back in very early 2024.

We forwarded this to the EOEGS, and then followed it up with them at our 3rd appointment (Q1 2024). They still denied responsibility, so we forwarded on the proof again. And waited. 3 months later (Q2 2024), we chased... and waited again.

Near the end of Q3 2024, the EOEGS finally wrote up the notes from the 3rd appointment (~6 months ago), and mailed them to us and our GP in the post (no digital copy or email)... with multiple factual errors :Sighing_Face: 🤦‍♀️

So, we scanned the letter, turned it into a PDF, then highlighted and corrected all the errors. We then politely emailed it across to the EOEGS, CCing in our GP, along with a clear restatement of outstanding issues and requests.

As the quarter ended, we got an offer of a 4th appointment (more surgical referral gatekeeping nonsense) next quarter. Then silence, yet again.

Q4 2024 came around. The EOEGS claimed that the IFR issue was still with its "service lead". We raised it at the 4th appointment. No answers. Only further promises to look into it and get back to us.

As 2024 ended, we went back to the NHS England IFR team. They confirmed once again that our gender clinic was shirking their responsibility over IFRs. So, we chased the EOEGS for the last time that year. No response ever came.

As we moved into 2025, we reached out to GDNRSS to ask for guidance and help. They responded quickly, but advised that the only thing we could do was to raise a complaint with PALS.

So, that's what we did, CCing in the EOEGS, and made it very clear that this was only being done as a matter of last resort.

By now, as you can imagine, we weren't expecting anything great. However, we hadn't been mentally prepared for the combination of incompetence, lack of reading comprehension, and institutional malice that followed.

They'd send us a complaint response that didn't show any understanding of our complaint. We'd go back and clarify the issues again, and suggest a call to discuss it. They'd investigate more, say that they'd pass along our request for a call, delay the response, and then send another one which again failed to address the core issues.

By Q2 2025, we reached the point where they refused to take the complaint forward any further, and just directed us to the PSHO, which is very much biased towards whatever the current government wants.

In other words, we'd run out of options to hold the EOEGS accountable 😞

NGL: in combination with multiple other factors, this kind of broke us, and we simply had none of the time, energy, spoons, or motivation to follow up any further.

After a few weeks, however, we decided on 2 last-ditch options available to us:

1. Raise a DSAR (Data Subject Access Request) under GDPR to request a copy of any and all communications mentioning us (directly or indirectly) and our requests by all organisations and individuals involved.
2. Reach out to the senior partner at our GP surgery, via the practice manager, to ask if they'd consider submitting an IFR for us for at least VFS.

On the 1st point, the ticking clock for that started just a few days ago. Officially they have 1 calendar month to comply, but can request up to 3 calendar months if the request is deemed complex. We are under no obligation to agree to this as the data subject.

On the 2nd point, the senior partner had a call with us over the issues, then asked whether we could compile all the info on everything for him. We said it would be difficult for us, but agreed, so he booked a follow-up appointment for us on 2025-06-09 (yesterday).

NGL: going through all the emails and documents again, then summarising them into a chronological sequence of events, was very, very difficult for many reasons, but primarily because it meant going back through everything and reliving the cumulative trauma of it :PleadingFace:

Nonetheless, we finished compiling it all just a couple of hours before the appointment. A "summary" document that spanned 4 sides of A4 and all the relevant "receipts" (digital documents like emails and PDFs), covering from August 2023 to June 2025.

Whilst the senior partner said it will take him time to go through it all, the key thing is that he agreed to submit the IFR for us.

It honestly made us teary just to have someone actually care enough to truly listen and be willing to discuss it with us :FaceHoldingBackTears:

Of course, this is just the beginning of another long, drawn-out process. It's likely going to take at least several weeks until we even get to the stage of working together to put together the best case possible, let alone getting the IFR submitted. It could even be months.

Even when it's submitted, it'll then be up to our local ICB to review the submission, and they will almost certainly find a reason or reasons to deny the application.

We're still not expecting this to succeed. We just wanted to have the chance to have at least one request submitted and reviewed.

The EOEGS and other NHS departments spent a level of magnitude more time, energy, and resources denying us the right to even consider submitting IFRs for us because, we suspect, they didn't want to set a precedent of trans patients in England utilising their rights.

Or maybe just because they didn't want to comply.

Whatever happens with the eventual IFR submission, at least we'll have tried every way we can think of to get the NHS to fund a basic gender-affirming surgery that would massively improve our daily quality of life.

If by some miracle the IFR is approved, it'll give us and maybe others a small glimmer of hope.

But realistically-speaking, at least then we can create a fundraiser for VFS with a clear conscience that we tried everything else we could first 🥺

If you got this far, thank you for reading this :TransHeart: Feel free to boost it, if you want others to read it too :BoostsOKPrideSymbol:

#trans #transgender #VoiceTraining #VoiceFeminisation #VoiceFeminisationSurgery #VFS #VoiceDysphoria #NHS #NHSEngland #EOEGS #PALS #IFR #ICB #ICS #GDNRSS #GAHT #GDPR #DSAR #TransRights #TransRightsAreHumanRights #LGBTQ+ #LGBTQIA+ #queer #GenderAffirmingCare

Hey folks :TransHeart:

So, we're going to try to keep this post shortish for our own wellbeing and sanity, as well as yours.

We will, however, frontload some abbreviations and links:

• EOEGS - East of England Gender Service
• Gender Clinics
  • Aka GIC (Gender Identity Clinic) or, solely by the NHS, Gender Dysphoria Clinic (GDC)
• IFR - Individual Funding Request
• ICB / ICS - Integrated Care Board / System
• GDNRSS - NHS Gender Dysphoria National Referral Support Services
• GAHT - Gender-Affirming Hormone Therapy
• FFS - Facial Feminisation Surgery
• VFS - Voice Feminisation Surgery
• GP - General Practitioner
• PALS - Patient Advice and Liaison Service
• PHSO - Parliamentary and Health Service Ombudsman

We have already written up about some of our early experience of trying to get gender-affirming care from the NHS in an article for TransActual, but that was published back in October 2023, so it's more than a little outdated now 😅

Back in August 2023, we knew it was possible to request funding for gender-affirming surgeries not routinely covered by the NHS via IFRs. These are submitted to your local ICB, who will likely refuse funding unless you've made a really good funding case.

(It's worth noting here that such gender-affirming surgeries are recommended by WPATH's SOC8: the NHS just disagrees and refuses to follow the international recommendations.)

Nonetheless, we mostly just wanted the chance to put our case forward for VFS. A standalone bilateral orchidectomy and FFS were there, but as lower priorities, since it was our voice causing us the most issues.

(We won't list all of our voice dysphoria issues here, but basically we've been doing voice feminisation training since December 2021 and we're nowhere near even the lowest-end voice goals. Our voice leads to us getting regularly misgendered both on the phone and even in person 😞 We've done our genuine best for years and VFS is very much our last resort.)

We are going to give selective details of what's happened since, but we'll first cut to key points: the EOEGS (our gender clinic) has been refusing to comply with their responsibilities for approaching 2 YEARS and no-one within the NHS will hold them to account.

First they denied responsibility for IFRs and tried to say it was our GP's responsibility. So, we went to our local ICB to ask them and got given the details for the NHS England IFR team, who told us -- in no uncertain terms -- that it was the responsibility of the EOEGS to submit these for us. That was back in very early 2024.

We forwarded this to the EOEGS, and then followed it up with them at our 3rd appointment (Q1 2024). They still denied responsibility, so we forwarded on the proof again. And waited. 3 months later (Q2 2024), we chased... and waited again.

Near the end of Q3 2024, the EOEGS finally wrote up the notes from the 3rd appointment (~6 months ago), and mailed them to us and our GP in the post (no digital copy or email)... with multiple factual errors :Sighing_Face: 🤦‍♀️

So, we scanned the letter, turned it into a PDF, then highlighted and corrected all the errors. We then politely emailed it across to the EOEGS, CCing in our GP, along with a clear restatement of outstanding issues and requests.

As the quarter ended, we got an offer of a 4th appointment (more surgical referral gatekeeping nonsense) next quarter. Then silence, yet again.

Q4 2024 came around. The EOEGS claimed that the IFR issue was still with its "service lead". We raised it at the 4th appointment. No answers. Only further promises to look into it and get back to us.

As 2024 ended, we went back to the NHS England IFR team. They confirmed once again that our gender clinic was shirking their responsibility over IFRs. So, we chased the EOEGS for the last time that year. No response ever came.

As we moved into 2025, we reached out to GDNRSS to ask for guidance and help. They responded quickly, but advised that the only thing we could do was to raise a complaint with PALS.

So, that's what we did, CCing in the EOEGS, and made it very clear that this was only being done as a matter of last resort.

By now, as you can imagine, we weren't expecting anything great. However, we hadn't been mentally prepared for the combination of incompetence, lack of reading comprehension, and institutional malice that followed.

They'd send us a complaint response that didn't show any understanding of our complaint. We'd go back and clarify the issues again, and suggest a call to discuss it. They'd investigate more, say that they'd pass along our request for a call, delay the response, and then send another one which again failed to address the core issues.

By Q2 2025, we reached the point where they refused to take the complaint forward any further, and just directed us to the PSHO, which is very much biased towards whatever the current government wants.

In other words, we'd run out of options to hold the EOEGS accountable 😞

NGL: in combination with multiple other factors, this kind of broke us, and we simply had none of the time, energy, spoons, or motivation to follow up any further.

After a few weeks, however, we decided on 2 last-ditch options available to us:

1. Raise a DSAR (Data Subject Access Request) under GDPR to request a copy of any and all communications mentioning us (directly or indirectly) and our requests by all organisations and individuals involved.
2. Reach out to the senior partner at our GP surgery, via the practice manager, to ask if they'd consider submitting an IFR for us for at least VFS.

On the 1st point, the ticking clock for that started just a few days ago. Officially they have 1 calendar month to comply, but can request up to 3 calendar months if the request is deemed complex. We are under no obligation to agree to this as the data subject.

On the 2nd point, the senior partner had a call with us over the issues, then asked whether we could compile all the info on everything for him. We said it would be difficult for us, but agreed, so he booked a follow-up appointment for us on 2025-06-09 (yesterday).

NGL: going through all the emails and documents again, then summarising them into a chronological sequence of events, was very, very difficult for many reasons, but primarily because it meant going back through everything and reliving the cumulative trauma of it :PleadingFace:

Nonetheless, we finished compiling it all just a couple of hours before the appointment. A "summary" document that spanned 4 sides of A4 and all the relevant "receipts" (digital documents like emails and PDFs), covering from August 2023 to June 2025.

Whilst the senior partner said it will take him time to go through it all, the key thing is that he agreed to submit the IFR for us.

It honestly made us teary just to have someone actually care enough to truly listen and be willing to discuss it with us :FaceHoldingBackTears:

Of course, this is just the beginning of another long, drawn-out process. It's likely going to take at least several weeks until we even get to the stage of working together to put together the best case possible, let alone getting the IFR submitted. It could even be months.

Even when it's submitted, it'll then be up to our local ICB to review the submission, and they will almost certainly find a reason or reasons to deny the application.

We're still not expecting this to succeed. We just wanted to have the chance to have at least one request submitted and reviewed.

The EOEGS and other NHS departments spent a level of magnitude more time, energy, and resources denying us the right to even consider submitting IFRs for us because, we suspect, they didn't want to set a precedent of trans patients in England utilising their rights.

Or maybe just because they didn't want to comply.

Whatever happens with the eventual IFR submission, at least we'll have tried every way we can think of to get the NHS to fund a basic gender-affirming surgery that would massively improve our daily quality of life.

If by some miracle the IFR is approved, it'll give us and maybe others a small glimmer of hope.

But realistically-speaking, at least then we can create a fundraiser for VFS with a clear conscience that we tried everything else we could first 🥺

If you got this far, thank you for reading this :TransHeart: Feel free to boost it, if you want others to read it too :BoostsOKPrideSymbol:

#trans #transgender #VoiceTraining #VoiceFeminisation #VoiceFeminisationSurgery #VFS #VoiceDysphoria #NHS #NHSEngland #EOEGS #PALS #IFR #ICB #ICS #GDNRSS #GAHT #GDPR #DSAR #TransRights #TransRightsAreHumanRights #LGBTQ+ #LGBTQIA+ #queer #GenderAffirmingCare

Hey folks :TransHeart:

So, we're going to try to keep this post shortish for our own wellbeing and sanity, as well as yours.

We will, however, frontload some abbreviations and links:

• EOEGS - East of England Gender Service
• Gender Clinics
  • Aka GIC (Gender Identity Clinic) or, solely by the NHS, Gender Dysphoria Clinic (GDC)
• IFR - Individual Funding Request
• ICB / ICS - Integrated Care Board / System
• GDNRSS - NHS Gender Dysphoria National Referral Support Services
• GAHT - Gender-Affirming Hormone Therapy
• FFS - Facial Feminisation Surgery
• VFS - Voice Feminisation Surgery
• GP - General Practitioner
• PALS - Patient Advice and Liaison Service
• PHSO - Parliamentary and Health Service Ombudsman

We have already written up about some of our early experience of trying to get gender-affirming care from the NHS in an article for TransActual, but that was published back in October 2023, so it's more than a little outdated now 😅

Back in August 2023, we knew it was possible to request funding for gender-affirming surgeries not routinely covered by the NHS via IFRs. These are submitted to your local ICB, who will likely refuse funding unless you've made a really good funding case.

(It's worth noting here that such gender-affirming surgeries are recommended by WPATH's SOC8: the NHS just disagrees and refuses to follow the international recommendations.)

Nonetheless, we mostly just wanted the chance to put our case forward for VFS. A standalone bilateral orchidectomy and FFS were there, but as lower priorities, since it was our voice causing us the most issues.

(We won't list all of our voice dysphoria issues here, but basically we've been doing voice feminisation training since December 2021 and we're nowhere near even the lowest-end voice goals. Our voice leads to us getting regularly misgendered both on the phone and even in person 😞 We've done our genuine best for years and VFS is very much our last resort.)

We are going to give selective details of what's happened since, but we'll first cut to key points: the EOEGS (our gender clinic) has been refusing to comply with their responsibilities for approaching 2 YEARS and no-one within the NHS will hold them to account.

First they denied responsibility for IFRs and tried to say it was our GP's responsibility. So, we went to our local ICB to ask them and got given the details for the NHS England IFR team, who told us -- in no uncertain terms -- that it was the responsibility of the EOEGS to submit these for us. That was back in very early 2024.

We forwarded this to the EOEGS, and then followed it up with them at our 3rd appointment (Q1 2024). They still denied responsibility, so we forwarded on the proof again. And waited. 3 months later (Q2 2024), we chased... and waited again.

Near the end of Q3 2024, the EOEGS finally wrote up the notes from the 3rd appointment (~6 months ago), and mailed them to us and our GP in the post (no digital copy or email)... with multiple factual errors :Sighing_Face: 🤦‍♀️

So, we scanned the letter, turned it into a PDF, then highlighted and corrected all the errors. We then politely emailed it across to the EOEGS, CCing in our GP, along with a clear restatement of outstanding issues and requests.

As the quarter ended, we got an offer of a 4th appointment (more surgical referral gatekeeping nonsense) next quarter. Then silence, yet again.

Q4 2024 came around. The EOEGS claimed that the IFR issue was still with its "service lead". We raised it at the 4th appointment. No answers. Only further promises to look into it and get back to us.

As 2024 ended, we went back to the NHS England IFR team. They confirmed once again that our gender clinic was shirking their responsibility over IFRs. So, we chased the EOEGS for the last time that year. No response ever came.

As we moved into 2025, we reached out to GDNRSS to ask for guidance and help. They responded quickly, but advised that the only thing we could do was to raise a complaint with PALS.

So, that's what we did, CCing in the EOEGS, and made it very clear that this was only being done as a matter of last resort.

By now, as you can imagine, we weren't expecting anything great. However, we hadn't been mentally prepared for the combination of incompetence, lack of reading comprehension, and institutional malice that followed.

They'd send us a complaint response that didn't show any understanding of our complaint. We'd go back and clarify the issues again, and suggest a call to discuss it. They'd investigate more, say that they'd pass along our request for a call, delay the response, and then send another one which again failed to address the core issues.

By Q2 2025, we reached the point where they refused to take the complaint forward any further, and just directed us to the PSHO, which is very much biased towards whatever the current government wants.

In other words, we'd run out of options to hold the EOEGS accountable 😞

NGL: in combination with multiple other factors, this kind of broke us, and we simply had none of the time, energy, spoons, or motivation to follow up any further.

After a few weeks, however, we decided on 2 last-ditch options available to us:

1. Raise a DSAR (Data Subject Access Request) under GDPR to request a copy of any and all communications mentioning us (directly or indirectly) and our requests by all organisations and individuals involved.
2. Reach out to the senior partner at our GP surgery, via the practice manager, to ask if they'd consider submitting an IFR for us for at least VFS.

On the 1st point, the ticking clock for that started just a few days ago. Officially they have 1 calendar month to comply, but can request up to 3 calendar months if the request is deemed complex. We are under no obligation to agree to this as the data subject.

On the 2nd point, the senior partner had a call with us over the issues, then asked whether we could compile all the info on everything for him. We said it would be difficult for us, but agreed, so he booked a follow-up appointment for us on 2025-06-09 (yesterday).

NGL: going through all the emails and documents again, then summarising them into a chronological sequence of events, was very, very difficult for many reasons, but primarily because it meant going back through everything and reliving the cumulative trauma of it :PleadingFace:

Nonetheless, we finished compiling it all just a couple of hours before the appointment. A "summary" document that spanned 4 sides of A4 and all the relevant "receipts" (digital documents like emails and PDFs), covering from August 2023 to June 2025.

Whilst the senior partner said it will take him time to go through it all, the key thing is that he agreed to submit the IFR for us.

It honestly made us teary just to have someone actually care enough to truly listen and be willing to discuss it with us :FaceHoldingBackTears:

Of course, this is just the beginning of another long, drawn-out process. It's likely going to take at least several weeks until we even get to the stage of working together to put together the best case possible, let alone getting the IFR submitted. It could even be months.

Even when it's submitted, it'll then be up to our local ICB to review the submission, and they will almost certainly find a reason or reasons to deny the application.

We're still not expecting this to succeed. We just wanted to have the chance to have at least one request submitted and reviewed.

The EOEGS and other NHS departments spent a level of magnitude more time, energy, and resources denying us the right to even consider submitting IFRs for us because, we suspect, they didn't want to set a precedent of trans patients in England utilising their rights.

Or maybe just because they didn't want to comply.

Whatever happens with the eventual IFR submission, at least we'll have tried every way we can think of to get the NHS to fund a basic gender-affirming surgery that would massively improve our daily quality of life.

If by some miracle the IFR is approved, it'll give us and maybe others a small glimmer of hope.

But realistically-speaking, at least then we can create a fundraiser for VFS with a clear conscience that we tried everything else we could first 🥺

If you got this far, thank you for reading this :TransHeart: Feel free to boost it, if you want others to read it too :BoostsOKPrideSymbol:

#trans #transgender #VoiceTraining #VoiceFeminisation #VoiceFeminisationSurgery #VFS #VoiceDysphoria #NHS #NHSEngland #EOEGS #PALS #IFR #ICB #ICS #GDNRSS #GAHT #GDPR #DSAR #TransRights #TransRightsAreHumanRights #LGBTQ+ #LGBTQIA+ #queer #GenderAffirmingCare

Hey folks :TransHeart:

So, we're going to try to keep this post shortish for our own wellbeing and sanity, as well as yours.

We will, however, frontload some abbreviations and links:

• EOEGS - East of England Gender Service
• Gender Clinics
  • Aka GIC (Gender Identity Clinic) or, solely by the NHS, Gender Dysphoria Clinic (GDC)
• IFR - Individual Funding Request
• ICB / ICS - Integrated Care Board / System
• GDNRSS - NHS Gender Dysphoria National Referral Support Services
• GAHT - Gender-Affirming Hormone Therapy
• FFS - Facial Feminisation Surgery
• VFS - Voice Feminisation Surgery
• GP - General Practitioner
• PALS - Patient Advice and Liaison Service
• PHSO - Parliamentary and Health Service Ombudsman

We have already written up about some of our early experience of trying to get gender-affirming care from the NHS in an article for TransActual, but that was published back in October 2023, so it's more than a little outdated now 😅

Back in August 2023, we knew it was possible to request funding for gender-affirming surgeries not routinely covered by the NHS via IFRs. These are submitted to your local ICB, who will likely refuse funding unless you've made a really good funding case.

(It's worth noting here that such gender-affirming surgeries are recommended by WPATH's SOC8: the NHS just disagrees and refuses to follow the international recommendations.)

Nonetheless, we mostly just wanted the chance to put our case forward for VFS. A standalone bilateral orchidectomy and FFS were there, but as lower priorities, since it was our voice causing us the most issues.

(We won't list all of our voice dysphoria issues here, but basically we've been doing voice feminisation training since December 2021 and we're nowhere near even the lowest-end voice goals. Our voice leads to us getting regularly misgendered both on the phone and even in person 😞 We've done our genuine best for years and VFS is very much our last resort.)

We are going to give selective details of what's happened since, but we'll first cut to key points: the EOEGS (our gender clinic) has been refusing to comply with their responsibilities for approaching 2 YEARS and no-one within the NHS will hold them to account.

First they denied responsibility for IFRs and tried to say it was our GP's responsibility. So, we went to our local ICB to ask them and got given the details for the NHS England IFR team, who told us -- in no uncertain terms -- that it was the responsibility of the EOEGS to submit these for us. That was back in very early 2024.

We forwarded this to the EOEGS, and then followed it up with them at our 3rd appointment (Q1 2024). They still denied responsibility, so we forwarded on the proof again. And waited. 3 months later (Q2 2024), we chased... and waited again.

Near the end of Q3 2024, the EOEGS finally wrote up the notes from the 3rd appointment (~6 months ago), and mailed them to us and our GP in the post (no digital copy or email)... with multiple factual errors :Sighing_Face: 🤦‍♀️

So, we scanned the letter, turned it into a PDF, then highlighted and corrected all the errors. We then politely emailed it across to the EOEGS, CCing in our GP, along with a clear restatement of outstanding issues and requests.

As the quarter ended, we got an offer of a 4th appointment (more surgical referral gatekeeping nonsense) next quarter. Then silence, yet again.

Q4 2024 came around. The EOEGS claimed that the IFR issue was still with its "service lead". We raised it at the 4th appointment. No answers. Only further promises to look into it and get back to us.

As 2024 ended, we went back to the NHS England IFR team. They confirmed once again that our gender clinic was shirking their responsibility over IFRs. So, we chased the EOEGS for the last time that year. No response ever came.

As we moved into 2025, we reached out to GDNRSS to ask for guidance and help. They responded quickly, but advised that the only thing we could do was to raise a complaint with PALS.

So, that's what we did, CCing in the EOEGS, and made it very clear that this was only being done as a matter of last resort.

By now, as you can imagine, we weren't expecting anything great. However, we hadn't been mentally prepared for the combination of incompetence, lack of reading comprehension, and institutional malice that followed.

They'd send us a complaint response that didn't show any understanding of our complaint. We'd go back and clarify the issues again, and suggest a call to discuss it. They'd investigate more, say that they'd pass along our request for a call, delay the response, and then send another one which again failed to address the core issues.

By Q2 2025, we reached the point where they refused to take the complaint forward any further, and just directed us to the PSHO, which is very much biased towards whatever the current government wants.

In other words, we'd run out of options to hold the EOEGS accountable 😞

NGL: in combination with multiple other factors, this kind of broke us, and we simply had none of the time, energy, spoons, or motivation to follow up any further.

After a few weeks, however, we decided on 2 last-ditch options available to us:

1. Raise a DSAR (Data Subject Access Request) under GDPR to request a copy of any and all communications mentioning us (directly or indirectly) and our requests by all organisations and individuals involved.
2. Reach out to the senior partner at our GP surgery, via the practice manager, to ask if they'd consider submitting an IFR for us for at least VFS.

On the 1st point, the ticking clock for that started just a few days ago. Officially they have 1 calendar month to comply, but can request up to 3 calendar months if the request is deemed complex. We are under no obligation to agree to this as the data subject.

On the 2nd point, the senior partner had a call with us over the issues, then asked whether we could compile all the info on everything for him. We said it would be difficult for us, but agreed, so he booked a follow-up appointment for us on 2025-06-09 (yesterday).

NGL: going through all the emails and documents again, then summarising them into a chronological sequence of events, was very, very difficult for many reasons, but primarily because it meant going back through everything and reliving the cumulative trauma of it :PleadingFace:

Nonetheless, we finished compiling it all just a couple of hours before the appointment. A "summary" document that spanned 4 sides of A4 and all the relevant "receipts" (digital documents like emails and PDFs), covering from August 2023 to June 2025.

Whilst the senior partner said it will take him time to go through it all, the key thing is that he agreed to submit the IFR for us.

It honestly made us teary just to have someone actually care enough to truly listen and be willing to discuss it with us :FaceHoldingBackTears:

Of course, this is just the beginning of another long, drawn-out process. It's likely going to take at least several weeks until we even get to the stage of working together to put together the best case possible, let alone getting the IFR submitted. It could even be months.

Even when it's submitted, it'll then be up to our local ICB to review the submission, and they will almost certainly find a reason or reasons to deny the application.

We're still not expecting this to succeed. We just wanted to have the chance to have at least one request submitted and reviewed.

The EOEGS and other NHS departments spent a level of magnitude more time, energy, and resources denying us the right to even consider submitting IFRs for us because, we suspect, they didn't want to set a precedent of trans patients in England utilising their rights.

Or maybe just because they didn't want to comply.

Whatever happens with the eventual IFR submission, at least we'll have tried every way we can think of to get the NHS to fund a basic gender-affirming surgery that would massively improve our daily quality of life.

If by some miracle the IFR is approved, it'll give us and maybe others a small glimmer of hope.

But realistically-speaking, at least then we can create a fundraiser for VFS with a clear conscience that we tried everything else we could first 🥺

If you got this far, thank you for reading this :TransHeart: Feel free to boost it, if you want others to read it too :BoostsOKPrideSymbol:

#trans #transgender #VoiceTraining #VoiceFeminisation #VoiceFeminisationSurgery #VFS #VoiceDysphoria #NHS #NHSEngland #EOEGS #PALS #IFR #ICB #ICS #GDNRSS #GAHT #GDPR #DSAR #TransRights #TransRightsAreHumanRights #LGBTQ+ #LGBTQIA+ #queer #GenderAffirmingCare

Hey folks :TransHeart:

So, we're going to try to keep this post shortish for our own wellbeing and sanity, as well as yours.

We will, however, frontload some abbreviations and links:

• EOEGS - East of England Gender Service
• Gender Clinics
  • Aka GIC (Gender Identity Clinic) or, solely by the NHS, Gender Dysphoria Clinic (GDC)
• IFR - Individual Funding Request
• ICB / ICS - Integrated Care Board / System
• GDNRSS - NHS Gender Dysphoria National Referral Support Services
• GAHT - Gender-Affirming Hormone Therapy
• FFS - Facial Feminisation Surgery
• VFS - Voice Feminisation Surgery
• GP - General Practitioner
• PALS - Patient Advice and Liaison Service
• PHSO - Parliamentary and Health Service Ombudsman

We have already written up about some of our early experience of trying to get gender-affirming care from the NHS in an article for TransActual, but that was published back in October 2023, so it's more than a little outdated now 😅

Back in August 2023, we knew it was possible to request funding for gender-affirming surgeries not routinely covered by the NHS via IFRs. These are submitted to your local ICB, who will likely refuse funding unless you've made a really good funding case.

(It's worth noting here that such gender-affirming surgeries are recommended by WPATH's SOC8: the NHS just disagrees and refuses to follow the international recommendations.)

Nonetheless, we mostly just wanted the chance to put our case forward for VFS. A standalone bilateral orchidectomy and FFS were there, but as lower priorities, since it was our voice causing us the most issues.

(We won't list all of our voice dysphoria issues here, but basically we've been doing voice feminisation training since December 2021 and we're nowhere near even the lowest-end voice goals. Our voice leads to us getting regularly misgendered both on the phone and even in person 😞 We've done our genuine best for years and VFS is very much our last resort.)

We are going to give selective details of what's happened since, but we'll first cut to key points: the EOEGS (our gender clinic) has been refusing to comply with their responsibilities for approaching 2 YEARS and no-one within the NHS will hold them to account.

First they denied responsibility for IFRs and tried to say it was our GP's responsibility. So, we went to our local ICB to ask them and got given the details for the NHS England IFR team, who told us -- in no uncertain terms -- that it was the responsibility of the EOEGS to submit these for us. That was back in very early 2024.

We forwarded this to the EOEGS, and then followed it up with them at our 3rd appointment (Q1 2024). They still denied responsibility, so we forwarded on the proof again. And waited. 3 months later (Q2 2024), we chased... and waited again.

Near the end of Q3 2024, the EOEGS finally wrote up the notes from the 3rd appointment (~6 months ago), and mailed them to us and our GP in the post (no digital copy or email)... with multiple factual errors :Sighing_Face: 🤦‍♀️

So, we scanned the letter, turned it into a PDF, then highlighted and corrected all the errors. We then politely emailed it across to the EOEGS, CCing in our GP, along with a clear restatement of outstanding issues and requests.

As the quarter ended, we got an offer of a 4th appointment (more surgical referral gatekeeping nonsense) next quarter. Then silence, yet again.

Q4 2024 came around. The EOEGS claimed that the IFR issue was still with its "service lead". We raised it at the 4th appointment. No answers. Only further promises to look into it and get back to us.

As 2024 ended, we went back to the NHS England IFR team. They confirmed once again that our gender clinic was shirking their responsibility over IFRs. So, we chased the EOEGS for the last time that year. No response ever came.

As we moved into 2025, we reached out to GDNRSS to ask for guidance and help. They responded quickly, but advised that the only thing we could do was to raise a complaint with PALS.

So, that's what we did, CCing in the EOEGS, and made it very clear that this was only being done as a matter of last resort.

By now, as you can imagine, we weren't expecting anything great. However, we hadn't been mentally prepared for the combination of incompetence, lack of reading comprehension, and institutional malice that followed.

They'd send us a complaint response that didn't show any understanding of our complaint. We'd go back and clarify the issues again, and suggest a call to discuss it. They'd investigate more, say that they'd pass along our request for a call, delay the response, and then send another one which again failed to address the core issues.

By Q2 2025, we reached the point where they refused to take the complaint forward any further, and just directed us to the PSHO, which is very much biased towards whatever the current government wants.

In other words, we'd run out of options to hold the EOEGS accountable 😞

NGL: in combination with multiple other factors, this kind of broke us, and we simply had none of the time, energy, spoons, or motivation to follow up any further.

After a few weeks, however, we decided on 2 last-ditch options available to us:

1. Raise a DSAR (Data Subject Access Request) under GDPR to request a copy of any and all communications mentioning us (directly or indirectly) and our requests by all organisations and individuals involved.
2. Reach out to the senior partner at our GP surgery, via the practice manager, to ask if they'd consider submitting an IFR for us for at least VFS.

On the 1st point, the ticking clock for that started just a few days ago. Officially they have 1 calendar month to comply, but can request up to 3 calendar months if the request is deemed complex. We are under no obligation to agree to this as the data subject.

On the 2nd point, the senior partner had a call with us over the issues, then asked whether we could compile all the info on everything for him. We said it would be difficult for us, but agreed, so he booked a follow-up appointment for us on 2025-06-09 (yesterday).

NGL: going through all the emails and documents again, then summarising them into a chronological sequence of events, was very, very difficult for many reasons, but primarily because it meant going back through everything and reliving the cumulative trauma of it :PleadingFace:

Nonetheless, we finished compiling it all just a couple of hours before the appointment. A "summary" document that spanned 4 sides of A4 and all the relevant "receipts" (digital documents like emails and PDFs), covering from August 2023 to June 2025.

Whilst the senior partner said it will take him time to go through it all, the key thing is that he agreed to submit the IFR for us.

It honestly made us teary just to have someone actually care enough to truly listen and be willing to discuss it with us :FaceHoldingBackTears:

Of course, this is just the beginning of another long, drawn-out process. It's likely going to take at least several weeks until we even get to the stage of working together to put together the best case possible, let alone getting the IFR submitted. It could even be months.

Even when it's submitted, it'll then be up to our local ICB to review the submission, and they will almost certainly find a reason or reasons to deny the application.

We're still not expecting this to succeed. We just wanted to have the chance to have at least one request submitted and reviewed.

The EOEGS and other NHS departments spent a level of magnitude more time, energy, and resources denying us the right to even consider submitting IFRs for us because, we suspect, they didn't want to set a precedent of trans patients in England utilising their rights.

Or maybe just because they didn't want to comply.

Whatever happens with the eventual IFR submission, at least we'll have tried every way we can think of to get the NHS to fund a basic gender-affirming surgery that would massively improve our daily quality of life.

If by some miracle the IFR is approved, it'll give us and maybe others a small glimmer of hope.

But realistically-speaking, at least then we can create a fundraiser for VFS with a clear conscience that we tried everything else we could first 🥺

If you got this far, thank you for reading this :TransHeart: Feel free to boost it, if you want others to read it too :BoostsOKPrideSymbol:

#trans #transgender #VoiceTraining #VoiceFeminisation #VoiceFeminisationSurgery #VFS #VoiceDysphoria #NHS #NHSEngland #EOEGS #PALS #IFR #ICB #ICS #GDNRSS #GAHT #GDPR #DSAR #TransRights #TransRightsAreHumanRights #LGBTQ+ #LGBTQIA+ #queer #GenderAffirmingCare

Any other trans folks, especially those who've done voice training to overcome voice dysphoria, find it odd when others compliment or like their voice, despite you not liking it yourself? 🥺

I know that logically I've made a lot of progress with feminising my voice in the last 2 and a bit years, but I'm still not at a point where I like my voice or feel happy with it.

#trans #transgender #TransVoice #voice #VoiceFeminisation #VoiceTraining #VoiceDysphoria #transition #LGBTQ+

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Be seriously, it DO be like this for me :PleadingFace: 😞

#trans #transgender #TransFem #meme #memes #dysphoria #VoiceDysphoria #GenderDysphoria

Do any other trans folks find that they feel dysphoria over their own voice whilst simultaneously liking many other trans folks' voices irrespective of how they sound?

Additionally, I don't feel the need for my voice to be cis passing, but I would also like to be correctly gendered when I speak.

Voice dysphoria be weird, right? :TransHeart:

#trans #transgender #TransFem #VoiceDysphoria #TransVoice