Shit my GIC says

A screenshot from nhs lothian's screening advice page. Transmen & Non-Binary If you’re a trans woman and taking hormones, the development of breast tissue means that you may be at risk of developing breast cancer.

the URL for this reads 'BS-Information'.

Screenshot from NHS Lothian's SHARED CARE AGREEMENT for Feminising Endocrine Treatment (Estradiol and GnRHa), 2024 4. The following are NOT required: • Osteoporosis screening (bone loss only happens with prolonged GnRH treatment without added-in oestrogen, which should not happen)

Screenshot from Bone Safety During the First Ten Years of Gender‐Affirming Hormonal Treatment in Transwomen and Transmen (sic) In transwomen (sic) in the highest estradiol tertile (mean 443 pmol/L), an increase in LS BMD was observed (+0.044 g/cm2; 95% CI, +0.025 to +0.063 g/cm2), whereas it decreased in those in the lowest tertile (mean 118 pmol/L: –0.026 g/cm2; 95% CI, –0.044 to –0.009 g/cm2).

Relatedly, the claim that BMD loss only happens if no E is taken with gnrhas is provably false: Low estrogen levels over time in trans women taking E lead to bone density loss.

pmc.ncbi.nlm.nih.gov...

Screenshot from NHS Lothian's SHARED CARE AGREEMENT for Feminising Endocrine Treatment (Estradiol and GnRHa), 2024 Estradiol levels up to 600 pmol/L are appropriate though regular screening of estradiol levels is not recommended. The GIC will base its advice regarding changing dose primarily according to clinical response.

Even the other GICs actually bother to measure estrogen levels.

Screenshot from NHS Lothian's SHARED CARE AGREEMENT for Feminising Endocrine Treatment (Estradiol and GnRHa), 2024. OR • Cyproterone acetate (25-100 mg daily: 6 monthly checks of LFTs are necessary as serious hepatotoxicity has been reported). This is likely to be used only when patients are already taking it eg prior to moving to Lothian and is rarely prescribed.

NHS Lothian joining the enough CPA to give an elephant brain cancer brigade in a document freshly created in 2024.

(queue is out, I will queue some more up when I get the energy and likely move to twice a week)

the 'lumpy comment made me so angry i wrote a complaint to the GIC 9it's northampton btw). they actually replied, with a complete nothingburger! here's their reply:

Screenshot from the 2012 version of Royal College of Psychiatrists' Good practice guidelines for the assessment and treatment of adults with gender dysphoria. progesterone is not usually indicated since no biologically significant progesterone receptor sites exist for biological males.

Content note: Anti trans slur

This is from the RCP rather than a GIC directly, but the authors are (or were) mostly GIC clinicians.

This is also just completely false.

Screenshot from the Northern Region Gender Service's analysis of a potential patient outcome rating scale. If we felt that a scale was useful, but that there might be questions about the ethics used to develop the scale, would that matter to you? (N=104)

uwu we're just a smol bean gender clinic pwease can we use the unethical research because *we* think it's useful uwu

Screenshot of the Tavistock and Portman GIC self referral form. SECTION 1 Please forward Section 1 and 2 of this referral form must be completed by your GP. Without this information the Self-Referral would be deemed in complete and unable to proceed with the referral. [Account note- grammatical and spelling errors are reproduced accurately to the original text]

GP required for self referral.

Screenshot from Sheffield GIC prescribing guidelines. Prescribing Guidelines Trans woman medication (This applies to a person assigned male, cis male, at birth undertaking gender transition to become a female) These guidelines are to support GPs in the ongoing management of adult patients requiring life-long medication.

Just in case anyone was worried trans women didn't also get a bizarre word salad.

Screenshot from the Nottingham GIC website. Is surgery funded on the NHS? Yes. Chest reconstructive surgery and genital reconstruction surgery (GRS or SRS) is necessary for many trans men or non-binary people to live their lives; and for some denial of access to treatment can be life-threatening. However, for a nationalised healthcare system such as the NHS it is important that only people who would benefit from surgery are given it. This is one of the reasons, aside from the great number of ethical considerations, that we have a process of diagnosis and evaluation.

Great number of ethical concerns.

Screenshot from the Irish National Gender Service. National Gender Service What to expect A member of the team will ask about your: Early life: Your Mother's pregnancy, your birth

One from Ireland- your mum made you trans

A screenshot of two feminising hormone therapy guides from the Tavistock GIC on top of each other. The top one is SHARED CARE PRESCRIBING GUIDANCE FOR Treatment of Gender Incongruence in Transgender women, Transfeminine and Non-binary People (Assigned Male at Birth) In the trans feminine population the risk of breast cancer appears to be reduced compared to cisgender females (incident ratio 0.3 [0.2–0.4]). This value is significantly higher than cisgender men (incident ratio 46.7 [27.2–75.4])[13] The bottom one is Hormone Treatment – feminine – information leaflet v2 It is known that for cisgender women prolonged HRT use beyond 5 years after the menopause (about age 55) is associated with an increased risk of breast cancer. However, we also know that breast cancer risk remains the same as your birth gender which is 10 lower than a cis gendered female, Author note: as stated in the main post, the claim that breast cancer risk in trans women remains the same as in cis men is false

This is from the same clinic. Both guides were last updated in Jan/Feb 2025. The top (and correct) one is aimed at other healthcare professionals, whereas the bottom one with the factual error is aimed at patients.

Screenshot from the Exeter GIC website. Appropriate use of pronouns may become an issue. Politely advise people of your preferred pronoun.

Preferred.

Screenshot from the Exeter GIC website. Will you respect my point of view? We will respect your point of view. The West of England Specialist Gender Identity Clinic is commited to a caring relationship of mutual respect.

Unless you assert you're trans before you've been seen by two experts/

Screenshot from the Welsh GIC website. The Gender Construction Kit provides useful information for (is there something missing here)

(yes)

Screenshot from the Exeter GIC clinic website. Living life in your new social role may be very different to your current life and you are likely to have many new experiences; be ready for change and for some challenging situations. Ask your named professional for help if you feel overwhelmed by everything; difficult challenges can be overcome with help

Don't forget to consult your named cis expert for help living in role! It's not like you'll have had 31 years of experience with it by the time you reach the top of the list.

Screenshot from the Sheffield GIC website. Top police award for our gender identity clinic

Cop approved gender cops

Screenshot from the welsh GIC website. In light of the recent Supreme Court ruling, we want you to know that you are valid

You. Are. Valid.

Screenshot from the Exeter GIC referal form. Please provide information regarding the following; • Development and duration’s of your patient’s gender concern (grammatical error reproduced accurately to the source)

Are *you* concerned about gender?

Patients should be urged not to make their own decisions.

(Tldr: if you were born after 1954 this isn't something you need to even think about)

(as I had someone worried - men and women's state pension age in the UK used to be different. A GRC changed whether you were considered a man or a woman for this. The pension age has since been equalised and everyone who it could have affected is over state pension age now.)

Screenshot from Hormone Treatment – feminine – information leaflet v2 (02/02/2025) by Tavistock GIC Similarly, using excessive amounts of oestrogen does not improve breast development and may even be counterproductive, as there is an enzyme present in the body that converts excess oestrogen back into testosterone.

This is just factually incorrect and the clinicians involved should know better.
There is no way for estrogen to become testosterone inside the human body.

Screenshot from the Exeter GIC website. Your pension and any benefits arrangements might be affected if you're a transgender. Seek advice from your private provider and/or the Department of Works and Pensions.

Presented without comment.

It does. It gives the context of what the image is, followed by the actual text in the image. You may have to click to view the entire whole text, but to my understanding it would just continue reading for a screen reader without needing further prompting.

taking oestrogen, or as i call it "becoming one of the lumpen-areoliat"

So, the context here is that this is aimed at GPs prescribing for their patients.

My best guess is that they were trying to say not intersex.

been known to stalk online to see who is complaining about them and retaliate.

I don't want to inadvertently become part of someone getting treated worse by their GIC just for some internet points.

Currently this is on a daily queue to post at 5:30pm GMT. I have several posts ready, it'll end up dropping frequency at some point.

Submissions welcome, but only of publicly available content. This is because whilst the letters we get sent can be equally odd, some clinicians have