Cold February mornings in Plymouth have me wishing I hadn’t lost the warm fur-lined gloves that my girlfriend brought back from Poland for me. Much like this cold chill emanating from my fingertips, the service being provided by the Laurels Gender Identity Clinic (GIC) in Exeter brings a shiver to my spine whenever it is mentioned.

I myself am one of the many unfortunate souls to be sitting on their waiting list. First referred in January 2016 I had my initial assessment appointment in May 2017. Not that this initial assessment was particularly useful, nor particularly informative as to what I should expect in regards to a timescale for my treatment pathway.

Or perhaps I should be more clear, they misinformed me about the timescale for my treatment pathway. I was told that I should expect a wait of ‘up to a year’ to be assigned a doctor. I am still waiting.

‘the Laurels and has, for the past few years, given hundreds of people false hope’

This lack of transparency in regards to waiting times is a common theme with the Laurels and has, for the past few years, given hundreds of people false hope as they look to this NHS institution for help and guidance during some of the most difficult stages of development and change that a person can encounter.

The current state of operation at the Laurels GIC sees them taking three months to get through one month of referrals. To put this into perspective; if, hypothetically, they had no-one on their books at present, they would begin making appointments and then with the current amount of referrals would have a wait of two months after only a single month of operation. This would increase exponentially each month. Month two the wait would climb to five months, month four to nine months and so on. After only six months of operation the clinic would already have a waiting list of over 15 months.

This exponential growth is the reason why we see the waiting times now listed on their website as the following:

‘Our current waiting time from receiving your referral to your first appointment is approximately 30 months. Following your first appointment, you can expect to begin treatment from around a further 26 months’

This, however, is not nearly transparent enough. This figure relates only to those who joined their waiting list 30 months ago. The wait for someone joining now would be three months longer than that for every month that has passed since then. An additional 90 months, making a total of 120 months. Yes, that’s 10 years… 10 YEARS!

This does not even consider that the wait to be assigned a doctor is then an additional 26 months. A wait which is on the same exponential scale. The same rate of efficiency applies to the wait for a doctor as applied to the wait for a first appointment.

My most recent conversation with the receptionist was in January, at which point they informed me that they were currently processing and assigning appointments to those referred to a doctor in October 2016. Funny because that’s what they said back in November.

‘ It really feels like we are simply just numbers on a spreadsheet’

I know what you’re thinking, all of these dates and timescales are becoming meaningless now, well if you are not one of the many in this system then hopefully you may be starting to get an idea of how it feels. It really feels like we are simply just numbers on a spreadsheet to them, it’s endlessly frustrating, stressful and honestly exasperating.

Skip back to my freezing little fingertips. I have a really good solution, I have some other gloves, or even my pockets, what a novel idea! My hands don’t have to stay out in the cold until more of the same gloves are bought for me. Thankfully I am able to think of another solution, all by myself. My fingers won’t have to wait out in the cold for too long at all.

‘the Laurels GIC has not shown to have made any steps to improve’

Not to belittle the scale of the issue that the Laurel’s faces. It is a huge waiting list, the rise in new referrals each month has put a tremendous amount of pressure on the clinic. However, my concern is that the Laurels GIC has not shown to have made any steps to improve the situation or the service they provide. In fact it would appear that the service has got worse over the past three years, with less doctors now working at the clinic.

Other GICs in the country have made active steps towards improving their services in order to handle the rise in new referrals. The waiting time at Charing Cross is 18-24 months, and whilst this is not ideal it is a reasonably reliable and stable waiting time. Even after waiting for over three years for treatment at the Laurels I am considering whether it would be quicker to switch to Charing Cross and be at the bottom of their list.

Private providers of healthcare in this field have also shown that they are committed to growing with the ever increasing demand. GenderGP have grown and taken on more staff, as have GenderCare who now have more doctors added to their list.

I decided to dig a little deeper

With no real reason behind the lack of progress in improving the services at the clinic, I decided to dig a little deeper into the matter.

What I found may shed some light onto an answer, but is somewhat concerning for what it reveals.

In an article in 2017 the Devon Partnership Trust Chief Executive Melanie Walker was interviewed about the rise in waiting times and what the clinic is doing to tackle this. Most notable is the following:

‘NHS England is reviewing the service specification for gender services nationally and we are awaiting the outcome of this process.’ – source link

The recent consultation of the service specification has returned that more focus will be put onto bringing trans healthcare into Primary Care (local GP surgeries). Thus easing the pressure on the GICs around the country and allowing people to have better access to the healthcare that they need.

Anyone who knows me will know that I have been saying this for some time now, so I am very happy to see it finally having some progress, even if it is at a snail’s pace at present.

‘their solution to the problem is to wait until the Primary Care practitioners step in and bail them out’

What I am not happy about is the attitude of the Laurels GIC. Rather than proactively try to improve their service to help those on their waiting list, it would appear that their solution to the problem is to wait until the Primary Care practitioners step in and bail them out. And in the mean time leaving the waiting list to grow exponentially and run the service only to the capacity that it has found comfortable.

I have most certainly lost hope that the service at the Laurels will ever improve. No doubt that with enough wait I will be seen eventually, but quite how long that will take is anyone’s guess. I certainly wouldn’t bother asking at reception. My advice to anyone looking to refer to a GIC would be to steer well clear of the Laurels in Exeter, you will never be seen.

To those on the waiting list, remember you are not alone. It may be an awful situation but at least we are in it together.

We are the number on a spreadsheet. We are exposed hands in the cold chill of February. We are waiting.

Amber x