Trans questions and answers

What are the first steps if you want to medically transition?

You’ll want to work out what options are available for you and which route you would like to take. You can find all of that information in this handy ‘how to’ guide on healthcare for trans people in Guernsey.

What vital health screening is recommended for trans people?

For funded health care, Guernsey students are considered ordinarily resident in both the UK and Guernsey. So a Guernsey student attending university in the UK will be funded for their treatment at the States funded Gender Identity Clinic (GIC), but not their travel within the UK.

Health & Social Care (HSC) will only fund the student while they are attending university in the UK.  If they remain in the UK after their studies, HSC will no longer fund their treatment. Clearly this would impact on their treatment pathway and is something students must take into consideration.

HSC has emphasised the following to anyone attending University in the UK (this applies for all treatment, not just gender):

  • All Guernsey university students must register with their local (UK) GP.
  • HSC will only fund gender treatment at the London Transgender Clinic (not at any other gender clinic)
  • For another example, if a student attending Liverpool University wants their orthopaedic treatment funded by HSC, the student must return to Guernsey and be referred by an MSG consultant to NHS Wrightington, Wigan and Leigh (where HSC has a contract).  HSC will not fund their treatment with NHS Liverpool.  If the student wants to receive NHS funded treatment in Liverpool, they must be referred by their local GP. The same principles apply to gender patients with the London Transgender Clinic being the clinic with which HSC holds an agreement and the referral required from HSC Oberlands Centre. (And the self-refer could be used to access NHS gender clinics if that is what an individual wanted).

The student will have to return to the island and see their GP who will refer them to the Oberlands Centre.  This will need to be attended in person, and if appropriate, the HSC clinician will refer them on to the States funded GIC.

To conclude, Guernsey students attending university in the UK will have their treatment funded at the States funded GIC, but HSC will not continue to fund their treatment if they remain in the UK once their studies are finished.

HSC funding at the GIC will cease if the student remains in the UK. The student will have to either fund their own treatment at the GIC or see their local GP in the UK and ask to be referred to the NHS.  The NHS will decide at which point the student is placed on their waiting list. (This is an ‘unintended consequence’ of the new private contract). Therefore students must think carefully about their treatment pathway when considering treatment in the UK.

Our advice would be that Guernsey university students register with a local GP when they arrive in the UK. They should request a referral to NHS Gender Services if they believe that they may be a chance that they intend to permanently reside in the UK after University – this should mean that they will have been on the NHS waiting list while at university and by the time they leave university (and if they stay in the UK) they should be near the top of the NHS waiting list (depending on current wait times).

Please also note that some detailed guidance notes in relation to the new UK-Guernsey Reciprocal Healthcare arrangements has been published, which covers students studying in the UK.

What does the States of Guernsey cover when someone medically transitions?

You can find a the comprehensive official States documents here of what is and isn’t covered.

States of Guernsey Health Care Policy

States of Guernsey Gender Reassignment Services document

If you are new to Guernsey and don’t know how the health care and doctor service works, you can find out more at Locate Guernsey.

 

What happens when you need to visit the UK for your Gender Identity Clinic appointment?

The Gender Identity Clinic that the States of Guernsey use for gender affirming care may change at times but any contract should ensure that people from the Bailiwick can be seen in a timely manner and it also represents a saving to the States of Guernsey on the services that are supplied in comparison to the previous NHS costs.

Some initial appointments may be able to be done via Zoom but you will need to visit the clinic in person before physically starting any medical transition.

Travel expenses are covered by the States of Guernsey.

Wait times for a first appointment (at the time of writing – end 2023) are approximately 2-4 months. Follow up appointments happen quite quickly after that.

Please note that you will be asked lots of questions about your life and your health and wellbeing including mental health – if this is triggering for you please bear this in mind before your appointments.

How to access gender affirming healthcare in Guernsey

What if accessing a doctor is too expensive?

If accessing a doctor is too expensive, there is support available.

The Victoria Hospital Incorporated (“VHI”) charity is able to provide funds to meet medical, medically-related or other costs in order to assist individuals or families affected by medical conditions.

If you are a low-income household, but don’t qualify for income support, it is possible in some cases to still get help with medical costs. To find out if you can get this help, you can contact  Income Support.

The Medical Expenses Assistance Scheme can be accessed to cover things like off-island medical expenses. More information on this can be obtained via the Travel Team, however they will usually contact you, if they have been told you have an appointment.

How can I bind safely?

Please do not start binding until you have done health and safety research on binding. Helpful research links:

Suppliers

There are three main companies who sell safe and effective chest binders. However, please bear in mind that no binder is ever safe to wear for a long time or when sleeping.

Underworks

Underworks are an American company who sell all kinds of body shaping garments for all genders and body parts that need ‘tucking in’. Because of this, make sure you buy a garment that specifically says ‘chest binder’ in the title, otherwise you’ll just be buying a compression shirt and it won’t do anything. There are few different types of binders that Underworks do.

Underworks binders often take only a few days to arrive from America and don’t pick up custom charges for you to pay.

Amazon does also sell from Underworks, but ensure that it is an actual Underworks one.

GC2B

These are binders for trans men designed by trans men and specifically only make chest binders for trans men. They are a different material to the Underworks ones in that they feel more like a swimming costume material and it’s slightly shiny. They also have amazing customer service and will always be happy to exchange sizes or send replacements out to any that get damaged. The other great thing about GC2B is that they do binders in all different skin tones so you can match up your skin tone and get one that blends into your skin tone. They are more expensive than Underworks and the binders are much less durable. You’ll be replacing them more often than you would the Underworks ones. They can also take upwards of 4 weeks to arrive from America and often come with a large customs charge. They do half binders and also full length. They are a little worse for sweating in than Underworks because of the material. They do a huge range of colours but the design is the same.

Spectrum Outfitters

Spectrum has a variety of binders (and other FTM wear) and it is UK based. They also have good information on sizing/fitting and also binding safely.

‘Tips from our team’

“Binders should not be worn during sport, but many people use sports bras. These vary, but I know that people rate the Running Sports Bras from Shock Absorber. They don’t look too ‘bra-like’ and are widely available, including Amazon.

It’s all an experiment of what works for you and your body shape and personal comfort, albeit an expensive experiment!”

How can I tuck safety

Tucking is a common practice for many trans women, helping them achieve a more feminine appearance. To do it safely and comfortably, here are some tips to keep in mind:

  • Choose the Right Undergarments: Invest in quality underwear that provides support without being too tight or uncomfortable. Gaffs, specially designed for tucking, can be a good option.
  • Preparation: Make sure the area is clean and dry before you start. This can help prevent chafing and discomfort.
  • Use a Tucking Method That Suits You: There are different tucking methods, such as the standard tuck, bikini tuck, or modified tuck. Experiment to find what works best for your body and comfort.
  • Be Gentle: When tucking, be gentle with your delicate areas to avoid injury. If something doesn’t feel right or is painful, stop immediately and adjust.
  • Stay Hydrated: Staying hydrated can help reduce the risk of cramps or discomfort while tucking.
  • Breaks: It’s essential to give your body breaks from tucking, especially if you plan to tuck for an extended period. This allows your skin to breathe and reduces the risk of irritation.
  • Confidence: Remember that tucking is a personal choice, and there’s no right or wrong way to be a woman. Confidence in your identity is just as important as physical appearance.
  • Reach Out for Support: If you’re new to tucking or have concerns, don’t hesitate to seek advice from the trans community or healthcare professionals who specialise in transgender healthcare.

Always prioritise your safety and comfort when tucking. It’s a personal decision, and how you choose to present yourself is entirely up to you.

How can I create a feminine chest?

Many trans women explore various methods to create the appearance of breasts before undergoing any medical transition. Here are some techniques to help achieve the illusion of breasts:

  • Padded Bras: Invest in padded bras or bras with removable padding. These can provide extra volume and a more feminine silhouette.
  • Breast Forms: Consider using breast forms or silicone prosthetics designed to mimic the look and feel of natural breasts. They come in various sizes and shapes to suit your preferences.
  • Layering Clothing: Layering can help create the illusion of curves. Choose tops with ruffles, frills, or patterns over a well-fitted bra to add volume to your chest.
  • Contouring Makeup: Some people use makeup techniques to highlight and shade the chest area, creating the appearance of cleavage and shadows.
  • Choosing the Right Bra:
  • Finding the right bra is essential for comfort and confidence. Here’s how to choose one that suits your needs:
  • Measure Properly: Get professionally measured or measure yourself to determine your accurate bra size. Sizes can vary between brands and styles, so knowing your measurements is crucial. Here’s a handy ‘How to measure your bra size at home’ guide While braless or wearing a is even add four inches.
  • Style: Opt for bras that enhance your natural shape or the shape you want to achieve. Push-up bras can provide lift and cleavage, while bralettes offer comfort and a more natural look.
  • Material: Choose bras made of comfortable, breathable materials like cotton for everyday wear. For special occasions, consider lace or satin for added elegance.
  • Straps and Bands: Ensure that the bra straps and bands are adjustable and fit snugly but not too tight. A well-fitted band provides the necessary support.
  • Try Before You Buy: If possible, try on bras before purchasing to ensure they fit comfortably and provide the desired shape.

Remember that creating the illusion of breasts and choosing bras is a personal journey. It’s essential to prioritise your comfort and confidence, and there are many options available to help you achieve the look and feel that aligns with your identity.

How can I change my voice to be more masculine or feminine?

Many transgender and non-binary individuals seek ways to adjust their voices to better align with their gender identity. Notaphase.org has partnered with Stephen (@trans.voice) to offer a series designed to educate trans+ individuals about their voices. This series covers topics like using and caring for your vocal cords, understanding how your voice functions, and providing the tools to develop a healthy and personally satisfying voice. The series covers trans masculine and feminine voices as well as non binary.