Hey folks   

This isn't any of the posts we've been trying to write for ages, but haven't had sufficient spoons, executive function, emotional regulation, or uninterrupted time (particularly from unexpected daily life events) to write 😅🥺  

No: instead, this is just something adjacent to some of these things, which has been increasingly on our mind recently... particularly as it feels like we've been seening significantly more posts by other trans+ people we follow on fedi, as well as other places, discussing topics like:

• Their overall worsening feelings of gender dysphoria, or feeling like they're making no progress towards their own transition goals.
• Increasingly yearning for a particular gender-affirming surgery, especially if it either is -- or feels like it is -- impossibly far away or actually impossible.

In light of our own issues with the NHS, we did get to the point where we did a post asking folks to remember to use CWs for such posts, as even with lots of filters, we couldn't keep up 🥺😔 (In a later post, we advised that we had changed our filters back from hide completely to hide with a warning, but we're still having to filter out a lot.)

Anyway, we're getting off track again. (Today has been another of those kinds of days.)

We've been thinking a lot recently about how it would almost be easier for us if we were a binary trans+ woman with stereotypical transition goals that align with the binary expectation of the NHS and other medical systems 😔

If we had had noticeable, intense genital dysphoria in the way that they expect all trans+ folks to have, then maybe we'd've been willing to compromise over surgeon and techniques in order to get some form of genital reconfiguration surgery (GRS), and we'd've been able to progress there.

However, because we don't feel that way, could not mask our real feelings, and would not be comfortable with the limited options offered, we're now stuck in a limbo where we may basically get nothing through the NHS whatsoever.

Just to clarify, we're acutely aware just how completely cursed this line of thinking is, and how much dysphoria -- especially around genitalia -- can be debilitating for many 🥺😔

It isn't a matter of anybody having it easier or worse: everybody should be able to get their healthcare needs met. However, unless you "play the game" and "play along", you won't get anything.

But yeah... this is the dumb situation we're in.

Our dysphoria doesn't match the NHS's binary model, so we're now just waiting to hear back about how we go about complaining about pretty much everything and trying to get somewhere.

We won't though, sadly. It'd take a secular miracle for somebody to actually show a single iota of care for us as an actual person / entity.

We feel bad for the complaint handler, as given the way she's replied, we think she actually still cares 🥺😔

That job will break her if she doesn't leave it.

We've already had our request for voice feminisation surgery (VFS) declined, and we haven't even tried to get them to hear us out over facial feminisation surgery (FFS), as they'd laugh us out the door.

If you want to know how cruel the NHS system is, just read part of the below in relation to the first rejected VFS individual funding request (IFR):

Yeah...

#GenderDysphoria #GenitalDysphoria #GenitalReconfigurationSurgery #GRS #GenderAffirmingSurgery #GenderAffirmingSurgeries #trans #transgender #enby #NonBinary #queer
#LGBTQ+ #LGBTQIA+ #NHS #EOEGS #NCTH #FuckTheNHS #VFS #FFS #IFR

Hey folks

Been trying and failing to write this post for a few days now.

Mood, health, energy, time, chores, obligations, and responsibilities kept getting in the way.

So, we're gonna summarise everything as much as we can, and try and limit our emotional response to it.

Important context

• We have been trying to get meaningful gender-affirming healthcare through the NHS since April 2021.
• We had tried to get clear information on surgery options, particularly genital reconfiguration surgery (GRS) options, for years, but never got clear options: only vague wording.
• We were almost certain sure that no form of penile-preserving vaginoplasty would be available, so we narrowed our choices to peritoneal pull-through (PPT) vaginoplasty or a bilateral orchidectomy.
  • We didn't and don't want penile inversion vaginoplasty (PIV) or vulvoplasty (aka zero-depth vaginoplasty).
• We finally passed all hurdles through an NHS pilot scheme (East Of England Gender Service; EOEGS) in late 2024.
  • This is under the Nottingham Centre for Transgender Health (NCTH).
• Our surgery referral was only sent over to a private hospital by the NHS Gender Dysphoria National Referral Support Service (GDNRSS) in late 2025.
• We had an initial assessment meeting with that private hospital this week.

Information from meeting

• The NHS will not fund PPT vaginoplasty unless there's medically no other option (i.e., last resort).
  • Basically only if you've got "inadequate donor site skin" for other methods.
• Despite offering PPT privately, the hospital considers PIV the "gold standard", and was heavily biased against PPT, advising that PPT:
  • "is not self-lubricating";
  • has "more granulation tissue" and "more complications associated with it";
  • typically has a "worse surgical outcome";
  • "turns into skin" in the long run;
  • is more likely to "stenose" and "scar".
• No form of penile-preserving vaginoplasty is available (as we thought).
• The NHS will not fund the hospital to do standalone bilateral orchidectomies for any referrals sent to them via GDNRSS.
• The specific (and only surgeon) we had asked to be referred to did not pick up our referral.
  • Worse, a surgeon we absolutely do not want to go anywhere near picked up our case!!!
• We discovered that NHS gender clinics sit in on their Multi-Disciplinary Team (MDT) meetings to discuss patients' surgery requests!!!

Outcomes for us

After considering options and offers, we resignedly sent an email to the private hospital, requesting that they refer us back to GDNRSS, advising that:

• The GRS options were explained to us, but we did not find them suitable.
• The surgeon who offered to take our case was not suitable.
• We wish to discuss next steps with the GDNRSS.

Sadly, an individual funding request (IFR) will almost-certainly be required, but the gender clinic has previously refused to submit any IFRs for us, so we're kinda very likely to be screwed here.

For anybody not aware, IFRs get submitted to your local integrated care board / system (ICB/ICS) in England. They'll only agree to fund something if:

• There are "exceptional clinical circumstances" to support the request.
• The IFR clearly demonstrates "clinical exceptionality".

Although technically an NHS GP can submit an IFR, unless it comes from the NHS gender clinic with a detailed explanation of why they can't / won't fund the surgery and why it's necessary, the local ICB funding team will just reject the request.

This is sadly a major issue for us, as we've raised multiple complaints against our gender clinic for their awful service (or rather lack thereof) and they've stopped responding to any of our emails now, so there's little to no chance of them even agreeing to submit an IFR for us, let alone doing one with a decent chance of being accepted.

We don't know what the current price is for a bilateral orchidectomy, but it was up to about £6k a year or two back, so it's probably more like £7K to £8K now 

In other words, nothing we could afford privately any time in the next decade.

So... yeah 🙃

If you wondered why our posts have been a little bit more bleak the last few days, this is among the reasons 😅 (There are sadly many other things contributing too.)

It's our own fault really for even trying to go through the NHS route and thinking that maybe, just maybe, they wouldn't continually fuck us around.

Anyway, that's the toot.

#NHS #NHSEngland #EOEGS #NCTH #trans #transgender #NonBinary #enby #FemEnby #GRS #GAS #vaginoplasty #orchidectomy #GenderAffirmingHealthcare #IFR #ICB #ICS #FuckTheNHS #FuckTheUK #DesegregateTransHealthcare #TransRights #TransRightsAreHumanRights #LGBTQ+ #LGBTQIA+

Au Colorado, un Beechcraft King Air équipé du Garmin Autoland a déclenché une procédure d’urgence et réalisé un atterrissage automatisé à Broomfield (KBJC). C'est la première fois que ce système d'urgence est activé. La démonstration est faite de son efficacité. #Aviation #Safety #Garmin #Autoland #KingAir #GeneralAviation #Avionique #IFR #ATC #KingAir

https://www.aerobuzz.fr/aviation-generale/premiere-100-reussie-pour-le-systeme-datterrissage-durgence-de-garmin/?utm_source=mastodon&utm_medium=jetpack_social

Темпы развития мировой роботизации, и зачем это нужно?

Пока политики спорят о безработице, компании переходят на новую валюту – роботоплотность. Именно она сегодня определяет, кто будет производить, а кто покупать. О том как стремительно перестраивается экономика труда.

https://habr.com/ru/articles/964702/

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