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Why would a young Doctor choose to specialise in Psychiatry? Why would he choose to work in a field that's frowned upon by many of his peers? To cap it all, why would he work in a clinic that had (in the past) acquired a very negative reputation among patients?

Dr Stuart Lorimer works at Charing Cross Gender Identity Clinic in Hammersmith, London. It's a busy place. In 2008, 771 people were referred there with various degrees of gender dysphoria. At any time the clinic is treating well over 1500 people. Some (not all) are seeking support for one of the biggest challenges anyone can undertake: successfully changing the way they live and present to accord with their internal sense of being a man or a woman.

In Britain as a whole, over 300 people apply for legal recognition of permanent gender changes each year. Many others, with less intense dysphoria, take cross-gender hormones or simply find that their feelings can be expressed within their existing gender role.

Helping people make informed decisions about the steps they take is a tough challenge, which is made no easier by having to help them cope with the enormous levels of discrimination which many of those patients will face on the way. The clinicians face challenges too -- not just from fellow Doctors who can't or won't understand, but from patients who arrive with negative expectations about the institution.

Stuart was at pains to stress that he cannot speak on behalf of the clinic he works in. This interview focusses upon him as one of a wholly new generation of specialists in the field, and his own thoughts about some of the controversial issues that have raged for years in this field. In sharing his own thoughts, however, he paints a picture of a team still struggling with an inherited reputation, constantly learning and evolving -- and wanting to do their best in difficult circumstances.

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  • Susannah Clark

    Thanks for this. I think that open and intelligent interviews like this help to cut through handed down fears and criticisms, and Stuart Lorimer’s willingness to just respond directly to your sharp questions is reassuring - and signifies a culture that is more to do with openness than defensiveness at Charing Cross GIC.

    I also appreciated your questioning, that cut through to some key points - in other words, you were asking some of the questions I’d have wanted you to ask.

    I think it’s sad and disappointing that someone sincere and clearly experienced in this field feels that some of the greatest difficulties come from GPs and PCTs. And the whole issue of the postcode lottery by which one PCT may sanction funding and another may not is particularly concerning - and sort of worrying because an issue like transsexualism has the potential to tempt decision-makers within PCTs to make decisions that may be influenced by religious dogma, and therefore there is a greater danger of prejudice and discrimination over the funding of transsexual patients than over, say, the funding of cancer patients - where the illness does not seem to cut across religious beliefs in the same way.

    Stuart Lorimer is a decent, direct and down-to-earth practitioner who treats patients/clients with kindness and respect.

    In my experience there are other practitioners at Charing Cross GIC who are also sensitive and supportive. I think this integrity came across in the interview. Thank you for making it happen.

    Mar 30, 2009 at 6:26 pm
  • Lim

    Re- edit of my original post: can you please amend, many thanks

    Dr Stuart Lorimer and Charing Cross GIC were instrumental in declining my referral for genital surgery despite the fact that I had completed more than 5 years RLT and complied with the HBSOC and all clinic protocols. I saw Dr Lorimer in the hope to facilitate a GRS referral. Both Dr James Barrett and Dr Lorimer clearly refused a referral. Since leaving Charing Cross GIC in early 2007 I have now seen another psychiatrist at another Hospital who gave me a referral at the the first appointment.

    May 10, 2009 at 9:31 pm
  • Anon

    In a similar issue to the above poster, despite having over 2 years RLE, two referrals for surgery from other NHS GICs, plus a PCT that are willing to fund surgery at Charing Cross, I am being refused my SRS from them and am now being expected in effect to end up with four referrals before I can obtain my surgery there.

    Whilst those within Charing Cross continue to lament their “inherited reputation”, the fact is those that have the power to actually change things for the better, and actually place trans people first and foremost over internal commissioning and politics would rather just continue their favourite game of ‘gatekeeping’

    May 18, 2009 at 8:03 pm
  • SJB

    It was an interesting interview.

    I was a patient at Charing Cross until 2007 when i successfully had my surgery and must state that I had a positive experience there.

    There were some excellent questions and it was good to hear about the myth of women having to wear skirts to appointments being gone. I never wore a skirt to an appointment and, during many sessions with Dr Penny Lenihan, never saw her wear anything other than trousers.

    The clinicians do a good job under difficult circumstances and they have to have some guidelines to work under. The real life experience is necessary and I agree with the guideline that this should include a year in employment/full time education/voluntary work. Sitting on one’s derriere does not help one through this momentous change.

    I found that the clinicians I saw were excellent and Dr James Barrett was both knowledgeable on his speciality and a fount of information on a wide range of topics within general life away from medicine (including a detailed knowledge of typography - I used to work as a typesetter for my local paper). He also treated me with the utmost courtesy and respect as a human being.

    This is not a glamarous branch of medicine but the results when the surgery is complete (I was lucky enough to have excellent surgical results by Mr Bellringer) dramatically improve one’s life.

    I have been able to successfully integrate into general society as the woman I am, and I have Charing Cross to thank for making this possible.

    Jul 5, 2009 at 11:16 pm
  • Steph

    Then Charing Cross has moved forward, I wish other gender clinics did similar. In my experiences at my GIC I was only taken seriously when I appeared wearing a skirt, blouse, make up etc etc. When I said that 99% of women wear trousers, I was told I had to “make more of an effort than other women” or “you have to go that extra mile”

    Nov 20, 2009 at 2:01 pm
  • Davina Woon

    I had my ‘Op’ at Charing Cross some four years ago, and Dr Penny was my guiding light! Never could I have found a better person to have helped me, in my time there she referred me to Dr Lorimore and Prof’ Green for second opinions! To say that I was treated with the greatest respect by all would be the underestimation of the Decade let alone the year! Being such a busy place there could well be someone who has felt that they were not fairly treated, but most often that would have been their own fault in the first place! The whole thing revolves around attitude! Yes your own attitude! Dr Penny I can not think of anything more to say than I could never have been referred to a finer person, My gratitude to you knows no bounds!

    Oct 3, 2010 at 10:18 am
  • Tracy Leanne Edwards

    Charring Cross was my lifesaver. I started my transition in 2006 with Dr Lorimer (fantastic Dr and person) and had my GRS in Nov 2009 with Mr Bellringer ( my GP said “he’s an artist” after seeing his work) I rearly looked forward to my appointments with CX GIC and enjoyed every minute of my transition with them. Thank you:- Dr Stewart Lorimer, Dr James Barrett, Mr Bellringer (surgeon) Iffi (gender nurse), Christella (Voice coach) ,over worked secretary’s,nurses at Riverside Ward CX hospital.

    Dec 8, 2010 at 7:35 am
  • Sophia

    I recently saw Dr Lorimer for my first assessment, and I can confirm that I had an excellent service from him. I had been on NHS waiting list for nearly a year without even being given a chance to see a psychiatrist. I found Dr Lorimer to be very understanding, welcoming and warm-hearted. Unlike other health professional I had to deal with in the past, Dr Lorimer listened to me very carefully and was extremely courteous and professional in the way he asked me questions about my past. I would have no hesitation in recommending Dr Lorimer to anyone wishing to go through the Gender Reassignment procedure!

    Feb 13, 2011 at 11:52 pm
  • gilly

    I am sorry to say that your interview is a completely misleading. you do not seem to have taken into account that Dr Lorrimer is simply a good liar. I met him on two occasions. At the first appointment he played the past of a generous scaring and intelligent professional, free from all the abuses Charing cross is so frequently associated with. On the second appointment Dr Lorrimer reverted to type and was so grossly and absurdly abusive that I became worried for his health. It is too indecent to repeat some of the appallingly offensive things he said to me, but suffice it to say, that any patient who imagines they can trust this man because he poses as a liberal for an interview is very much mistaken, All the staff of Charing Cross gender Clinic are equally abusive. It is recommended that al;l patients both lie continuously when they met these clinicians and definitely record every appointment on your phone or other such device, since they will lie about everything you say afterwards.

    May 15, 2011 at 6:07 pm
  • Kim Whittaker

    I know Dr Lorimer, both personally and professionally ( as a service user of the WLMHT), and have a long lasting relationship, both as an ex patient, and as the founder of it’s Patient support group, and whilst Dr Lorimer was never my clinician at the CX GIC, the service I received at the clinic (from 1999-2005), both by Dr’s Barrett and Dalrymple and Mr Bellringer was excellent.

    I had already commenced my full time transition prior to my first appointment there, and the only reasons there was any delay in me receiving surgery were a) the time it took for funding to be agreed, and b) the length , at the time (approx 12 months) of the waiting list for surgery.

    I cannot commend the clinic highly enough, and having had dealings with it since, through the patient support group I represent, and other NHS committees I sit on, I con only say thatthe ONLY reasons they will NOT refer for surgery are either because they believe the patient is not ready (physically and mentally) yet OR because somebody has another health problem which may possibly endanger their lhealth further should they have this surgery.

    The Clinic is there NOT to stop people having surgery, but to help people make the right lifetime and lifetsyle decisons which will make them a better and happier person.

    Sometimes that may mean that the minimum 2 year RLE requirement may be extended.

    People need to ask themselves WHY they have been refused surgery, they need to take a deeper look at themselves, and their own behaviour when attending the clinic, and remember the clinicians there work under extreme pressures due to a shortage of resources, and do their very best to help their patients come to terms with themselves.

    time have changed since the Days of Randall, Prof Green and Dr Montgommery, all of who had their own personal (rather than professional) stereotypical views of what women should act like and dress, None of the current clinicians practising there now hold similar views to them. Far from it they are probably far more accommodating to the many different expressions of gender variance than many other so called professional gender identity specialist.

    May 15, 2011 at 8:07 pm
  • Joanne

    I have had a great deal to do with Dr Barrett @ the GIC, I personally found him to be rude, a liar, and thinks he has the right to play god with peoples lives. I spent 6 years going to the clinic at the end of it I got me GRC and that is all, he refused hormone treatment and SRS. Even after leaving the GIC he still thinks he can rule your life by talking to your GP about you. I had been on hormones since ‘93 five years before I finally got to see them at all, if you live in hampshire you do not have any choice at all, you have to see them and if he don’t like you you won’t get any treatment at all, people talk about Dr Montgomery, Dr Barrett is worse. I was first diagnosed when I was 13, I am now 49 and still fighting to get treatment. I am glad I have the backing of the HRC in bringing a case against CX GIC and hampshire PCT for ignoring my human rights as well as formal complaints to the GMC about Dr Barrett and my GP for breach of confidence, it is about time this clinic was made to comply with goverment rullings and guidelines regarding the treatment of all trans-gendered people.

    Jun 22, 2011 at 6:49 am
  • jenny

    Looking at the comments it makes sense that some manage to get what we are ALL entitled to by Law and common decency., otherwise the clinic would have closed down. I wonder how Joan of arc would have faired at the Charring Cross interrogation unit?? James Barrett BSc MSc (not a doctor bye the way) is undeniably the Gatekeeper for the N.H.S. and if he decides your not to be treated then pack your bags for Thailand. Obviously the ones HIS clinic treats are full of praise that’s how he gets away with it. I’m a Psychologist Lets cut to the chase, Where’s the evidence of fair treatment?? How many people have been refused treatment or discharged from the clinic ?? How many of those being refused and or discharged have self harmed?? Transsexuals are born NOT made and believe it or not, are Real people. They come in different shapes and sizes have different mind-sets and opinions on life and the world around them. Some Transsexuals can work it out for themselves(self-diagnosis) and don’t need to be patronised or unfavoured by the self-appointed guardians of the status quo.

    Oct 16, 2011 at 12:12 am