consultation

Featured Trans* Jersey

Manifesto 2014

Trans* Jersey’s manifesto defines the problems faced by transgender, transsexual, genderqueer, androgynous, bigender and intersex Jersey residents in 2014 and explains what actions we intend to take to address these issues.

DoctorTrans* Jersey believes that the island’s trans population is being patchily served by GPs and the States of Jersey Health and Social Services (“H&SS”) Department. This is due to the lack of clear guidelines for healthcare professionals working with trans patients. Individual clinicians within the H&SS Department are not seen to be at fault and, once the H&SS Department has been accessed, experiences of care have been good to excellent, largely through the efforts of the clinician acting on their own initiative. However, the initial route into healthcare for trans patients is unclear. The evidence suggests that the quality of healthcare provided is also influenced by the tenacity and perseverance of the trans individual being treated.

GenderRecActTrans* Jersey supports the calls by trans* organisations in the UK that the process for procuring a gender recognition certificate (“GRC”) needs revision. The Gender Recognition (Jersey) Law 2010 allows for a GRC from a recognised jurisdiction to be passed in the Royal Court. Any revisions that happen to the UK Gender Recognition Act 2004 as a result of the consultation happening with trans* organisations will, therefore, directly affect trans islanders. At present, Jersey has no mechanism by which to issue a GRC. However, this may change if trans* organisations within the UK are successful in calling for the Gender Recognition Act to be scrapped and for the issuance of a GRC to be an administrative process driven by the trans individual.

lawTrans* Jersey is committed to ensuring that all States of Jersey legislation that directly affects trans* islanders is scrutinised and responded to on behalf of the Jersey trans* community in order to safeguard our human rights. Trans* Jersey is currently preparing a response to both the States of Jersey consultation on sex discrimination and the imminent debate on equal marriage. Trans* Jersey will also be reviewing all legislation in force to ensure that there are no revisions that need to be called for.

equal marriageTrans* Jersey believes that equal marriage legislation is essential to ensure that trans islanders are not discriminated against, and that any equal marriage law introduced in Jersey should not contain the so-called Spousal Veto. Trans islanders who are married or in a civil partnership at the time of their transition have no option currently but to get divorced before they can acquire a full GRC. On the granting of a full GRC, the couple may formalise their partnership again by having another wedding ceremony. This situation is patently in violation of all human rights.

TeacherTrans* Jersey believes that education is the key to many of the issues faced by trans* individuals in society and is therefore committed to providing opportunities and resources to cisgender islanders in order that they can learn more about the trans* population. In the coming months, Trans* Jersey will be seeking conversations with private schools and the States of Jersey Education, Sport and Culture (“ES&C”) Department about including trans* issues within the sex education curriculum.

These are not the only issues faced by trans* individuals in Jersey, but they are the most important ones to be addressed. We are a small group with no financial backing. This manifesto is, therefore, necessarily realistic in its aims. It is not possible to hit all targets at once so we are being selective. Once progress has been made on these issues, we can turn our attention to other areas where reform is needed.

You can download the complete manifesto as a pdf here.

Trans* Jersey

MtF finance

Even if you take the publicly funded healthcare route to manage your transition, the costs are higher for trans* islanders than for trans* individuals in the UK because we have to travel to see the specialists who can assist us to transition.

For those transwomen with island medical insurance policies, you will find that they specifically do not cover any treatment relating to gender reassignment.

Below are some of the costs that you will need to fund whichever transition route you follow:

Travel
Flights to the UK for consultations with your therapist. You will need to budget for more than one visit. Depending on how your therapy goes, you could be visiting regularly for a while. The cheapest flights from Jersey to the UK are on the Gatwick route so take this into consideration when you and your GP select your therapist. Your appointment should only be an hour so you should be able to get over and back in the day. Also, remember to budget for the Gatwick Express into London and transport in London.

GP visits
You will need to visit your GP more regularly than usual to keep them updated on progress, to ask for referrals, to have bloods taken to check your hormone levels and to ask their advice on a range of issues. Budget for about one every two months during your first two years of transition.

Change of name
The costs given below are approximate. They may change.

Deed poll prepared by Jersey advocate and sworn in Royal Court: £435
New driving licence: £40
New passport: £75
Passport photographs: £5

See the change of name page for more details.

Devices for passing
Some transwomen like to use breastforms and gaffs to assist them in passing. Breastforms start at about £30 and can go up as high as £750 for realistic skin tone, shape and nipples. Gaffs are around £35-£50. For more information about suppliers see the help page.

financeBelow are some of the costs that are optional depending on how you manage your transition. You may elect to go completely private, completely public through the States and NHS systems, or do a mixture of private and public:

Gender therapy
For those who wish to see a gender therapist privately in the UK, an hour’s consultation will cost about £200.

Hormone therapy
For those who wish to see an endocrinologist privately in Jersey, an hour’s consultation will cost about £280.

Surgery
Bottom surgery (GRS): costs vary depending on the surgical procedure being undertaken. Orchiectomy: £3,000 app. Cosmetic genital reconstruction surgery without vaginoplasty: £9,500 app. Vaginoplasty (penile inversion): £10,800 app. Colon vaginoplasty: £13,000 app.

If you go abroad for surgery, don’t forget to add in the travel, accommodation and food costs. For GRS, for example, you won’t be able to fly for a least a week afterwards, which means a hotel bill. Full recovery time is six to twelve weeks.

Top surgery: costs vary depending on the type of breast augmentation surgery being undertaken. There are two types of implant commonly used. However, you can expect to pay between £3,500 and £5,000.
Facial feminising surgery: costs vary depending on the surgery being undertaken, and there is a large range of procedures you can have done. You can pay anything from £1,000 for a minor procedure to £10,000 for a full facelift.

See the surgery page for more details of MtF surgery.

Funding
The truth is transitioning costs the trans* individual and, because it is still seen as a choice rather than a necessity, especially by insurers, there is little financial help available.

Try to put away £100 of your salary every month into a transition fund or hold a ‘transition fund’ event where friends and family show their support by donating as much or as little as they want without embarrassment.

Don’t fund your transition through credit cards or pay-day loans. These are the worst ways to borrow money as the interest rates are so high. If you need to borrow, talk to your bank about a loan. Trans* Jersey has contacted NatWest bank in Jersey and they have confirmed that they would do a personal loan for treatment or surgery and that anyone who approached them would be treated sensitively and with discretion. Criteria for the loan would be the standard requirements, ie. any person wanting a loan will need to bank with NatWest for 6 months, have a regular income mandated to the account and be able to afford the loan. Anyone seeking this sort of facility can contact Tanya Nerac, Assistant Relationship Manager, in the first instance who is one of our trans* allies.

Trans* Jersey

MtF timeline

For those who are still questioning their gender, take some time to read this site, to surf the Internet and watch video clips uploaded by transwomen, to read some of the excellent personal accounts of transitioning available as books from Amazon, and to feel comfortable with the idea that you are trans*. This is an important step and not one that should be hurried. It can take years to reach a point of ease with who you are.

However, it is worth reaching that point before you more forward with your transition, especially in Jersey. We all know how quickly news travels in small communities, more so than in a big city. You are unlikely to be able to keep your transition a secret in the island. You need to be prepared to ‘out’ yourself to all sorts of people in order to get their help and you can only do that if you are proud and confident about who you are.

Having reached a place where you know that you are transgender, your first point of contact is your doctor/GP in Jersey. Explain to them that you are unhappy with the gender assigned to you at birth and that you would like to start the process of transitioning. Ask your GP to write a letter of referral to a gender therapist (if going the privately funded route) or to a psychiatrist within the health services in Jersey (if going the publicly funded route).

There are no gender therapists in Jersey so you will have to go to the UK for counselling. Your GP can either refer you privately to a gender clinic of your choice or your Jersey psychiatrist can refer you through the NHS to the Charing Cross Gender Identity Clinic. The advantages of going private are that you control the timetable and can get things moving as quickly as you need to. The disadvantage is that you pay for private consultations (see the finance page). The NHS route is free but you are stuck with their timescale.

Remember that your therapist is not there to ‘judge’ you. They are there to help you make sure that transitioning is what you want to do. Therapy is a time for you to ask questions about transitioning, to be honest with yourself and answer the therapist’s questions as openly as you can, to think about alternatives to transitioning and to understand why they are not an option for you, and to double-check your feelings with an impartial and skilled observer.

Depending on how you and your therapist feel about your readiness to transition, the next step is either to change your name by deed poll to the name by which you want to be known going forward or to commence hormone therapy.

For more information about changing your name and all your documents, see the change of name page.

evolution-womanJersey has the necessary skills on the island to administer your hormone therapy, which will be a lifelong commitment to taking estrogen, progestogen and antiandrogen in some form. Your therapist will need to provide a letter to your GP or psychiatrist recommending that you commence hormone therapy, the appropriate delivery method of the hormones and the doses that you require. Your GP or psychiatrist can then refer you to the island’s endocrinologist. This can be done privately, for which you will pay, or you can be referred through the States system, which is free.

For more information about hormone therapy, see the hormones page.

This may be as far as you wish to go in your transition. You may consider the changes made by the hormone therapy sufficient to allow you to pass as a woman. However, you may elect to undergo one or more surgical procedures to further feminise your body. If so, you will need to leave the island again for your operation(s). Jersey has no surgeons who can perform this specialist surgery. You will need to decide whether you wish to pay for surgery privately or whether you are prepared to wait for surgery in the UK through the NHS.

If you elect to have surgery through the NHS, you need to ask your NHS therapist to place you on the NHS waiting list.

If you elect to have private surgery there are two advantages: you can choose your surgeon, so you can choose to see anyone in the world who takes private patients, and the timing of your surgery is your choice. You should research your surgeon carefully, taking time to read testimonials from transwomen who have had surgery with them. If you are unsure about your choice, ask your GP for their opinion.

Once you have selected your surgeon, contact them directly. You do not need to go back to your GP for a referral. However, the surgeon will undoubtedly want a letter from your therapist or GP referring you after you have made the initial contact.

For more information about surgery, see the surgery page.

Finally, take ownership of your transition. If you are not getting the answers you require from your health professional, keep asking until you do. Research as much as you can and prepare the questions you want answered before every consultation. Your Jersey GP may never have taken a patient through a transition process so you may need to guide them on what they need to do next for you.

Trans* Jersey

States of Jersey consultation on sex discrimination

The States of Jersey are currently asking for comments from the public on the next phase of the island’s discrimination legislation, so called sex discrimination. They have published a consultation paper, which can be downloaded here.

The next phase of the legislation is due to be debated later this year with a view to it becoming law in September 2015. The consultation process closes on 30 May 2014 and responses will be published on 29 August 2014.

The consultation paper outlines the main areas for debate:

  • Sex
  • Pregnancy and maternity
  • Sexual orientation
  • Gender reassignment
  • Marriage and civil partnership

Trans* Jersey is most interested in the States’ proposals for gender reassignment. We have therefore requested involvement in any forum convened by the States to discuss the proposed legislation.

We are concerned by a number of aspects of the States’ consultation document:

1. The adoption of the UK Equality Act as the model on which to base Jersey’s legislation. This Act has been in place for 4 years in the UK and campaign groups have highlighted a number of problems with it. The LGBT Consortium have called for a review of it and the Gender Recognition Act.

2. The language used in the document’s section on gender reassignment especially when talking about a person “completing” their transition.

3. The suggestion within the consultation that an exception should be made to permit discrimination against trans* people to occur in the case of “the provision of communal changing facilities or shared accommodation”.

4. The confusion of the term “sex” with “gender” throughout. Man/woman refers to a person’s gender. Male/female refers to person’s sex.

5. The assumption that there are only two sexes or genders.

statesGet involved

Whilst Trans* Jersey encourages you to complete the online survey, we would also like to receive your comments about the States’ proposal regarding gender reassignment discrimination.

We believe that by speaking together as a group of trans* islanders our comments on the consultation will carry more weight.

We therefore invite you to email us with your comments, suggestions, thoughts or concerns at admin@transjersey.org

Please let us know whether you would be interested in being involved in any face-to-face discussions with the States as part of a Trans* Jersey group.

Trans* Jersey

FtM Finance

Even if you take the publicly funded healthcare route to manage your transition, the costs are higher for trans* islanders than for trans* individuals in the UK because we have to travel to see the specialists who can assist us to transition.

For those transmen with island medical insurance policies, you will find that they specifically do not cover any treatment relating to gender reassignment.

Below are some of the costs that you will need to fund whichever transition route you follow:

Travel
Flights to the UK for consultations with your therapist. You will need to budget for more than one visit. Depending on how your therapy goes, you could be visiting regularly for a while. The cheapest flights from Jersey to the UK are on the Gatwick route so take this into consideration when you and your GP select your therapist. Your appointment should only be an hour so you should be able to get over and back in the day. Also, remember to budget for the Gatwick Express into London and transport in London.

GP visits
You will need to visit your GP more regularly than usual to keep them updated on progress, to ask for referrals, to have bloods taken to check your hormone levels and to ask their advice on a range of issues. Budget for about one every two months during your first two years of transition.

Change of name
The costs given below are approximate. They may change.

Deed poll prepared by Jersey advocate and sworn in Royal Court: £435
New driving licence: £40
New passport: £75
Passport photographs: £5

See the change of name page for more details.

Devices for passing
Some transmen like to use packers and binders to assist them in passing. Packers start at about £12 and can go up as high as £500 for realistic peeing and playing packers. Chest binders are around £35-£50. For more information about suppliers see the help page.

financeBelow are some of the costs that are optional depending on how you manage your transition. You may elect to go completely private, completely public through the States and NHS systems, or do a mixture of private and public:

Gender therapy
For those who wish to see a gender therapist privately in the UK, an hour’s consultation will cost about £200.

Hormone therapy
For those who wish to see an endocrinologist privately in Jersey, an hour’s consultation will cost about £280.

Surgery
Top surgery: costs vary depending on the type of chest surgery being undertaken. There are two methods commonly used. However, you can expect to pay between £5,000 and £10,000.

Bottom surgery: Hysterectomy: £7,500-£12,500. Costs vary depending on the type of penile construction surgery being undertaken. Metoidioplasty: £10,000-£15,000. Phalloplasty: this is complex requiring numerous procedures so you are looking at anything from £25,000 upwards.

If you go abroad for surgery, don’t forget to add in the travel, accommodation and food costs. For chest surgery, for example, you won’t be able to fly for a least a week afterwards which means a hotel bill.

See the surgery page for more details on FtM surgery.

Funding
The truth is transitioning costs the trans* individual and, because it is still seen as a choice rather than a necessity, especially by insurers, there is little financial help available.

Try to put away £100 of your salary every month into a transition fund or hold a ‘transition fund’ event where friends and family show their support by donating as much or as little as they want without embarrassment.

Don’t fund your transition through credit cards or pay-day loans. These are the worst ways to borrow money as the interest rates are so high. If you need to borrow, talk to your bank about a loan. Trans* Jersey has contacted NatWest bank in Jersey and they have confirmed that they would do a personal loan for treatment or surgery and that anyone who approached them would be treated sensitively and with discretion. Criteria for the loan would be the standard requirements, ie. any person wanting a loan will need to bank with NatWest for 6 months, have a regular income mandated to the account and be able to afford the loan. Anyone seeking this sort of facility can contact Tanya Nerac, Assistant Relationship Manager, in the first instance who is one of our trans* allies.

Trans* Jersey

FtM timeline

For those who are still questioning their gender, take some time to read this site, to surf the Internet and watch video clips uploaded by transmen, to read some of the excellent personal accounts of transitioning available as books from Amazon, and to feel comfortable with the idea that you are trans*. This is an important step and not one that should be hurried. It can take years to reach a point of ease with who you are.

However, it is worth reaching that point before you more forward with your transition, especially in Jersey. We all know how quickly news travels in small communities, more so than in a big city. You are unlikely to be able to keep your transition a secret in the island. You need to be prepared to ‘out’ yourself to all sorts of people in order to get their help and you can only do that if you are proud and confident about who you are.

Having reached a place where you know that you are transgender, your first point of contact is your doctor/GP in Jersey. Explain to them that you are unhappy with the gender assigned to you at birth and that you would like to start the process of transitioning. Ask your GP to write a letter of referral to a gender therapist (if going the privately funded route) or to a psychiatrist within the health services in Jersey (if going the publicly funded route).

There are no gender therapists in Jersey so you will have to go to the UK for counselling. Your GP can either refer you privately to a gender clinic of your choice or your Jersey psychiatrist can refer you through the NHS to the Charing Cross Gender Identity Clinic. The advantages of going private are that you control the timetable and can get things moving as quickly as you need to. The disadvantage is that you pay for private consultations (see the finance page). The NHS route is free but you are stuck with their timescale.

Remember that your therapist is not there to ‘judge’ you. They are there to help you make sure that transitioning is what you want to do. Therapy is a time for you to ask questions about transitioning, to be honest with yourself and answer the therapist’s questions as openly as you can, to think about alternatives to transitioning and to understand why they are not an option for you, and to double-check your feelings with an impartial and skilled observer.

Depending on how you and your therapist feel about your readiness to transition, the next step is either to change your name by deed poll to the name by which you want to be known going forward or to commence hormone therapy.

For more information about changing your name and all your documents, see the change of name page.

timelineJersey has the necessary skills on the island to administer your hormone therapy, which will be a lifelong commitment to taking testosterone. Your therapist will need to provide a letter to your GP or psychiatrist recommending that you commence hormone therapy, the appropriate delivery method of the testosterone and the dose that you require. Your GP or psychiatrist can then refer you to the island’s endocrinologist. This can be done privately, for which you will pay, or you can be referred through the States system, which is free.

For more information about hormone therapy, see the hormones page.

This may be as far as you wish to go in your transition. You may consider the changes made by the hormone therapy sufficient to allow you to pass as a man. However, you may elect to undergo one or more surgical procedures to further masculinise your body. If so, you will need to leave the island again for your operation(s). Jersey has no surgeons who can perform this specialist surgery. You will need to decide whether you wish to pay for surgery privately or whether you are prepared to wait for surgery in the UK through the NHS.

If you elect to have surgery through the NHS, you need to ask your NHS therapist to place you on the NHS waiting list.

If you elect to have private surgery there are two advantages: you can choose your surgeon, so you can choose to see anyone in the world who takes private patients, and the timing of your surgery is your choice. You should research your surgeon carefully, taking time to read testimonials from transmen who have had surgery with them. If you are unsure about your choice, ask your GP for their opinion.

Once you have selected your surgeon, contact them directly. You do not need to go back to your GP for a referral. However, the surgeon will undoubtedly want a letter from your therapist or GP referring you after you have made the initial contact.

For more information about surgery, see the surgery page.

Finally, take ownership of your transition. If you are not getting the answers you require from your health professional, keep asking until you do. Research as much as you can and prepare the questions you want answered before every consultation. Your Jersey GP may never have taken a patient through a transition process so you may need to guide them on what they need to do next for you.