Five Minutes for Me. Years for Them.
This afternoon I picked up my first prescription for HRT.
On the face of it, there is nothing particularly remarkable about that sentence. I am a woman in my mid-forties, I have been experiencing a growing collection of perimenopause symptoms, I spoke to someone at my GP surgery and they prescribed HRT.
What I was not prepared for was just how easy it would be.
I have worked in the LGBTQ+ sector for 27 years. Several of my close friends are trans, non-binary or gender diverse. I obviously cannot claim any first-hand experience of accessing trans healthcare in the UK, but I have spent a very long time hearing about it from people who do (or have at least attempted to).
I have watched friends wait years for appointments. I have heard about referrals disappearing into systems, endless assessments, changing criteria, GPs unwilling to prescribe, battles over shared care and the sheer exhaustion of having to repeatedly explain and justify something as fundamental as who you are.
So, subconsciously, that had become my main frame of reference for what “trying to get hormones from the NHS” looked like.
Then my own hormones decided to become a problem.
Over the last six to twelve months or so I have collected an increasingly irritating selection of symptoms.
My previously reliable sleep has gone completely rogue. I now wake up at around 3am most nights for absolutely no useful reason, at which point my brain decides this is the ideal time to review every unfinished task, embarrassing thing I have ever said and problem facing humanity.
I am tired all the time. My concentration is worse. I am more irritable and anxious than usual. Perfectly ordinary words occasionally disappear halfway between my brain and my mouth.
Then there is the heat.
My internal thermostat appears to have been handed to a small child who is playing with the controls for fun.
Add in changes to my periods, migraines, bladder symptoms and various other indignities and it became increasingly difficult to avoid the conclusion that I have apparently reached the “woman of advancing years” section of the programme.
Eventually I decided I should probably stop moaning about it and actually speak to someone.
So I prepared for battle
Because of everything I knew about my trans friends’ experiences of accessing hormones, I was expecting this to be difficult.
So I prepared accordingly.
I wrote down my symptoms. I noted dates. I documented changes to my periods. I researched HRT, different formulations, risks and benefits. I looked at the clinical guidance. I thought about what I wanted and what I would say if I was dismissed.
I was mentally prepared for several appointments. Blood tests. Being told to wait and see. A referral elsewhere. Being told I was too young, too old, not symptomatic enough, insufficiently menopausal or some other variation of “come back when you are suffering more convincingly”.
I was ready to advocate for myself.
None of that happened.
I had a conversation lasting about five minutes with a physician associate.
Not even a GP, although the whole physician associate situation is a different rant for another day.
We talked about my symptoms. She suggested HRT. I agreed.
Prescription issued.
That was basically it.
I collected it this afternoon.
Five minutes.
As it happens, NHS guidance on menopause HRT is pretty straightforward. If menopause symptoms are bothering you, you can discuss HRT with a GP. You do not need to wait until your symptoms become severe or until your periods stop completely. The decision should involve a conversation about benefits, risks and what is right for you.
Which, broadly speaking, is exactly what happened to me.
And no, I am not complaining
I want to make this really clear because there is always somebody on the internet enthusiastically misunderstanding things.
I am not complaining that I got healthcare too easily.
I am not going back to my surgery and demanding they introduce an arbitrary five-year waiting list in the interests of equality.
Quite the opposite.
I am very glad that when I said, essentially, “Something is happening to my body, it is making me feel like shit and I would like to try a treatment that might help”, my account of my own experience was accepted.
I did not have to prove that I was suffering enough.
I did not have to convince anyone that I really knew my own mind. And quite frankly with my current levels of brain fog, I’m not sure that I could.
I was given information, there was a conversation about treatment and I was allowed to make a decision about my own body.
That isn’t dangerously easy access to healthcare. That is what good healthcare is supposed to look like.
I sincerely hope the HRT works.
I would quite like to sleep through the night again. I would like to stop feeling permanently knackered. I’d enjoy knowing roughly what temperature I am going to be from one minute to the next.
It would also be nice to finish sentences without staring blankly into the middle distance while waiting for a noun to come back.
Basically, I am hoping to become slightly less of a sweaty, grumpy, forgetful mess.
More than anything, I want to feel more like myself again.
And that is the thought I haven’t been able to shake since the appointment.
I wanted medication because I wanted to feel more like myself.
Nobody found that idea controversial.
One good appointment does not mean women’s healthcare is good
Before anyone interprets this as me claiming women stroll effortlessly through a healthcare system beautifully designed around our needs, absolutely not.
One good appointment does not cancel out everything we know about the treatment of women in medicine.
Women are routinely not believed about our own pain. Symptoms are minimised. Conditions affecting women have historically been under-researched. Women’s bodies have too often been treated as inconvenient variations on the male default rather than half of the human population.
This isn’t just something women complain about among ourselves.
When the Government asked women about their experiences of healthcare, 84% said there had been occasions when they felt they had not been listened to by healthcare professionals. Women described symptoms being dismissed, having to repeatedly advocate for themselves over months or years to get a diagnosis, and their preferences being ignored when treatment was finally discussed.
The Government’s own Women’s Health Strategy acknowledged that, historically, the health and care system has been “designed by men for men”, with the male body treated as the default across research, clinical trials, healthcare education and the design of services. A renewed Women’s Health Strategy published in April 2026 acknowledges that longstanding problems in women’s health outcomes, experience and access still need addressing.
And when you look at maternity care, some of the failures are horrifying.
The final Ockenden review into maternity and neonatal services at Nottingham, published in June 2026, considered the experiences of more than 2,500 families. It found women being ignored, complaints being dismissed, missed opportunities to identify deteriorating patients and a culture in which parents and junior staff could be silenced.
Those failures are not experienced equally either.
The latest Government evidence shows that Black women in England are still nearly three times as likely to die during or after pregnancy as White women. Asian women also have a higher risk of maternal death. Research with women from global majority communities has documented fear, lack of trust and experiences that leave some women feeling unsafe giving birth within the system.
The NHS’s own 2025 maternity experience research found that feeling listened to was central to women’s experiences of care, and recorded reports of discrimination related to ethnicity, age and sexuality.
That is not a footnote. It is a scandal.
There are also huge inequalities shaped by disability, poverty and other parts of people’s lives.
So no, the point of this article is not “women are listened to by doctors and trans people aren’t”.
Women know perfectly well what it feels like not to be believed by medicine.
That was another part of the reason I arrived at my own appointment so prepared.
There is a reason so many women go into healthcare appointments armed with timelines, symptom diaries and enough research to defend a doctoral thesis.
We learn very quickly that if we cannot make an airtight case for our own pain, somebody may decide it isn’t really happening.
On this occasion I was lucky. The fight I had prepared for never happened.
One straightforward appointment for one white, middle-aged cis woman does not erase any of that.
My good experience does not prove that women’s healthcare is good. It certainly does not mean other women, particularly women who experience racism, disability discrimination, poverty or other forms of inequality, will be treated in the same way.
But it did make another inequality impossible for me to ignore.
Because my trans friends are asking for something very similar
I wanted medication because changes in my hormones were making me uncomfortable in my own body and affecting my ability to live my life normally.
I wanted treatment that might make me feel more like myself.
That was accepted within minutes as a legitimate medical need.
My trans friends are also asking for healthcare that helps them feel comfortable in their own bodies.
They are also asking for treatment that helps them feel like themselves.
In some cases they are literally asking for the same hormone I have just been prescribed.
And some of them have had to wait years for it, if they have been able to access it at all.
Not years for some incredibly rare experimental treatment.
Not years for surgery.
Years just to get through the door for a first appointment.
The NHS itself describes waiting times for gender dysphoria clinics as “currently very long”.
That is something of an understatement.
NHS England’s review of adult gender clinics found that, in October 2024, people finally attending their first appointment had waited an average of 296 weeks.
Five years and seven months.
By March 2025, more than 40,000 people were waiting for a first assessment. Without significant improvement, a majority of clinics were projecting waits of 15 years or more for people newly referred.
NHS England itself described those waiting times as unacceptable.
Fifteen years.
That is not a waiting list. That is a substantial chunk of someone’s life.
And this isn’t an old problem that has since quietly disappeared. In July 2026 the Government was still publicly acknowledging that waits for specialist gender services were too long and that lengthy waits were having a negative impact on people’s mental health.
And then there is the hysteria
What makes all of this particularly surreal is the story we are constantly told about trans healthcare.
If you believed sections of the mainstream media and the anti-trans campaigners who are endlessly invited to comment on it, you might imagine gender clinics were basically drive-through hormone dispensaries.
Turn up confused on Tuesday, have a quick chat, collect a carrier bag full of oestrogen on Wednesday.
Powerful drugs being handed out on a whim.
People being rushed into treatment.
Nobody asking enough questions.
Doctors merrily throwing hormones around like sweets at a children’s party.
Except that bears very little resemblance to the NHS adult gender services my trans friends have actually encountered.
And I want to emphasise the word adult here.
One of the many frustrating features of the public debate about trans healthcare is how often completely different services, age groups and treatments are collapsed into one frightening blob called “gender medicine”. A discussion about healthcare for children becomes a claim about adult hormone treatment, which becomes a claim about surgery, and before long hardly anyone is talking about the same thing.
I am talking here about adults seeking adult healthcare.
The current NHS adult service specification does not describe hormones being handed out after a casual chat.
It requires a minimum of two core assessments. It requires assessment of a person’s gender dysphoria or incongruence, their objectives, relevant health and psychosocial history and their suitability for hormone treatment. It requires informed consent, consideration of material risks and alternatives, and discussion of fertility where treatment could affect it.
And before people even get to those conversations, there is the small matter of waiting five, ten or potentially fifteen years to walk through the door.
Which makes the contrast with my experience even more absurd.
The mythical five-minute hormone appointment did happen today. It happened to me, a cis woman.
I am the person who had a five-minute conversation and walked away with hormones.
Not my trans friends.
They are the ones facing specialist referrals, assessments and waits measured in years.
There is something darkly ironic about that.
For years we have heard words like “experimental”, “dangerous”, “irreversible” and “life-changing” attached to gender-affirming healthcare in ways clearly intended to create fear.
Of course hormones have effects.
Of course they have risks and potential side effects.
Of course medical treatment should involve proper clinical judgement and an informed conversation between patient and clinician.
I am not suggesting healthcare should mean being able to stroll into a GP surgery, point at a drug and say, “I’ll have one of those, please.”
Good healthcare should involve a proper discussion about risks, benefits, alternatives and what is appropriate for the individual.
That is true when the patient is trans.
It is also true when the patient is me.
But apparently the exact same category of medication becomes dramatically more frightening when the person taking it is trans.
My hormones are healthcare. Their hormones are treated as politics.
That distinction tells us rather a lot.
Some of the people most loudly warning that hormones are being handed out too casually appear strangely relaxed about somebody like me getting them after one brief conversation.
Nobody is writing newspaper columns about the terrifying possibility that I might regret my oestrogen.
Nobody is demanding that I prove I have really thought hard enough about being a perimenopausal woman.
Nobody has suggested that my prescription represents a dangerous ideology, threatens the fabric of British society or requires an urgent national debate.
I just got some medicine.
And that is precisely the point.
The oestrogen doesn’t know I’m cis
There is something almost absurd about knowing that a trans woman can spend years trying to access oestrogen while I can be prescribed it following a short conversation at my local GP surgery.
Yes, the dosage may be different.
Yes, the treatment plan may be different.
Yes, there are different clinical considerations for different people.
But ultimately:
The oestrogen doesn’t know whether the person taking it is cis or trans. The system does.
For me, hormones are framed as something that might improve my wellbeing and allow me to feel comfortable in my body again.
For a trans person, that same desire can suddenly become politically contentious.
Their understanding of themselves is interrogated.
Their decisions about their own bodies become material for newspaper columns, parliamentary arguments, television debates and social media pile-ons.
People who will never meet them and will never need to use a gender clinic become intensely invested in deciding what healthcare they should be allowed to receive.
And the constant public hostility has consequences.
A 2026 TransActual report, based on a UK survey of more than 4,000 trans people, found that 99% of respondents said media coverage had harmed their mental health. Almost two thirds said they had avoided going to a GP even when they were unwell. It is a community survey rather than an NHS dataset, but the scale of those responses should still give anyone who cares about access to healthcare pause for thought.
This is not an abstract culture war happening somewhere above people’s heads.
There are actual human beings underneath all that noise.
Meanwhile, the person who actually needs the healthcare waits.
And waits.
And waits.
And waits.
None of this needs to be a competition
I do not want women to have worse healthcare so that things are equally shit for everyone.
That would be a fairly bleak interpretation of equality.
I want women to be listened to.
I want Black women to stop being at greater risk of dying during or after pregnancy.
I want women’s pain to be taken seriously.
I want research and medicine to stop treating male bodies as the default human setting.
I want disabled women, poorer women and women from marginalised communities to receive healthcare that recognises their lives and experiences.
And I want trans people to get the healthcare they need without spending years fighting for it.
Those demands are not in competition.
Better healthcare for trans people does not require worse healthcare for women. We are allowed to demand better for everyone.
In fact, many of the underlying questions feel painfully familiar.
Who gets believed about their own body?
Whose pain counts?
Who is considered capable of making informed decisions?
Who has to prove that they really know themselves?
Whose healthcare is allowed to remain between them and their clinician, and whose body becomes a political battleground?
These are not questions feminists are unfamiliar with.
I keep coming back to those five minutes
I had prepared so carefully for that appointment.
I had my notes.
I had done my research.
I knew what I wanted to say.
I had mentally rehearsed what I would do if somebody dismissed me.
In the end I needed almost none of it.
I was believed.
I was treated as somebody capable of understanding what was happening to my own body.
I was able to have a conversation about treatment and make a decision.
That should not feel remarkable.
Being believed about your own body should not be a privilege.
Hopefully, over the coming months, HRT will help me sleep, think more clearly, stop randomly overheating and generally feel a little bit more like myself again.
That is really all I want from it.
And when I think about my trans friends, stripped of all the politics, headlines, culture wars and manufactured outrage, what they are asking for is not actually so different.
To feel comfortable in their own bodies.
To be able to get on with their lives.
To feel like themselves.
To receive healthcare without having to become an expert advocate, campaigner and amateur endocrinologist simply to get through the system.
Today, I got to experience what healthcare looks like when somebody says, “This is what is happening to me and I think this treatment could help”, and the response is essentially:
Okay. Let’s talk about it.
I want more women to receive healthcare like that.
I want Black and other racialised women to receive healthcare like that.
I want disabled people to receive healthcare like that.
And I want my trans friends to receive healthcare like that too.
Healthcare should help people live in their bodies, not make them spend years proving that they deserve to.
Sources and further reading
NHS: When to take hormone replacement therapy (HRT)
NHS guidance on starting HRT during perimenopause, including that people do not need to wait until symptoms are severe or periods have stopped.
NHS: About hormone replacement therapy (HRT)
Overview of HRT, the menopause symptoms it can help and the role of oestrogen and progestogen.
Department of Health and Social Care: Women’s Health Strategy and call for evidence
The call for evidence found that 84% of respondents had experienced occasions when they felt healthcare professionals had not listened to them. The original Women’s Health Strategy also acknowledged the historic “male as default” approach within healthcare.
Department of Health and Social Care: Renewed Women’s Health Strategy for England, 2026
The current ten-year strategy for improving women’s health, healthcare experience and access, published in April 2026.
Ockenden Review: Nottingham University Hospitals maternity and neonatal services, 2026
The independent review covering more than 2,500 family cases and identifying serious and sustained failures in maternity and neonatal care.
NHS England: Maternity Experience Survey 2025
Qualitative research highlighting the importance of women feeling listened to and experiences of maternity care, including reports of discrimination.
Government Race Equality Engagement Group: One Year of Action, 2025 to 2026
Current evidence on racial inequalities, including maternal and neonatal health and the continuing disparity in maternal mortality affecting Black women.
Office for Equality and Opportunity: Confidence in maternity care services among ethnic minority women
Research into trust, experiences and barriers affecting ethnic minority women using maternity services, including women reporting that their concerns or pain were dismissed or not believed.
NHS: Gender dysphoria and incongruence
NHS patient information on gender dysphoria and gender incongruence, including acknowledgement that waiting times for assessment at gender dysphoria clinics are currently very long.
NHS England: Operational and delivery review of adult gender dysphoria clinics, 2025/26
The Levy Review of NHS adult gender services, including evidence on waiting times, access, the scale of waiting lists, assessment requirements and the adult treatment pathway.
NHS England: Adult Gender Identity Services service specification
The NHS specification for non-surgical adult gender identity services, setting out requirements for specialist assessment, informed consent and the provision of medical interventions.
UK Parliament: Waiting lists for transgender healthcare, July 2026
Government response acknowledging that waiting lists for specialist gender services remain too long and that lengthy waits can negatively affect people’s mental health.
TransActual: Trans Lives 2025: Continuing to endure the UK’s hostile environment
Survey of 4,008 trans people in the UK examining healthcare access, discrimination and the effects of anti-trans hostility and media coverage.
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