You can visit the GenderCare website here. You will learn that Gendercare is a ‘network of individual healthcare practitioners’ who ‘share a general commitment to providing friendly, accessible private services, tailored to individual needs and timescales, in a variety of comfortable London settings.’
It is the tailored timescales that appear to be the biggest draw for those who seek the services of GenderCare. Many are disturbed by the long NHS waiting lists and drawn by the knowledge that, in the words of one young patient, “obviously Gendercare is renowned for getting people on hormones very quickly.”
While the speed of service is of greatest importance, the lure of Stuart Lorimer, the father figure of the organisation, is not to be underestimated. Lorimer is an incredibly charismatic man in the eyes of those who seek his services. I spent an afternoon watching YouTube videos about first appointments with GenderCare and not a bad word was said about him. He is described by those who flock to his surgery as:
so nice, he understood me…
he’s actually very validating…
the fucking nicest guy I’ve ever met, it’s like talking to a mate…
as soon as you meet him you feel warm…
He was super lovely, I had a nice time…
He’s a really nice bearded man. He’s really cute.”
Lorimer, a flamboyant gay bloke who is ‘particularly interested in engagement with the wider binary and non-binary trans community’ (whatever the fuck that’s supposed to mean) knows how to flatter the young women who sing his praises on YouTube. After all, he too nestles beneath the ever-expanding LGBTQIA+ umbrella. He gets them. And they love him. This patient has even got a tattoo of Lorimer’s face, as featured on his super-cool business card, on their neck:
Lorimer’s pronouns are in his bio. He listens to his patients and they feel he validates their feelings and desires. “He called me Mr,” they say. “He didn’t misgender me’ or ‘He said my voice was really masculine’.
Two thirds of Lorimer’s patients are transmen. These (modified) pictures are taken from their YouTube videos:
Founding a dream
With his past experience working at the Charing Cross Clinic, Lorimer founded Gendercare in 2010. He estimates he has seen more than 4000 patients over a period of fifteen years. The business is highly successful. He sees the main issue facing him at the moment as ‘coping with increasing numbers while maintaining quality.’
GenderCare only deals with adults- although the young women in the videos I watched all looked astonishingly young. Lorimer admits to having had at least one patient as young as seventeen, tweeting in 2017: ‘My youngest patient is 17, my oldest 96’.
He seems to believe he brings humour and bonhomie to the transition process, as can be seen by these tweets from 2016/17.
It’s not possibly to view what Lorimer is currently tweeting, as his tweets are now protected.
While his milkshake may indeed ‘bring all the boys to the yard’ the GenderCare website’s handy guide to choosing your clinician makes it clear that Lorimer’s primary interest does not lie in discussing his patients’ feelings in depth but in diagnosis, prescribing hormones and referring for surgery.
Time for Tumblr
In 2016 Lorimer arrived on Tumblr, an area of the net frequented primarily by teenagers. ‘Tumblr, like lycra is probably not for anyone over 30 –yet here I am’ announced Lorimer chirpily, posting his trendy business cards while making it clear that he didn’t represent his ‘NHS employers or my GenderCare colleagues’. Oh and adding that he may post pictures of cute animals.
‘Don’t worry, young person about your first trip to get T. You will meet a cuddly gender doc wearing a pink suit.’ observes SunMum wryly in her article for 4thWaveNow, ‘GenderCare: London private clinic with a winning business model’
“After all, this is all a game, a joke. Fun. Isn’t it? Well I for one don’t think it is. My son, you see, became seriously depressed in his second year at university and developed sudden onset gender dysphoria… Urged on by a counsellor, I, in my naivety, paid out for an assessment at GenderCare… I was astounded when my son came back telling me that he would be starting hormones in a few weeks.”
GenderCare Tumblr has not posted since September 2016.
Instagram posts with the hashtag #gendercare contain pictures like this one, a prescription for testosterone prescribed by Lorimer, accompanied by cheers of ‘well done bro’ and ‘yay congrats’.
Another patient tags a #gendercare picture with ‘Dr Lorimer and I, Bro-ing out ?? He give me the go ahead for testosterone.’
Recently a young woman used the hashtag to pose with two packets of ‘testogel’.
‘Happy one month on T to me’ posts another.
‘Finally got my private prescription for testosterone gel!!… can’t wait!’ another announces, #gendercare accompanied by a letter with Lorimer’s letterhead.
“Dr Lorimer is fantastic! Absolutely loved him, made me feel so comfortable.”
‘I see Lorimer at ChX sometimes and he’s the best :)’
Another photo of a prescription is accompanied by the words “I filed this prescription today. So surreal. Its finally happening. ?’ #gendercare
‘After a few days of no sleep, filled with excitement we went to London on Tuesday to meet Dr Lorimer at Gender Care!’ posts another, with a photo of a couple standing by Big Ben.
‘Guess what… ??? know it’s unreal!! ??’‘ accompanies a picture of an unopened GenderCare letter.
“Exciting! Congratulations bro!”
Have you noticed what I’ve noticed? Do these people sound like adults embarking on serious, life altering processes? No, of course they don’t. From a sociological perspective I would say they use the language and emoticons most commonly used by excited teenage girls, and there’s probably a very good reason for that.
“It’s not an adventure if you know what is going to happen” posts one young client after a ‘gofundme’ paid for an appointment with GenderCare.
This isn’t a fucking gap year in Thailand.
I type ‘gendercare lorimer first appointment’ into YouTube. Scores of videos come up. Consultations are expensive. Many of the young women using GenderCare have donation options linked to their vlogs. Others have parents who pay for the appointments; some hold down an extra job.
Don’t take my word for this. You too can while away several never-to-be-regained hours of your short life by watching these diverse yet strangely homogeneous young women talk about their experiences with GenderCare. They have put their experiences on YouTube; they want their transition videos to be seen. Views are important. Some of them slip in footage of tube station signs and mainline railway stations, as the trip to London to visit GenderCare is documented for their YouTube channels. Often they apologise to their followers for not posting enough. References are made to how bad the lighting in the video is, how awful they look today; self harm and mental health services are mentioned, as are helpful and unhelpful parents (note that even the most unhelpful ones seem to provide transportation to appointments). It’s all part of ‘my transition journey’.
Here are some of the things they say:
“I had my first GenderCare appointment last Friday with Dr. Lorimer, it went amazing and I’m starting testosterone soon and I ALSO HAVE A DATE FOR SURGERY”
After a first GenderCare appointment: “It went really well… there were two people (outside) that were FTM trans so I was oh ok, I’m in the right place. He asked “when did you know this was yourself?”… “I saw a video of a person transitioning and I was like yeah that’s me, that’s the moment I knew I was trans… when I was a kid I never felt dysphoric.. I can like dresses and a lot of people say that makes me less trans… I can dress up as a woman for silly skits…” If my blood tests are ok he says he’ll make sure I can get testosterone within a month, or maybe a month and a bit.”
After a first GenderCare appointment: “He (Lorimer) said ‘don’t worry, I want to try to get you on testosterone without having to get more bloods done’.. at the end he said he was formally diagnosing me with gender dysphoria which means I’m officially trans which is pretty cool… at 10pm he emailed me saying all I needed to do was call my doctor (to get a test result) and he could give me the go ahead for testosterone. It doesn’t even feel real. I’m gonna have started testosterone by Christmas and that’s a really scary thought.”
After a first GenderCare appointment: “He (Lorimer) knows what he’s talking about.. he was so nice, he understood me, he got it. He said there’s people out there who’d advise him to advise me I shouldn’t be filling myself up with hormones… he asked what I’d say to him if he said that.. I quite like the person I’ve turned out to be now but… I don’t like the fact that my fat stores on my bum and my hips… my voice is like a 12 year old boy’s… I’m not comfortable in my body… I’m not seen the way I should be seen in my head.” He said ‘based on these questions I’d say you definitely fit the category of gender dysphoria’… he can see me getting testosterone by the end of January.” (the video was posted in December)
After a first GenderCare appointment: “I’d been waiting two years through the NHS and I was done with waiting… he does passport letters for free… he (Lorimer) asked where I would like to go with my transition, what are you looking forward to with testosterone?.. he’s actually very validating, he said you have quite a masculine voice… it’s nice to hear. I said I didn’t want a receding hairline he said yeah thats what most people say they don’t want. He laughed because he has a receding hairline, so I felt a bit awkward saying that. He said I was more than ready for testosterone.”
After a first GenderCare appointment: “This is the biggest mission to manliness I’ve had so far. Both my mum and dad came with me which is awkward because they’re divorced… they like each other now because they both don’t want me to be trans. My mum seems to ruin every exciting thing about my transition. I’m sure you’ve heard this before if this isn’t the first gendercare video you’re watching but Dr Lorimer is the fucking nicest guy I’ve ever met… it’s like talking to a mate, he didn’t misgender me. He asked if I had a cold, I said no I’ve just been crying. He sorta laughed that off. He asked about mental health services I’ve actually been referred to CAMHS (for self-harming) but I ended up not going to that. (I said) ’I’m not doing it any more mum, I’m fine.’ My mum’s one of those people who wants to believe it’s true so badly that she’ll just believe me… At the end of the appointment I have been diagnosed with gender dysphoria!… He said he would have been happy to prescribe me testosterone within the next few weeks if it wasn’t for my parents.
After a first GenderCare appointment: ‘We had a chat about my history, how I’ve been presenting, pronouns I’ve used in the past, pronouns I use now… reaffirming that I am trans.. even though I didn’t know it in my head… he’s a really nice guy… and came to the conclusion that yes I should be on testosterone… I should be on testosterone in about a month.”
“I chose to go with Dr Dundas (at GenderCare) because he has the shortest waiting list.. got an email a week later saying tell me what you want and I’ll see what I can do.
After a first GenderCare appointment: “It went really well and smoothly. We didn’t have to go really deeply into any topics that were uncomfortable… One result was missing from my blood test results so I have to get that sorted out… and I still need to find a GP practise that is ok with ‘shared care’ but hopefully… I should be able to start testosterone maybe right at the end of September or in October.. . I’m really not good with months or the order they come in. ” (video was posted end of August)
After a first GenderCare appointment: “NHS was no longer an option for me… so I paid to go and see Dr Seal to assess me and diagnose me with gender dysphoria… if you’re like me and you didn’t know you were trans at the age of six don’t worry, he’s not there to judge you. I was so nervous, I had butterflies, I felt sick… but super-excited… after it I felt so happy, he diagnosed me with gender dysphoria, he said I could start T and I had to wait 2 weeks to start it. I was over the moon. I felt my life was finally going to start…”
After a first GenderCare appointment: “If you’re like me and want to pay in cash there’s a cashpoint two minutes walk from the clinic… Dr Lorimer is one of those people as soon as you meet him you feel warm… he asks what you want from GenderCare and why you’re there… then you get more into childhood, your family, coming out… if you want to freeze your eggs, that one took me aback a little bit… it felt like an hour wasn’t enough but we finished on time… he has a really cool cute little business card. He diagnosed me with gender dysphoria; it didn’t cross my mind I’d come out with a diagnosis. To me it’s not a mental health problem. Last thing was to look at my bloods and check if he feels I’m ready for hormones… he had a quick little skim read and said he’ll send Dr Seal an email. He concluded he’d be happy to provide me hormones but I’d have to wait a few weeks. Overall really, really exciting! It’s so cool.”
“My first appointment was in August 2016… a last minute cancellation… I was having panic attacks… I wasn’t in a good place that day… obviously GenderCare is renowned for getting people on hormones very quickly… I was like, I’m gonna get hormones! At the time I was 19. It doesn’t look like a clinic, it’s very bright. His office is not like an office at all, there’s an old rug in there. He’s a really nice bearded man. He’s really cute. A few weeks later I got this 6 page letter and a passport letter and my T letter saying ‘there are no contradictions to his beginning testosterone, I’d be grateful if you could start him on the following…’ The difference between NHS and private is the waiting time. I’d recommend anyone to go private if they can.
“I’m non binary. I had an appointment with Dr Lorimer.. he was lovely.. asked quite a few gatekeeping questions.. you kind of lay on this whole thing, like, yeah when I was a kid I was a tomboy; I didn’t like girl things, never wore dresses.. it’s kind of ridiculous that you have to but it just feels a lot easier if you go with the narrative. He was super lovely, I had a really nice time. My second appointment was with Dr Lenihan, I found her very intimidating, she doesn’t seem very up on non-binary. I did lay on the narrative again, a bit more than is necessarily true for me. She didn’t seem comfortable with me going for top surgery. She said if I had top surgery everyone would think I was a man. At the moment people either think I’m a guy or think I’m a woman but I hope to one day live in a society that’s a little bit more open minded than that. (laughs) In the end I left very upset. I didn’t think she was going to approve me. My course leader and former employer emailed her to say I was non binary. (Then) very quickly she was very efficient in getting that approval sent off to the surgeon of my choice. Wow, I’m having top surgery soon!… Lorimer said I was a standard case of ‘Yup, top surgery.” so that was quite straight forward. Lorimer charged £200 and Lenihan £250. Those prices have recently gone up.”
“Most people get prescribed T after two appointments, which I’m now on. Whoo! Lorimer asked questions about social transition, Dr Seal asked more medical things’ like ‘did you have a normal birth?’ Both doctors are really there to nudge you in the right position. They want to get you to where you want. I’m sure, like myself, there are a lot of trans guys out there who first identified as lesbian and were quite uncomfortable with it and later on progressed to realising they had a much more masculine identity and that ‘lesbian’ didn’t really fit. He (Lorimer) didn’t ask too many questions about that which I was pleased about… Dr Seal took my height, weight and blood pressure and that’s it. That’s the physical examination. It’s very basic stuff. He talks really fucking quick. I had to ask him several times ‘what was that? What did you say?’ and get him to repeat the question… he’s a busy guy. It is pricey, but positives with GenderCare; the reason the fees have gone up with Lorimer is you can now get a bridging prescription. (Ask for this) because if there’s a 6 month wait between you seeing him and seeing Dr Seal, that’s six months you could be on testosterone!”
What did I learn?
What did I learn from my day of watching these videos? Well, as customers they invariably seem to be dealt with remarkably quickly by GenderCare, receiving prescriptions for testosterone following first and second appointments.
We are living in a world where diagnosing a suicidal, depressed or self-harming young woman with gender dysphoria seems to be synonymous with offering her irreversible drugs and double mastectomy.
I can still find nothing to suggest that previous generations of young women have believed themselves to be men. There have been women who ‘lived like men’ and women who ‘dressed like men’, certainly, but women who actually believed themselves to be men, or believed that they could actually become men? There is no precedent for that.
Suddenly a generation of young women (and men, but this article is focused on the women) have been told that this is a reasonable thing to believe. Furthermore they have been told that this is a reasonable thing to attempt, and that with the right money and support it is something they can achieve.
Letters, containing ‘passport letters’ and testosterone prescriptions, marked with the GenderCare stamp, are waved at the camera with the enthusiasm of Hogwarts students anticipating a new life in a magical world of fantasy and wonder. Concerns for careful medical care do not appear to be of high concern among patients. Expectation of desired results is high. Immediate gratification is expected. One GenderCare client speaks angrily of being expected to attend further appointments at a cost of an extra £300 before receiving more testosterone, but seems less concerned by the medical cause of the delay (which included returning periods) than being expected to ‘’pull all this money out of my ass’, concluding ‘you can’t just take something away from me that is my reason to live.’
The terrible predicament faced by those of us who choose to acknowledge this crisis in mental health among young women is that if we question it, if we refuse to speak the lie and say they are actually men, then we are accused of pushing them towards suicide. We are told that if we speak out, it will be our fault if someone is triggered by hearing our words. We will be blamed. That we are literally erasing people. The Samaritans tell us that one in five people has suicidal thoughts at some point in their lives, yet in no other demographic is the threat of suicide seen as an acceptable reason for silencing people who disagree with you.
In the meantime, doctors, clinicians, therapists and a few high profile individuals are making fortunes out of perpetuating the myth. This industry needs to be analysed and examined and it needs to happen now. We need to question this treatment of young people, however uncomfortable it makes us. We need to listen to the ever-louder voices of desisters and detransitioners.
Lorimer himself seems to have adopted a lower profile these days, but the girls keep flocking to the GenderCare yard. Have the affirmative clinics become trapped in their own webs? Are they stuck in this lucrative cycle of giving young women what they ask for because it’s too late to back away from all that affirmation and consider that just possibly they have been a little free with the prescriptions?
Or is it just entirely convenient to keep feeding the cycle of dysphoria that keeps them comfortable?