Sulfasalazine: The sequel

Once again my doctor is refusing to give me any medicine.

Part one: Medicine


I have an auto-immune disease that makes my joints attack themselves. At its worst I can’t walk properly, only limp. And it hurts like hell - the pain makes me useless. It completely floors me.

It also affects my skin. I get huge scabs over all parts of my body. The worst I ever had was on my foot because it never healed on its own. I got one on my arm once, which made me freak out because of how visible it was. It’s most noticeable on my head though - my entire scalp turns into a scab, and there’s a visible red line on my face. It’s really embarrassing because it makes it look like I have terrible hygiene and dandruff, no matter what I do.


I take various medicines to calm down my immune system. I inject my leg once every two weeks with something called Adalimumab. It’s great - it works like magic. And it gets sent to me by courier from the hospital. I have to keep it in the fridge.

It’s not enough on its own though, and I have to also take Sulfasalazine. It’s a yellow pill and I have to take four of them everyday. It calms down my white blood cells.

My GP is supposed to prescribe me Sulfasalazine, but they don’t. And I’ve now run out, and my joints hurt like hell.


I take a hormone blocker to stop my primary sex hormone. It works by sending hormone production into overdrive for about a week, which makes my body ‘go on strike’ and give up making it.

A nurse is supposed to inject it into my butt every three months, so I asked my GP to help with that. Unfortunately, they refused, so I asked a gender clinic in London. They do my blood tests, but they refused to do the injections.

So instead, my partner does it. She’s not a health professional, or nurse, and it’s a very nerve-wracking experience for both of us. We did a training session with a nurse the first time, but it’s still really hard.

Part two: Change


Over the years, the hospital has given me prescriptions for all sorts of different medicines. Some of these are more potent than others.

The more potent medicines get given to me by the hospital itself. The weaker ones get given to me by the GP. They share out the responsibility. It’s called “shared care” and it’s very common here.

The hospital can give me the weaker ones, but they really don’t like to because the hospital pharmacy is always overloaded and understaffed due to cuts by the lying tory government.

Throughout the years, my GP has given me whatever the hospital has asked them to. It’s standard practice.



Ever since I asked the GP to help with safe Triptorelin injections, they have refused to give me any medicine.

The hospital wrote a letter to ask them to give me Sulfasalazine while I was still asking for help with Triptorelin. The GP was being uncooperative and ‘cautious’ with me at the time, so they said that “the wording in the letter” wasn’t clear enough.

It said something like “the patient should be prescribed…” but it wasn’t explicit about who should prescribe it.

Instead, I had to be a middleman. I explained to the hospital that my GP refused, and the hospital didn’t believe me. They couldn’t possibly understand why the GP wouldn’t prescribe it to me.

Therefore, the hospital also refused to give me any Sulfasalazine.

Taking too long

After tens of back-and-forth emails, I convinced the hospital to prescribe it to me. I had to repeat this lengthy exchange every three months. Sometimes, the email exchange took longer than three months. It was like starting from scratch each time.

This happened for two years.


During all of that time, I kept asking the hospital to write a new letter to my GP. They couldn’t understand why a GP would refuse to give me Sulfasalazine. They didn’t believe me.

I asked in emails, in calls, and in person, multiple times.

After two years, they finally agreed. And they sent a letter to my GP, explicitly instructing them to prescribe it to me.

I was relieved when the letter went through. I saw a forwarded copy, and I got notified when the GP received it. And “Sulfasalazine” appeared on the system as a medicine that I can get from the pharmacy.

Part three: Anger


When my Sulfasalazine got down to three weeks supply, I requested my next repeat prescription.

I got an email back from the GP saying something like “All good, we’ll send it through”.

One day later, the GP called me and told me that they can’t give me any medicines without a letter and agreement.

I told them that the hospital sent them a letter asking them to.

They told me they didn’t have the letter.

I told them I could send them a copy of the letter.

They said ok.

I sent them the letter.

They said they’d get back to me in a day.

They didn’t.

I asked them if they received the letter.

They said they did, and they’d get back to me in a day.

They didn’t.

I’ve now run out of Sulfasalazine again and it hurts like hell.


Everything changed when I asked for help with Triptorelin. This is a story that’s all-too-familiar for trans people around the world.

Today I am going to call up the GP, and if that doesn’t work, I’ll go there in person. I’m taking time off work for this.

The lying tory government

The lying tory government drastically cuts funding to health services because of their obsession with stealing money, and they pressure doctors to refuse services to trans people, and they build a culture of hate, which kills people.

We must vote them out. Don’t be too proud to vote tactically. Don’t waste your vote.

And we must instill a better voting system, like proportional representation, so that the lying tory government never gets in power again.


I called the GP and the receptionist confirmed that a doctor hasn’t approved the letter yet. They said they would get a doctor to look at it today, and I should call back at 5:30pm.

I called the GP at 5:30pm and the receptionist confirmed that a doctor hasn’t approved the letter yet. They said they would get a doctor to look at it today, and I should call back at 6:30pm.

I called the GP at 6:30pm and the receptionist confirmed that a doctor hasn’t approved the letter yet. They said they would get a doctor to look at it today, and I should call back in the morning tomorrow.

Tune in tomorrow for another update.

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