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Supporting Patients Accessing Gender Identity Services

This guide is for GPs on the care of patients accessing NHS Specialist Gender Identity Services (SGIS). Trans people are entitled in law and policy to equal access but health inequalities remain and trans people have not always had a good experience of NHS care. This guide aims to enable GPs to get ‘up to speed’ on some of the key issues. 

Working alongside SGIS, well-informed, sympathetic and helpful GPs can be a vital part of the information and support network for trans people undergoing gender transition.

GPs play a central role in making the initial referral to SGIS, prescribing cross-sex hormones as part of a shared care arrangement and on-going liaison with the SGIS throughout the patient’s care. They also support and assist the patient before and after surgery, as well as assisting with document changes and other matters. GPs also arrange local mental health support where needed and may also play a vital harm-minimisation role where patients are self-medicating with cross-sex hormones obtained outside of medical supervision. 

For a link to each of the sections of this guide, see the index, below. You may also find the Quick Tasks menu in the table at the bottom of this page helpful.  

You can access a PDF version of this guide for easy printing in the table below

Index

Section 1.0 About This Guide

Section 1.1 Why This Guide Is Needed

Section 2.0 Developing Understanding About Trans People

Section 2.1 New Thinking About Gender

Section 2.2 About Trans Identities

Section 2.3 About Gender Pronouns

Section 3.0 High Quality Services for Trans People

Section 3.1 Getting It Right

Section 3.2 A Special Note on Children and Young People

Section 3.3 A Special Note on Screening: Screen for the Organs Present

Section 4.0 Understanding the Patient Groups

Section 4.1 Understanding Specialist Gender Identity Services

Section 4.2 The Approach to Treatment

Section 4.3 Treatment Protocols

Section 4.4 Available Treatments - Adults

Section 4.5 Available Treatments - Children and Young People

Section 4.6 The Role of the GP

Section 5.0 Changing NHS Records

Section 5.1 Information Sharing - The Gender Recognition Act 2004

Section 5.2 Medical Reports

Section 6.0 Supporting Patients

Section 6.1 Sources of Information and Support

Section 7.0 Glossary

Acknowledgements

This guide was written by Dr Nick Douglas, Independent Consultant and Trainer.

With special thanks to: The Brighton and Hove Trans Alliance, the LGBT Health and Inclusion Project at Brighton and Hove LGBT Switchboard and Dr Katie Stead, Jane Lodge and Christopher Roskelly at Brighton and Hove Clinical Commissioning Group.

I need to refer my patient to a specialist gender identity service

To look up a service, or to download template referral forms for children, young people, and adults, please see the table at the bottom of the Understanding Specialist Gender Identity Service page here

I need a diagram of the gender identity services care pathway

 

 

To download a copy of this diagram, please see the table at the bottom of the Understanding Specialist Gender Identity Service page here

I need to understand the hormone treatment and monitoring regimen

I need to understand what surgical treatments are available via the NHS

I need to write a report for a Gender Recognition Certificate application

I need to inform my patient about sources of support outside the NHS

PDF Version of Supporting Patients Accessing Gender Identity Services



The PDF Version of Supporting Patients Accessing Gender Identity Services is for use by clinicians.

If you have any questions about this document, please contact us.