Guide To Supporting Patients Accessing Specialist Gender Identity Services
NHS Brighton and Hove Clinical Commissioning Group is committed to providing excellent services to all local patients, including those accessing Specialist Gender Identity Services (SGIS). GPs have an important role to play in supporting these patients but information about how best to do this is not always easily accessible. This guide was written for GPs but may be useful to a range of primary care staff.
You can go directly to relevant sections of the guide but it will be most useful if read in full and in sequence. You can find a Quick Task Menu in the table at the bottom of the Guide Home Page, and the Glossary for any unfamiliar terms.
The guide is for information only and does not replace or revise any existing CCG policy. It is not a comprehensive guide to trans people’s experiences, trans health or expert management of patients undergoing gender transition. It focuses on providing the busy GP with accessible information on issues arising from working with patients accessing Specialist Gender Identity Services (SGIS). This includes:
- Developing understanding about gender and trans people, including terminology issues
- Straightforward guidance on working respectfully with trans people and providing good quality services
- Understanding SGIS, the treatment protocols and how to refer patients
- The key responsibilities of GPs in the shared-care arrangements for people under the care of SGIS
- Changing identity details on NHS records, information governance issues and report writing
- Information about supporting patients.
This guide is a developing resource and we welcome feedback and suggestions. Please email us with your feedback.
Introduction Guide Home Page
Section 1.0 About This Guide
Section 1.1 Why This Guide Is Needed
Section 1.2 Current Context
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
Further Sources of Information on Trans Health
- RCGP E-Learning Course for GPs
- GIRES Caring for Gender Non-Conforming Children and Young People Course for health and social care professionals
N.B. Some information in these publications is now out of date (e.g. treatment and care pathways). However, general information is still relevant. Titles include:
- Transgender Experiences Information and Support
- Guidance for GPs, Other Clinicians and Health Professionals on the Care of Gender Variant People
- A Guide to Hormone Therapy for Trans People
- Medical Care For Gender Variant Children And Young People: Answering Families’ Questions
- Trans. A Practical Guide for the NHS.
Trans Health & Wellbeing
N.B. Many available resources originate from North America but contain relevant information.
- Age UK Factsheet: Transgender Issues in Later Life
- Centre of Excellence for Transgender Health
- NHS Choices Transgender Health
- Terrence Higgins Trust Sexual Health Guides for Trans Men and Trans Women
- Unison & GIRES Factsheet: It’s just good care - A guide for health staff caring for people who are trans
- World Professional Association for Transgender Health (WPATH) Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People.
- Brill, S.A. & Pepper, R. (2008) The Transgender Child: A Handbook for Families and Professionals. San Francisco: Cleis Press
- Erickson-Schroth, L. (eds.) (2014) Trans Bodies, Trans Selves: A Resource for the Transgender Community. New York: OUP USA
- Greatheart, M. (2013) Transforming Practice: Life Stories of Transgender Men that Change How Health Providers Work. Toronto: Ethica Press
- Kaufman, R. ‘Introduction to Transgender Identity and Health’ in Makadon, HJ., et al (eds.) (2008) The Fenway Guide to Enhancing the Healthcare of Lesbian, Gay, Bisexual and Transgender Patients. USA: American College of Physicians.