This Section is designed for healthcare professionals and GP Practice staff.

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Guide To Supporting Patients Accessing Specialist Gender Identity Services

Section 7.0


Language and terminology are constantly evolving and individuals will have preferences about the words they like to use and how they understand them. Here are some of the more commonly used terms that GPs may encounter.

Biological Sex – Conceptual model that separates humans based on physical characteristics related to reproductive functions: genes, chromosomes and genital organs.

Cis-gender – Describing a person whose core gender identity as male or female is congruent with their biological sex.

Cross dresser (CD) – Describing a person who wears clothing typically associated with a different gender to express aspects of their personality and/or to gain a sense of happiness and fulfilment. The term ‘transvestite’ would now be considered out-of-date language.

Disorders of Sex Development – Medical terminology to describe congenital conditions in which development of chromosomal, gonadal, or anatomical sex is atypical. Sometimes referred to as ‘disorders of sex differentiation’ or ‘differences of sex development’. These terms can be regarded as stigmatising language and ‘Intersex’ may be preferred.

Female-to-male (FtM) – Describing a person who is born female but transitions (socially and/or physically) to live as a male.

Gender (identity) - A person’s psychological and felt sense of being masculine, feminine or genderqueer.

Gender binary – A conceptual model that identifies only two (opposing) categories of gender identity, masculine and feminine based on biological sex.

Gender dysphoria – Refers to discomfort or distress caused by a discrepancy between a person’s gender identity and their assigned sex at birth, associated gender role and/or primary and secondary sex characteristics.

Gender expression  How a person chooses to express their gender identity through aspects such as dress, mannerisms, speech, personal grooming etc.

Gender identity clinic (GIC) – See Specialist Gender Identity Services.

Gender non-binary – See Genderqueer.

Gender pronouns  Terms used to denote a particular gender, such as female or male: she/her/hers, he/him/his. Gender-neutral pronouns can be used: they/them/theirs.

Genderqueer – A multifaceted term for gender identities other than male or female and outside of a male/female gender binary. May denote one of the following: a) holding more than one gender identity, e.g. being both masculine and feminine, b) being without a gender identity, c) moving between genders or with a fluctuating gender identity. Similar and related terms include: Androgyne, Agender, Bi-gender, Non-gender, Gender-fluid, Gender Non-binary and Third-gender.

Gender Recognition Act (GRA) 2004 – A UK Act of Parliament that allows people who meet specified criteria to change their legal gender.

Gender Recognition Certificate (GRC) – A certificate granted by the Gender Recognition Panel in accordance with the GRA 2004 showing that a person has satisfied the criteria for legal recognition in their acquired gender.

Gender spectrum – A conceptual model that recognises a range of gender identities existing between polarities of masculine and feminine (opposed to Gender Binary, see above).

Gender variance  Behaviour or gender expression that does not match expected typical gender roles or cultural and social norms.

Intersex  Describes congenital conditions in which development of chromosomal, gonadal, or anatomical sex is atypical. Can also be used as a self-identification. Sometimes referred to in medical terminology as Disorders of Sex Development although this can be regarded as stigmatising language.

Male to female (MtF)  Describing a person who is born male but transitions (socially and/or physically) to live as a female.

Primary sex characteristic  Biological sex characteristics directly involved in reproduction, e.g. testes, ovaries and external genitalia.

Real Life Experience (RLE)  A mandatory period of time spent living in the new gender role before certain medical treatments can be commenced such as hormone therapy and surgery.

Secondary sex characteristic  Distinguishing biological sex characteristics that are not directly involved in reproduction (e.g. breasts, facial hair, Adam’s Apple).

SOFFAs  An acronym for 'Significant Others, Family, Friends and Allies'. Denotes people who are partners, family and friends of trans people and/or those who support and engage in activity to achieve equality and human rights for trans people.

Specialist Gender Identity Services (SGIS) – Specialist NHS services providing expert care and treatment for people experiencing gender dysphoria or seeking help with gender identity issues.

Stealth  Where a trans person has transitioned and others are not aware of their previous gender or trans history. Individuals may be stealth in some contexts and not in others (e.g. stealth at work but not with their family).

Transgender (Trans)  An ‘umbrella’ term to describe people whose experience of gender differs from the assumptions, expectations and social and cultural norms of their society, and who blend, challenge, or cross gender roles. 

Trans man – A person assigned female at birth but who has a male gender identity and transitions to live as a man. Sometimes used as preferred term to transsexual.

(Gender) Transition  The psychological, physical and social processes involved when a person recognises their need to live permanently in a different gender and takes steps to actualise this. Previously known as ‘sex-change’ but this is now considered out-of-date language.

Transphobia – Fear of trans people or ridicule, prejudice, discrimination or hatred directed against them. Can be manifested in transphobic hate crime and violence.

Transsexual – A person whose core gender identity as male or female is different than their biological sex and who uses hormones and/or surgery to enable their body to match their gender identity. Some trans people resist this term as a medical label while others embrace it.

Trans woman  A person assigned male at birth but who has a female gender identity and transitions to live as a woman. Sometimes used as preferred term to transsexual.


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