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
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
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