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

For public information, please visit the Brighton and Hove CCG public home page.

Why This Guide Is Needed

Guide to Supporting Patients Accessing Specialist Gender Identity Services

Section 1.1 

Unfortunately, trans people have not always experienced optimal healthcare from the NHS (1,2,3) . There are many possible reasons for this, including:

  • That the research evidence-base on the health needs of trans people is poor
  • Limited access to training and awareness among some healthcare staff about the health needs of trans people
  • A mistaken assumption that best clinical practice is to treat trans people ‘just like everyone else’; leading to health inequalities and trans people’s specific needs being overlooked
  • Transphobic and discriminatory attitudes and practices among some healthcare staff, including mistaken beliefs that trans people are inherently mentally ill, confused and/or that being trans is simply a ‘life-style’ choice.

In many cases, this is not only poor clinical practice but contravenes the law. B&H CCG is determined to ensure that trans people get the best possible healthcare from GPs and other services because:

  • Good clinical practice promotes and protects the health of trans people, making the best use of NHS resources
  • Trans people are legally entitled to equal access and quality treatment. This is enshrined in law and local and national NHS policy (see the table below)
  • Active trans communities are constructively working with the NHS in its mission to address health inequalities and provide accessible, effective, legally compliant services. NHS services can expect to be held to account in this.

It is in everyone’s interests to improve quality and practice for trans patients. By reading and acting on this guide, you are making a contribution to reducing health inequalities and improving the patient experience.



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

1  Whittle, S., Turner L., & Al-Alami, M. (2007) Engendered Penalties: Transgender and Transsexual People’s Experiences of Inequality and Discrimination
2  Hough, K. (2013) Twitter Trend Reveals Transgender Discrimination from GPs
3  McNeil, J., Bailey, L., Ellis, S., et al. (2012) Trans Mental Health Study 2012.

Equality Provisions Promoting Trans People’s Rights in Healthcare

Equality Act

Under the Equality Act 2010, ‘gender reassignment’ is a ‘protected characteristic’. People who hold this characteristic are legally protected from discrimination, victimisation and harassment. This covers people who are proposing to undergo, currently undergoing or have undergone a process of gender reassignment. No medical diagnosis or treatment is needed to confer protection. The Act also extends the ‘public sector equality duty’ to include gender reassignment as one of the ‘protected characteristics’ for which public bodies must take due regard of: the need to eliminate discrimination, harassment and victimisation; the need to promote equality; and the need to promote good relations.


NHS Constitution

“The NHS provides a comprehensive service, available to all irrespective of gender, race, disability, age, sexual orientation, religion, belief, gender reassignment, pregnancy and maternity or marital or civil partnership status (p. 3).”

NHS Brighton and Hove CCG commits to putting this principle into effect in the ervices it delivers.  This is laid out in the CCG's Equality and Diversity Policy.