Gender Identity
This page contains links and resources for gender dysphoria, Trans, non-binary and LGBT+
Prescribing Guidelines by Clinical Area
Gender Incongruence and Gender Services
Every patient has the right to high-quality and inclusive healthcare. The GMC provides information on Trans healthcare - ethical topic - GMC including advice on how you can apply the principles in their guidance when caring for transgender and gender diverse patients.
The GMC also provides guidance on good medical practice which highlights:
- You must provide a good standard of practice and care. If you assess, diagnose or treat patients, you must:
-promptly provide or arrange suitable advice, investigations or treatment where necessary
-refer a patient to another practitioner when this serves the patient’s needs.
(Good medical practice, paragraph 15)
Resources
NHS Somerset Primary Care Healthcare Professionals can access the Trans health TeamNet page once logged in.
Trans healthcare – ethical topic – GMC (gmc-uk.org)
RC PSYCH Good practice guidelines for the assessment and treatment of adults with gender dysphoria
See the Evidence Based Interventions (EBI) Service for Interventions Not Normally Funded (INNF) page to find:
- Fertility Assessment and Treatment Prior Approval Policy
- Fertility Assessment and Treatment Prior Approval Treatment Application Form.
- Secondary Care Referral Form for Fertility Preservation – Prior to oncology and other medical treatments
The NHS page Having a baby if you’re LGBT+ has some useful information on starting a family if you’re lesbian, gay, bisexual, transgender or non-binary, including:
- Ways to become a parent if you’re LGBT+
- Testosterone and pregnancy
- Chestfeeding if you’re trans or non-binary
See the Evidence Based Interventions - NHS Somerset ICB page to access the inclusive fertility policy, including services for LGBT+ people.
People assigned female at birth (AFAB) can become pregnant while taking testosterone if they do not use contraception.
FSRH Contraceptive choices and Sexual Health for Transgender and Non-Binary People
Good practice guide to monitoring sexual orientation and trans status 2021 If we're not counted, we don't count- This guide explains how monitoring plays an instrumental role in identifying and addressing
inequalities.
Children and Young People
NHS England is committed to improving and expanding gender services for children and young people to ensure that they receive safe, responsive, holistic care.
Information will be updated as soon as it is available.
Gender incongruence and gender services for children and young people
There have been recent national changes to the way NHS services for children and young people with gender incongruence are delivered. Following the Cass Review and the introduction of new service standards, referrals to the national CYP Gender Service can no longer be made directly from primary care. Instead, referrals must now come through secondary care – either Paediatrics or Child and Adolescent Mental Health Services (CAMHS).
This change has been introduced to ensure that young people receive a holistic assessment of their health and wellbeing needs, with coordinated support before any onward referral to a specialist gender service.
Updated: guidance to primary care about unregulated providers who supply hormone medications to children and young people for gender incongruence - 12th March 2026 NHS England » Guidance to primary care on unregulated providers
Clinical Policy: Puberty suppressing hormones - Updated 21st March 2024
New Government restrictions on use of Puberty Suppressing Hormones (Puberty Blockers); Information for prescribers and pharmacists/dispensing doctors. Effective from 3rd June 2024
NHS England is committed to improving and expanding gender services for children and young people to ensure that they receive safe, responsive, holistic care. These documents outline the steps that NHS England has already taken guided by interim advice from Dr Cass and sets out how we will take forward the recommendations made in the final report:
- Following on from the establishment of two new NHS Children and Young People’s Gender Services in April, the NHS will continue to appoint up to six additional new providers between 2024 and 2026 on a phased basis.
- The next new service to become operational will be in Bristol in November 2024. This new service will initial take patients from across England, but move to offer services to the South West and South Wales populations over time.
- Cambridge University Hospitals NHS Foundation Trust is working with NHS England on plans for a regional service for the East of England, with an anticipated start date of spring 2025.
- The new services will have a nominated medical practitioner (paediatrician or psychiatrist) who has overall clinical responsibility for patient safety within the service.
Further updates will follow when they are published.
Local support
Alongside the national pathway, Somerset ICB commissions 2BU Somerset, a local youth work charity supporting LGBTQ+ young people aged 11-18 with their mental health and emotional wellbeing. 2BU works closely with CAMHS and other local services. GPs may wish to signpost young people and their families to 2BU while the referral process is underway.
The Somerset pathway
In Somerset, we are implementing a joined-up approach. If a young person requests a referral to the national CYP Gender Service:
- GP practices should refer to the CAMHS Single Point of Access (SPA).
- CAMHS and Paediatrics will then undertake a joint assessment, in line with the wishes of the young person, to identify their needs and agree the most appropriate next steps.
Resources for patients and families
Somerset support- 2BU Somerset Supporting young people from 13-17 years and adults.
For more resources, please see the Equality and Diversity page.
