Gender Identity

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)

Gender Referrals

Resources

Prescribing Resources and NHSE Information

NHS Somerset Primary Care Healthcare Professionals can access the Trans health TeamNet page once logged in.

Trans healthcare – ethical topic – GMC (gmc-uk.org)

Trans Health Transcript – GMC

Primary Care Responsibilities In Regard To Requests by Private On-Line Medical Service Providers to Prescribe Hormone Treatments for Transgender People

RC PSYCH Good practice guidelines for the assessment and treatment of adults with gender dysphoria

Primary Care Responsibilities in Prescribing and Monitoring Hormone Therapy for Transgender and Non-Binary Adults (updated) NHSE 2016

Evidence Based Interventions (EBI) Service for Interventions Not Normally Funded (INNF)

Having a Baby if you’re LGBT+ NHS Public Resources

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:

See the Evidence Based Interventions - NHS Somerset ICB page to access the inclusive fertility policy, including services for LGBT+ people.

Contraception if you’re Trans or Non-binary

GP and Healthcare Professional Education and Resources

If We're Not Counted, We Don't Count

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.

National Policies and Information

Clinical Policy: Puberty suppressing hormones - Updated 21st March 2024

Prescribing of Gender Affirming Hormones (masculinising or feminising hormones) as part of the Children and Young People’s Gender Service

Puberty suppressing hormones (PSH) for children and young people who have gender incongruence / gender dysphoria

New Government restrictions on use of Puberty Suppressing Hormones (Puberty Blockers); Information for prescribers and pharmacists/dispensing doctors. Effective from 3rd June 2024

Government restrictions on use of puberty suppressing hormones (puberty blockers): information for primary care - August 2024

Implementing the Cass Review Recommendations

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:

NHS England » Children and young people’s gender services: implementing the Cass Review recommendations

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

The Somerset Pathway

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.

Gender Incongruence and Gender Services

Resources

Children and Young People

Gender incongruence and gender services for children and young people

Resources for patients and families

Contact details

Quick links