Gender Identity
Gender dysphoria
If your patient requests treatment for gender dysphoria, referring them to a Gender Identity Clinic (GIC) or an experienced gender specialist without delay will likely be the best option. An experienced gender specialist will have evidence of relevant training and at least two years’ experience working in a specialised gender dysphoria practice such as an NHS GIC.
Every patient’s treatment journey will be different and GICs aim to provide care packages tailored to individual need. By focusing on your patient’s priorities and concerns and exploring with them the options available, you can collaborate with GICs to provide effective care and a positive experience for your patient.
All GPs in England, Northern Ireland and Scotland may refer their patients directly to a GIC and do not need to refer them to a mental health service for assessment beforehand. GPs in England don’t need to seek prior approval from their Integrated Care Board (ICB).
15. 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)
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
Contraception if you’re Trans or Non-binary
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
Evidence Based Interventions (EBI) Service for Interventions Not Normally Funded (INNF)
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
GP and Healthcare Professional Education
Keeping your professional knowledge and skills up to date
If you feel you lack knowledge and experience about the healthcare needs of trans people you should ask for advice from an experienced gender specialist and address your training need. An experienced gender specialist will have evidence of relevant training and at least two years’ experience working in a specialised gender dysphoria practice such as an NHS GIC.
7. You must be competent in all aspects of your work, including management, research and teaching.
8. You must keep your professional knowledge and skills up to date.
9. You must regularly take part in activities that maintain and develop your competence and performance.
(Good medical practice, paragraphs 7–9)
GP and Healthcare professional education
Gender Identity Research and Education Society
The Equality Act 2010 gives legal protection to people who reassign their gender away from the sex they were assigned at birth. Trans people legally are to be treated in accordance with their legal gender identity. The Equality Act describes gender reassignment as those who ‘propose to undergo, are undergoing or have undergone a process or a part of a process’ to reassign their gender away from the sex assigned at birth.
Not all Trans people will have surgery, not all Trans people will be under the care of the Gender identity clinic (GIC) and not all Trans people will be taking hormones to affirm their gender.
The Gender Recognition Act 2005 provides Trans people with the option to apply for a Gender Recognition Certificate (GRC). This enables a person to legally change the sex detailed on their birth certificate and other legal documents. It is not a requirement to change the sex recorded on other records, such as NHS records, bank accounts, etc. Not all Trans people will choose to apply for a GRC. A GRC is not required in order to live and be afforded the protection under the Equality Act 2010, as detailed above. It is neither appropriate nor lawful to ask a person if they have a GRC.
Gender Identity Research and Education Society has information on terminology which you may find useful and more in depth than this short section.
NHS Somerset Primary Care Healthcare Professionals can access the Trans health TeamNet page once logged in.
Having a Baby if you’re LGBT+
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:
For more resources, please see the Equality and Diversity page.