Trans Health
All of Trade’s services and support groups are open to and inclusive of trans*, non-binary, and gender diverse people. We have been working with the local NHS to reduce the barriers to accessing healthcare for trans* people and to reduce health inequalities that affect the community. Our Trans* Thriving project is actively creating opportunities for trans* people to look after their health and wellbeing.
Updating your patient record
If you are registered with a GP surgery, you should be able to ask them to update your:
- name
- title (e.g. Mr, Ms, Mx…)
- sex marker (if you are over 18)
Sex markers can be changed to male (M), female (F), or to a ‘not specified’ option if you do not wish to record your sex as male or female.
You do not need any of the following to update your patient record:
- a Gender Recognition Certificate
- a formal diagnosis
- to be on hormones, or to have had surgery
If you are changing the name you are using, it can be helpful to have made a deed poll or statutory declaration, as the GP surgery will normally ask for some evidence of a name change (although this is not legally required).
Because the NHS uses so many different systems to store patient records, you might find that some hospital and other NHS services are not automatically updated when you change your patient record with your GP.
HRT options/hormones
If you are considering medical transition, it is useful to understand the different option for hormone replacement therapy that are available to you.
Trans women and non-binary people assigned male at birth can take:
Oestradiol – a “feminising” hormone
Finasteride – an optional hormone therapy used to suppress testosterone, typically taken as a tablet
GnRH agonist – used to suppress testosterone (if required), typically given as an injection
Trans men and non-binary people assigned female at birth can take:
Testosterone – a ‘masculinising’ hormone
Medroxyprogesterone acetate – an optional therapy that can be used to suppress menstruation whilst waiting for testosterone treatment to achieve the same effect.
GnRH agonist– this can be used (if required) to suppress menstruation if testosterone treatment alone does not successfully achieve it.
Regular blood tests
If you are taking hormones, you will need to have regular blood tests. These are important for two reasons:
- To make sure you are on the right dose, the hormones are doing their work, and not causing any potential side effects.
- To identify any potential problems before they occur. Hormone replacement therapies have some risks and side effects associated with them (including blot clots, liver and kidney problems, and others). Regular blood tests can help spot these before they cause you problems.
You will also need to have your weight and blood pressure monitored regularly. You should be able to request these tests from your GP (even if you are self-administering hormones). However, you will find that some GPs do not understand how to interpret the blood tests monitoring your hormone levels and might be over-cautious.
Referral to a Gender Dysphoria Clinic
If you would like to medically transition, you should ask your GP for a referral to a Gender Dysphoria Clinic (GDC, previously called the Gender Identity Clinic or GIC). You are entitled to choose which clinic you’d like to be referred to. There are two GDCs in the East Midlands – one in Northamptonshire and one in Nottingham. You are not obliged to attend the nearest clinic. If you’re able to travel, it is worth checking waiting times at different clinics.
Some GDCs ask for a blood test to check your hormone levels prior to your first appointment – your GP will be able to help you with this. If this is the case, it is useful to take a printout of your blood test results to your first appointment.
Shared care agreements
If you are prescribed hormone treatment by a private service, you can ask your GP to make a shared care agreement. This may include your GP taking responsibility for prescribing hormones and arranging blood tests.
If you are referred to an NHS Gender Dysphoria Clinic, the clinic will typically ask your GP to sign a shared care agreement. Then, if you are prescribed blockers and/or hormones, the GDC will write to your GP asking them to prescribe the hormones and blockers as required. The GP is then responsible for prescribing them and for organising regular blood tests. If you’re prescribed injections, a nurse at your surgery should be able to administer these.
Useful links
TransActual provide extensive information on healthcare for trans people:
Trans HealthInformation for Trans People – TransActual
Dandelion are a Bristol-based harm reduction group for trans+ people who are self-medicating with HRT:
Dandelion
Anne Healthcare provide inclusive and accessible gender-affirming healthcare for trans+ people:
Anne – trans+ gender affirming healthcare
Queer Health/theLoveTank produce a ‘Little Backpocket Guide’ series which contains several guides relevant to trans+ health:
‘Little Back Pocket Guide To’ Series — QueerHealth