Gender care in GP
The Village Practice recognise that many transgender and non-binary individuals face significant barriers in accessing timely and appropriate healthcare. Long wait times (often several years) for Gender Identity Clinics (GICs), limited availability of resources and services, and inconsistent care experiences are unfortunately common. We understand how distressing this can be, and as a practice, we are committed to providing compassionate, respectful, and inclusive care for all our patients.
Our commitment to high-quality LGBTQ+ healthcare has been recognised through the Pride in Practice Award, reflecting our ongoing work to create a safe and supportive environment for trans and gender-diverse patients.
In March 2025, The Royal College of General Practitioners (RCGP) published a statement regarding the role of GPs in transgender care. RCGP proposed GPs are not expected to act as gender specialists, rather encouraged to engage supportively and safely with patients as part of their broader healthcare team. “The provision of detailed advice about gender identity issues and associated treatments does not fall within the remit of a GPs education and training, therefore GPs often feel it its outside their area of competence to advise patients with gender dysphoria.”
All hormone medications used to treat gender incongruence are being used outside of their license in the UK and are subject to complex monitoring requirements that are directed by specialist gender physicians and endocrinologists. Some of these medications have irreversible unwanted effects, and may adversely affect physical characteristics, impair future fertility, and can also pose risks such as risks of breast cancers and major blood clots.
In the GMC’s Good Medical Practice prescribers are advised to work within the limits of their competence (Article 14) and only prescribe medications outside of license if they are fully competent in the treatment, understand the risks and benefits, and can take full clinical responsibility for its use. The GMC defines an experienced gender specialist as a clinician with both formal training in gender care and at least two years of practice in a recognised gender dysphoria service, such as an NHS Gender Identity Clinic.
Our Prescribing Policy
We currently do not have the specialist training required to initiate gender-affirming hormone therapy. We are unable to prescribe or accept shared care agreements for children.
We will only prescribe hormone treatment for adults over the age of 18 years, as part of a shared care agreement with an NHS GIC or a recognised and reputable private provider. Each case is reviewed individually to ensure that appropriate clinical governance is in place.
If a patient is being seen by a private gender clinic, we will only continue prescribing in line with NHS GIC prescribing protocols. This is to ensure consistency, safety, and adherence to evidence-based practice. For example, we are unable to take over the prescribing of progesterone in trans female patients, even if this is recommended by a private specialist. Currently the NHS GICs do not support this prescribing as there is not sufficient evidence for its benefits however there is documented evidence of its risks and side effects.
For us to consider taking over a shared care from a private gender clinic, we require confirmation that:
- The clinic is reputable and operates within GMC standards. Any clinician making a recommendation needs to clearly state their role and registration details.
- A full assessment has been carried out by qualified professionals
- Clear prescribing and monitoring plans are in place.
Self-Sourcing Medications
We understand that due to long wait times, some individuals may feel compelled to source hormones online or from unregulated suppliers. However, this can be extremely dangerous. Self-sourcing carries significant risks, including:
- Receiving counterfeit or contaminated products
- Incorrect dosages that can cause long-term health damage
- Lack of medical supervision for side effects or complications
In particular we advise against taking Spironolactone, which can cause hyperkalaemia (high potassium), which can lead to irregular heart rhythms and kidney damage. Evidence suggests that Spironolactone triples the risk of an upper gastro-intestinal bleeding, and that patients taking Spironolactone are more likely to have insufficient breast growth.
If you are currently self-medicating, please let us know. While we cannot endorse this approach, we will work with you to ensure you receive non-judgemental support and appropriate monitoring for your safety.
What You Can Do While Waiting to Be Seen by a GIC
The current wait times for our local GIC, the Tavistock and Portman, can be found here
There are several things you can do to support your wellbeing and prepare for your assessment:
- Update your records (you can change your name, title, and gender marker at the GP practice if you wish) You do not need to bring proof of an official name change.
- Social transitioning: This is an extremely important part of managing gender incongruence. It’s really important to make a social gender role change into whatever role best suits you; and as much as possible to let family, friends and your workplace know your gender identity (not necessarily telling people your sex assigned at birth or that you are trans or non-binary). The GIC need to see evidence that a person is committed to their gender identity and able to cope with the challenges of transitioning.
- Smoking Cessation: It is of paramount importance that you quit smoking. Anyone seeking hormone therapy (likewise for surgery) must have completely quit smoking for 3 months, due to increased cardiovascular and thromboembolic disease risks. The GIC will not endorse hormones for anyone that is smoking and may have to stop or reduce therapy if they return to smoking.
- Access mental health support through NHS services or LGBTQ+ organisations (see more information below)
- Keep a diary of your experiences, goals, and any challenges related to your gender identity – this can be helpful during your GIC assessment
- Explore peer support groups and online forums for community and guidance
- Maintain regular health check-ups, If you change your name and gender at the practice, you may miss invites for national health screening programmes, such as cervical smear tests and breast screening. As a practice we try to ensure you do not miss these important screenings, however, you can also ask us to arrange the right screening appointments for your needs.
- Taking care of your overall wellbeing:
- Do things you enjoy such as exercise, hobbies and community activities.
- Eat a healthy diet
- Mindfulness/ meditation
Support for Trans and Non-Binary Patients
Here are some trusted organisations offering support, information, and advocacy:
Gendered Intelligence – Trans-led organisation offering youth groups and educational resources
👉 www.genderedintelligence.co.uk
Stonewall – National LGBTQ+ rights charity with trans-specific resources
👉 www.stonewall.org.uk
MindLine Trans+ – Confidential mental health support helpline run by Mind
👉 www.mind.org.uk
NHS GIC Services – Details of NHS gender clinics across the UK
👉 https://www.nhs.uk/nhs-services/gender-identity-clinics/
- Islington Talking Therapies: Free, confidential help for problems such as stress, anxiety, depression and insomnia.
👉 https://www.camdenandislingtontalkingtherapies.nhs.uk/
- Mermaids – Support for trans, non-binary, and gender-diverse children, young people and families