Gender incongruence is the term used to describe the experience of having a gender different to the sex you were born with. Gender dysphoria describes the distress or discomfort associated with gender incongruence.

We want to support you as best we can if you think you may have gender dysphoria. We hope the following information is useful but please let us know if you think we may have incorrect information, or we have left out something important.

I think I might have gender dysphoria, what should I do?

For more specific information about transgender issues, Tranzwiki has a list of more local support services Tranzwiki – – Gender Identity Research & Education Society – Tranzwiki directory (gires.org.uk).

Some people feel that they want to start living as the gender they feel they identify with. You don’t need anyone’s permission to do this! It can be difficult having conversations with family, friends and colleagues about this and this is often where the organisations above come in useful.

I know that I have gender incongruence, what should I do next?

Gender dysphoria diagnosis

A diagnosis of gender dysphoria is required for NHS therapies including hormone treatment, speech and language support, facial hair reduction, gamete (egg or sperm) storage and surgery. This diagnosis can only be made by a specialist in gender care – i.e. not your GP.

We are happy to refer you to an NHS gender specialist but please be aware that waiting times are growing at an extreme rate – current wait times are around 8 years.

There are 7 adult NHS gender clinics in England and you can be referred to any one of them.

There are also a number of other clinics in London, Manchester, Sussex and Liverpool but they are currently limited in who they can see and don’t offer a service to Herefordshire residents yet.

The NHS website has a list of them all and it may be worth you contacting them to find out how long their individual waiting lists are as they may all be different. How to find an NHS gender dysphoria clinic – NHS (www.nhs.uk)

Tavistock clinic, London:

Gender Identity Clinic – GIC – The largest and oldest gender clinic in the UK. We accept referrals from all over the UK for adults (over 17 years and nine months) with issues related to gender

Sheffield:

Gender Identity Clinic | Sheffield Health and Social Care (shsc.nhs.uk)

Leeds:

Leeds and York Partnership NHS Foundation Trust -Gender Identity Service (leedsandyorkpft.nhs.uk)

Newcastle:

Northern Region Gender Dysphoria Service – CNTW038 – Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

Northampton:

Gender Identity Clinic | NHFT

Nottingham:

The Nottingham Centre for Transgender Health | Transgender (ncth.nhs.uk)

Exeter:

Gender identity | DPT

Some of the clinics even have a self-referral form that you can complete and then bring to us for some basic medical information to be completed prior to referral. It’s worth checking their websites for information on this.

If you are under 18 things get more complicated as the only young person’s clinic currently in England is not accepting new referrals. It would be best to come in and talk to us about options.

Changing your name

You can change your name by deed poll – you don’t need to officially change your gender or see a gender specialist to do this.

Change your name by deed poll: How to change your name – GOV.UK (www.gov.uk)

Changing your name and gender at the surgery

You have a legal right to change your name, title and gender marker on your medical records. You don’t need a gender recognition certificate or a new birth certificate to do this.

When you ask us to change your name, title and gender, we will apply for you to have a new NHS number. We then re-register you as a new patient with your updated details. It is important to note that if you ever want to change your gender back again, you would need another new NHS number – you can’t go back to the original one.

We will transfer medical information across from your existing notes, but your original name, title and gender will NOT appear in your new notes.

If you’d like to go ahead and change your details on your medical records, we ask that you make an appointment with a GP as the first step to go through some of the points above in more detail.

The new registration process should be completed in five working days.

If you don’t wish to change your name or gender on your medical records, but do wish to be called something specific when we contact you or call you in from the waiting room, please let us know and we will do our best to ensure this happens.

Passport and driving license changes

The Tavistock clinic has some useful information on this. Changing your passport or driving licence – Gender Identity Clinic – GIC

Getting a gender recognition certificate (GRC)

You need to have seen a gender specialist before this can be issued. The GRC allows you to change your gender on your birth certificate, have your affirmed gender on your death certificate when you die, and either get married in your affirmed gender or have your gender changed on your existing marriage or civil partnership certificate.

Remember that you don’t need a GRC to be a recognised transgender person. Many people choose not to get one.

Apply for a Gender Recognition Certificate: Overview – GOV.UK (www.gov.uk)

Gender recognition certificate – Gender Identity Clinic – GIC

NHS screening checks

This is really important. If you change your gender with us at the surgery, you will not be routinely called for some cancer screening tests. So as a trans man, we would not call you for a cervical smear test or breast screening mammograms, but if you still have a cervix or breasts, it is really important that you have access to these tests. As a trans woman, you would be entitled to aortic abdominal aneurysm screening after the age of 65 and if you are taking oestrogen, you should have breast screening from age 50 to 70.

You need to contact us to have screening tests if you are registering as a different gender than that assigned to you at birth. Additionally, you can opt out of having screening invitations sent (for example if you are a trans woman, or a trans man who has had their cervix removed, you may not want to be sent cervical smear invitations).

There is some excellent, detailed information on screening on the Government website.

NHS population screening: information for trans and non-binary people – GOV.UK (www.gov.uk)

Or try Cancer Research UK’s page:

Trans and non-binary cancer screening | Cancer Research UK

• I’ve been buying hormones on the black market, what should I do?

We understand that starting hormone therapy can be the main aim for many trans folk, and the waits for gender identity clinics are too long. Whilst we strongly advise against buying hormones on the black market, we don’t judge you for it.

It is really important that we try and keep you as safe as possible so we would encourage you to make an appointment to come and talk to a GP about it. We can often arrange monitoring tests and may be able to access advice from NHS gender specialists even if you’re not officially under their care.