General guidance
The GMC have created a trans healthcare hub that gives information on how to treat trans and non-binary people. This is the most important information to read about how to support your patients.
BMJ subscribers can also access BMJ Best Practice - Gender dysphoria in adults.
Policies
Each nation has different policies for how patients should be treated.
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NHS England
NHS England’s services for adults follow these specifications for Non-Surgical Interventions and Surgical Interventions. The services for children are described in Gender Identity Development Service (GIDS) for Children and Adolescents. NHS England have also published information for GPs on prescribing and monitoring hormones and information for GPs on handling requests from private medical service providers.
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NHS Scotland
NHS Scotland follows their Gender Reassignment Protocol. You should also read Interim Guidance which contains updates to the protocol. Some explanatory notes have been published which may help you.
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NHS Wales
For non-surgical matters, NHS Wales follow the Specialised Services Commissioning Policy and Service Specification. Surgical matters are referred to NHS England and follow their policy. All Wales Medicines Strategy Groups have also published information for GPs on endocrine management of gender dysphoria in adults and information for GPs on handling requests for shared care.
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HSC Northern Ireland
The HSC NI services for adults follow the Royal College of Psychiatrists Good Practice Guidelines for the Assessment and Treatment of Adults with Gender Dysphoria. For further information contact the Brackenburn Regional Gender Identity Service. The HSC NI service for young people follows the WPATH Standards of Care.
Additionally, services across the UK will follow the Royal College of Psychiatrists Good Practice Guidelines for the Assessment and Treatment of Adults with Gender Dysphoria.
Some CCGs and Trusts have written local policies relating to gender diversity of patients and staff. You can find a large list of these on the genderarchive.org.uk website.
Specialist gender services
A number of specialist NHS services across the UK provide diagnosis and treatment to people experiencing issues related to gender. Some specialise in providing services to under-18s. A number of private specialist gender clinics are also available in the UK for patients who can afford this.
Full list of UK specialist gender services
Some specialist gender services have produced additional guidance for GPs. You can find a list of publications from these services including guidance on shared care and prescribing information on the genderarchive.org.uk website.
There is no need to refer adult patients to a local mental health team before making a referral to a specialist gender service. Young people in England, Wales and Northern Ireland may benefit from a referral to CAMHS first, but the services may be willing to accept a direct referral. Young people in Scotland can be referred (or self-refer) to Sandyford’s Young People’s Gender Service in the first instance.
It may be appropriate to prescribe hormone therapy before a patient has been seen by a specialist clinic. See our Accessing HRT without a diagnosis page for more information.
Updating medical records
If a patient wants to update their medical records to match a change in gender, name, or title, there is information on how they can do this in our Updating NHS patient details article.
Books
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Transgender HealthA Practitioner's Guide to Binary and Non-Binary Trans Patient Care
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Supporting Young Transgender MenA Guide for Professionals
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Counseling Transgender and Non-binary YouthThe Essential Guide
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The Transgender HandbookA Guide for Transgender People, Their Families and Professionals
Further reading
You can find a detailed list of resources for doctors, nurses, psychologists, counsellors, and therapists on the the genderarchive.org.uk website.
Errors and omissions
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