Step-by-step: how to get medical support

1. Do you need medical support?

   Read our formal diagnosis page to decide if a medical service is right for you.

2. Choose the right service

   Read our page about all of your options and our tips for choosing a gender service. If you can afford it, and are over 18, using both private and NHS services together can help you access hormones more quickly.

3. Get your referrals

   Read our how to get referred page for more information.

   Once you are referred you will be placed onto a wait list. We have a page with information about wait times. If you’d like to begin hormone therapy while you are waiting you can also ask your GP for a bridging prescription.

4. Attend assessment appointments

   Read our first appointments page so you know what to expect.

   Once the assessment is complete you may be given a formal diagnosis.

5. Under 18 only: further assessments

   Young people using NHS gender services will have two additional assessment appointments with the UCLH team.

6. Under 18 only: get puberty blockers

   Young people may then be offered gamete storage and GnRH agonist medication. Access to GnRH agonists may be affected by future changes to NHS services.

7. Approval for hormone treatment

   In the UK, gender services may allow you to start hormones at this point if either:

   • you are over 18
   • or you are over 15, have taken blockers for more than a year

   and your clinical team feel you are ready to begin.

   Services based outside the UK may not require you to meet these criteria.

   Read our hormones page for more information about hormones.

   If you are using a private service you will need to book an appointment with a private endocrinologist to begin your hormone treatment. After that appointment your endocrinologist can write to your GP to request shared care.

8. Onward referrals

   If you are over 18, you can ask for referrals to services such as speech therapy, surgery, and laser or electrolysis hair removal. If you have not undertaken it already, you can also ask for a gamete storage referral (ideally before hormone treatment is started).

What do I do if something goes wrong?

We have information about fixing common problems and about making a complaint.

More information

• List of UK services
• Choosing a service
• How to get a referral
• Wait times
• First appointments
• Hormones
• Surgery
• Surgical consultations
• Speech therapy
• Dealing with problems
• Making a complaint
• Updating NHS records
• Accessing HRT without a diagnosis
• Blood testing
• Self-injection safety
• Gamete storage
• Private fees
• Private surgery

Errors and omissions

Is there something missing from this page? Have you spotted something that isn't correct? Please tweet us or message us on Facebook to let us know.