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Medical gender services

Information for under 17s

NHS procedures for people aged 16 and younger in England and Wales are currently being reviewed and this information may not reflect your experience. More information about referrals to youth services in England and Wales can be found on the Arden and GEM website.

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

Errors and omissions

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