To get gender-related medical treatment, you normally need to be referred to a specialist gender service. This works just like being referred for any other kind of medical treatment.

How do I get a referral?

Private gender services let you refer yourself and their website will normally tell you how. Getting a referral typically involves sending them an email or filling in a form on their website.

Some NHS gender services also let you refer yourself. You can do this by downloading a form from their website, filling it out, and emailing it to them. You can find out which NHS services allow self-referral on our list of gender services.

To be referred to an NHS gender service which doesn’t allow self-referral, you will need to make an appointment to speak to your GP. This could be a telephone or in-person appointment.

How do I ask my GP for a referral?

In your GP appointment, you should tell your GP that you want them to refer you to a gender service.

What happens next depends on your age:

• if you’re under 17, you will normally be referred straight to a gender service, but in some parts of the UK, your GP might first need to refer you to Child and Adolescent Mental Health Services (CAMHS) who will then refer you on to gender services. You can see your GP without your parents present, and the GP shouldn’t tell your parents about what you’ve talked about without your consent, though they might encourage you to talk to them yourself.
• if you’re 17 or over, your GP should always refer you straight to the gender service. You should not be asked to use a mental health service or counsellor. If you are living in England, you may be asked which gender service you wish to be referred to. If you don’t know which services you can access use our list of UK gender services.

The person making the referral may take your height, weight, blood pressure, and waist size, and may ask you to have some blood drawn for testing. They might also ask you if you want to update your name or gender on their records. They should not ask you to let them examine your chest or genitalia.

The person making the referral will also ask you some questions.

What might I be asked?

Many gender services publish their referral form on their website, so you can check ahead of time which questions you might be asked.

Common questions could include:

• What is your current gender identity and pronouns?
• Have you previously attended a gender clinic?
• Are you taking any hormones?
• Do you need any support to attend appointments (e.g. an interpreter, advocate or carer)
• What medications do you currently take?

Specific questions about gender could include:

• When did you start feeling something was wrong related to your gender?
• Did you experiment with gender during childhood (clothes, hair, makeup, etc)?
• Have you made a name change? If not, do you have a preferred name?
• Have you updated your NHS records?
• Have you made any public changes to your gender presentation?

The person referring you will need to list your medical conditions on your referral. This may mean you are asked questions about your medical history or family medical history. In particular, you are likely to be asked if you have any of the following:

• mental health conditions
• DSD or intersex conditions
• ADHD or autism
• learning disabilities or a developmental disorder
• a history of self-harming or suicidal behaviour

You might also be asked:

• Do you use any recreational drugs? Do you drink? Do you smoke?
• Do you have a criminal record?
• Where do you live? Who do you live with?
• Are you employed? Are you in education?

If you’re being referred to a service for young people, you are likely to be asked:

• whether your parents or guardians are happy for you to be referred
• whether you have experienced any bullying
• whether you have experienced any abuse

What can I do beforehand?

Think about whether it would be helpful to have someone with you when you ask for a referral. Do you find it difficult to explain things clearly? Do you find it hard to say no to things that make you uncomfortable? Would having someone else there make you feel more comfortable?

You might want to think about the questions that you’ll be asked before your appointment so that you feel confident to answer them.

Dealing with problems

If you find you have difficulties getting your GP to make a referral, you can read about what to do on our page about dealing with common healthcare system problems.

What happens next?

After you’ve been referred, most services send you a confirmation letter, letting you know you have been added to their waiting list. This usually takes a few weeks. If you’ve not heard back within a month, try phoning or emailing to check that your referral has been received correctly.

Most services will say on their website how long you can expect to wait and how long people who are currently being offered appointments have been waiting. You might find it helpful to write down what date your referral was made for later reference.

While you are waiting, you could look into:

• what changes you can make that don’t require you to have been seen by a gender service. If you’re not sure where to start, check out our Getting Started article
• what support you could get on our page on support services
• connecting with other people in similar situations through local organisations
• stopping smoking or smoking less if you are planning to take hormones or have surgery

You can also prepare for when you are seen by the gender service. You can read more about this on our page about your first appointment at a gender service.

Acknowledgements

This page is illustrated using a photograph by Alex Green available at Pexels.

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.