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Getting a referral

To get access to specialist medical and surgical treatment on the NHS, you normally need to be referred to an NHS gender service, often called a “gender clinic” or GIC. This is just like being referred for any other kind of specialist treatment.

How do I get a referral?

Make an appointment to speak to your GP. This could be an appointment to speak on the telephone, or an appointment to speak in person.

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

Your GP will ask you a few questions. This is so they can provide the information that the service they are referring you to has asked for. There is a list of common questions you might be asked further down the page.

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.

If you are living in England, you may be asked which gender service you wish to be referred to. If you don’t know what clinics there are, we have our own page with a list of gender services.

If you are under 17, your GP may suggest you are referred to your local Child and Adolescent Mental Health Services (CAMHS) first, who may then ask you the questions above. They may also ask you more questions, particularly around your mental health.

The person who you have asked for a referral:

  • should not ask you to let them examine your chest or genitalia
  • should not tell you to go to a mental health service or counsellor (unless you are under 18)
  • should not tell you that no help is available to you

If your GP is unsure what the next step should be, you can direct them to the advice for GPs published by the General Medical Council, or the resources on our Information for clinicians page.

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’ll be asked a number of questions as part of being referred to a gender service. We’ve listed common questions below. You might want to think about them beforehand, so that you feel confident to answer them in your appointment.

What might I be asked?

Many clinics publish their referral form on their website, so you can look ahead to see exactly which questions your GP might ask you.

Common questions that GPs might ask include:

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

Specific questions about gender you could be asked are:

  • When did you start feeling something was wrong related to 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?

Your GP will need to state which medical conditions you have, or have a history of. This may mean your GP needs to ask you 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 happens next?

After you’ve been referred, most services send a confirmation letter to you, 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, it may be worth 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:

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.

Errors and omissions

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