Trans and non-binary people’s general health needs are the same as anyone else’s, but trans people may have specific health needs in relation to gender incongruence. We recognise that trans and non-binary people may feel like health care services don’t always cater for this or have had difficult experiences. We want to be as supportive as possible. If you think we don’t get things right, then please let us know so we can try and do things better.
Referral to NHS Gender Identity Clinic (GIC)
Your particular needs may be best addressed by transgender health services offered by NHS GIC clinics. These clinics have a variety of specialists, including psychologists, endocrinologists, surgeons and speech and language therapists.
If you would like to be referred to a Gender Identity clinic, please make an appointment to discuss this further.
You do not need an assessment by a mental health service prior to being referred.
This is a list of the NHS GIC clinics
How to find an NHS gender dysphoria clinic – NHS (www.nhs.uk)
Waiting lists are unfortunately very long at the moment. Please see this website for more information about waiting lists at the different GICs.
UK service wait times – Gender Construction Kit (genderkit.org.uk)
Private Gender Clinics
We recognise that, with waiting lists being long, patients are seeking healthcare in the private sector, including at private gender clinics.
It is very important that you remain under review to allow ongoing safe monitoring and prescribing. Harborne Medical cannot issue prescriptions on behalf of private gender clinics.
Changing your name and on your medical records
You are able to change your name on your medical records at any time. You do not need a deed-poll or gender recognition certificate to do this. You do not need to have undergone any gender affirming care to do this or be under a gender clinic.
Please let reception know and we can arrange this. We may ask to see ID. We can change your title to Mx (non-gender specific) without changing your gender on your health record.
Changing your gender on your medical records
You can change your gender marker on your medical records, if it is different to your sex assigned at birth. This involves a process where we contact PCSE (Primary Care Support England) who are the administrative service for primary care. It means that you will be given a new NHS number and a new medical record is created with your gender. You will then be registered as a new patient at the surgery.
Your old records will be transferred into your medical records in a closed file and previous gender information can be redacted
Please note this process is not reversible.
Changing your gender marker on your records will mean that you are not automatically invited to cancer screening programs that are still relevant to you as a trans-person. Please see below for more information.
This is an important step for many trans-patients and we would like to support you with this process if you want to go ahead with it.
You would need to let hospitals know your new NHS number to ensure that their records are updated, particularly if you are on the waiting list for GIC.
Your new health records need to have either M or F as a gender marker. NHS record systems unfortunately don’t allow for non-binary as an option at this time, which we recognise can be frustrating.
If you are non-binary then it may make sense to keep your gender as your birth sex, so you are invited to the appropriate cancer screening, but a note can be added to your records.
Please see this for more information
Adoption and gender reassignment processes | PCSE (england.nhs.uk)
Health screening
If you have changed your gender on your medical record it is important to note that you will not automatically be sent invitations for cancer screening that you are eligible for.
There are 3 main cancer screening programs in England- breast cancer, cervical cancer and bowel cancer screening (all patients are eligible regardless of gender). There is also AAA (abdominal aortic aneurysm) screening for patients assigned male at birth, aged 65.
The links have detailed information about different screening programs
Trans and non-binary cancer screening | Cancer Research UK
NHS population screening: information for trans and non-binary people – GOV.UK (www.gov.uk)
Cervical screening
People with a cervix are eligible for cervical cancer screening (smear test) from 25-64yrs old. If your gender on your health record is female then you should be invited automatically for these.
If you are a transman and your gender has been changed on your health record, unfortunately you will no longer be automatically invited, but it is important that you still have the opportunity to attend for smears every 3 years. You can request this screening by making an appointment with the nurses.
If you have had a hysterectomy (removal of womb and cervix) then you do not need a smear.
If you are a transwomen and your gender has been changed on your record, you may be automatically invited for smears. If you have no cervix you do not need smears – please let us know and we can ensure that no more invitations are sent.
This has more information about cervical screening, including lots of useful tips to make the experience better.
Breast cancer
Breast cancer screening is every 3 years from 50-70 and involves a mammogram
If you are a transman and your gender is male on your health record then you can request this test but are not automatically invited for this.
If you are a transfemale and have been taking oestrogen based gender affirming hormones for 5 years, then it is recommended you attend this screening when invited, due to there being an increased risk of breast cancer, compared to not being on hormones.
Prostate cancer
If you are transfemale or non-binary, and are assigned male at birth then you will have a prostate. If you have gender reconstructive surgery the prostate isn’t removed due to the risk of side effects. It is still possible to have prostate related problems due to enlarged prostate, cancer or infection, as can happen in cis-men, but is less common on those taking gender-affirming hormones.
There is no screening program for prostate cancer at this point, for cis or transmen. This has much more information.
Can trans women get prostate cancer? | Prostate Cancer UK
If you have any questions about this, or want to talk about your health further then please book a GP appointment to discuss further. Dr Lloyd (he/him) has an interest in trans-health, but all GPs have experience in this area.