FAQ: COVID-19 & Trans Health

All information provided here is from a team of volunteers. We are not paid for this work and we are not professionals, but we are all trans people with personal experience of the healthcare system in the UK. We do our best to keep this up-to-date. If you have corrections or questions, email transhealthuk[at]riseup.net

This FAQ was last revised on 23/11/2020.

Table of Contents:

You can click on an item in this list – the link will take you to the appropriate section.

  1. Are the Gender Identity Clinics (GICs) closed?
  2. Is my surgery postponed?
  3. Are other therapies still operating?
  4. Does the pandemic mean the GIC waiting lists will be longer?
  5. Will my GP still do hormone injections and blood tests?
  6. If I can’t get GP care, what else can I do?
  7. Are private clinics still seeing patients and taking on new patients?
  8. Are internet pharmacies still shipping?
  9. What should I do if I need to isolate due to COVID vulnerability, but have to leave the house for errands or healthcare?
  10. What happens if I miss my hormones?
  11. Are there any trans crisis funds?
  12. Where can I get gender-affirming supplies?
  13. Are there any trans helplines open?
  14. Are there any online trans social groups?
  15. Where can I get more advice?

 

1. Are the Gender Identity Clinics (GICs) closed?

GICs are not fully closed, but all have reduced their services in some way. This varies from GIC to GIC. Some have cancelled all appointments. Some have cancelled face-to-face appointments, but are continuing some or all appointments by phone or video. Some have announced publicly that they are no longer issuing new hormone prescriptions (i.e. they are not progressing transitions while appointments are remote only), but not all have said this, so this may not be the case for you. Some have closed referrals to their waiting list, but not all have said this, so this may not be the case for your area.

We have an information page on GICs, which has details for your clinic. If that does not have your answer, you should contact your GIC directly at the contact details listed there.

If you have information on GIC services we have not listed, please email us.

 

2. Is my surgery postponed?

To the best of our knowledge, all trans-related surgeries were postponed at the beginning of the pandemic, but most GICs are now rescheduling them in the original waiting list order. Rescheduling will depend on how much your GIC and surgery provider have reopened during lockdown easing. Some trans-related surgeries are now talking place, but this varies from region to region. If you have not been notified by your healthcare provider with more information, you should contact them now to make sure.

 

3. Are other therapies still operating?

Hair removal is generally operated by beauty salons, which are closed during stricter lockdown measures (such as are in place as of February 2021). The NHS requires assessment for funded hair removal to be in person, which most GICs are not currently operating.

Where voice therapy is provided by the NHS remotely, by phone or video, this is generally still operating, but this varies from region to region, and in person voice therapy is generally not possible.

Similarly, where mental health suppport is provided remotely, it is still operating, but this varies from region to region. Independent mental health support and helpines are operating similar or increased services: see question 11.

 

4. Does the pandemic mean the GIC waiting lists will be longer?

Most (but not all) GIC waiting lists will be longer because of the pandemic. Before the pandemic, you could expect a wait of at least 2 years across the UK, longer in some areas. All GICs have restricted services in some form, which slows down the progression of people’s transitions and their ability to see new patients, which means the lists are likely to progress more slowly now.

However, GICs which moved to video call appointments early, and which use them for new patient assessment, have moved more quickly through their waiting list (as, for example, Chalmers Edinburgh confirmed to patient groups). In addition, new pilot projects have begun in London, Manchester and Cheshire and Merseyside which are moving waiting lists more quickly in those regions.

Our GIC page has our most up-to-date information, including currrent estimated waiting times.

 

5. Will my GP still do hormone injections and blood tests?

All GPs have reduced their services in some way, but this varies from GP to GP. Some have fully closed their surgeries, some have cancelled all face-to-face appointments, and some are reducing face-to-face appointments. This means that whether you can receive hormone injections, blood tests and other health checks will depend on your GP.

We have heard reports of trans people being notified their hormone injections are cancelled. However, we have also heard reports of trans people contesting this and getting their appointment reinstated once they explained the urgency. If an urgent healthcare appointment is cancelled, you should first try to get it reinstated, because many GPs will not have realised the urgency of the trans healthcare need.

It is likely that you will encounter more obstacles to receiving healthcare like this. You should expect it to take more time to receive your healthcare and plan early. If you are outside the GIC system, or a migrant with an overseas diagnosis, or are otherwise marginalised from trans healthcare, you may encounter more obstacles.

Here are some resources that can help you get over obstacles to healthcare during the pandemic:

If you have more advice on obtaining healthcare during the pandemic, please email us.

 

6. If I can’t get GP care, what else can I do?

You shouldn’t assume your GP is closed, and many are still open, so first try to get care from there if you are able.

In Scotland, the GIC has advised that trans people who cannot get GP care should contact them to see if they can help (see this information from the Scottish Transgender Alliance). We have not heard any reports on whether this is useful or not. It may be worth contacting the GIC in your local area.

In London, 56 Dean St and London Transgender Clinic are both offering a free weekly clinic to any patient with a prescription (NHS or private) who cannot access hormone injections or implants as normal. To arrange, contact 56DS (Wednesday evenings) on 020 3315 5656  or LTC (variable) on 0207 487 0910 / hormones@thelondontransgenderclininic.uk.

If you need a hormone injection, cannot access support and cannot self-administer, many trans communities have developed this expertise. Consider asking trans people you know, or local grassroots trans groups, if anyone is able to help with an injection. Ensure that they have experience of doing this and that you trust them to administer safely.

It is possible to self-administer most injections, though it can be harder to do safely and it is better to be trained. Here are some medically-approved self-injection guides: 

If you need a hormone prescription and cannot access it from your GP, again, many trans communities have sources of hormones they might be able to help with. Be aware that this is legally sensitive, and that testosterone is a controlled substance in the UK (see the IPED website for more information), so ensure to ask only within connections of trust.

If you have access to financial resources or are able to run a crowdfunder (see question 10 below), private gender clinics may be able to help in your situation (see question 7 below).

 

7. Are private clinics still seeing patients and taking on new patients?

Yes, most private clinics are doing both in some form. The full information is on our private clinics page.

We recommend checking r/transgenderuk for reviews of private gender clinics, where you can also find independent information on costs.

If you have specific information on these providers, or information which contradicts their announcements, please email us.

 

8. Are internet pharmacies still shipping?
The pandemic has interrupted some internet pharmacies, with some routes being closed and others suffering shortages. However, some are still shipping. We cannot take responsibility for linking to specific pharmacies. For regularly-updated reviews of different internet pharmacies, see r/TransDIY/wiki/pharmacies. 

If you have other recommended resources, please email us.

 

9. What should I do if I need to isolate due to COVID vulnerability, but have to leave the house for errands or healthcare?

You can contact your local mutual aid group for help, so they can provide safe and hygienic support for your errands. You can find your local groups at the COVID Mutual Aid directory here.

There are also trans-specific mutual aid groups which can help meet your needs:

See Question 6 for advice on self-injection. See the TransDIY wiki for advice on paid postal blood tests.

If you have links to other advice or support, please email us.

 

10. What happens if I miss my hormones?

If your hormone intake is missed or delayed, you are unlikely to experience immediate physical effects. Over time, your gonadal hormones may begin to increase, and this can begin producing associated secondary sex characteristics (like hair growth patterns and fat distribution), but the effects are slow and reversible when hormone therapy resumes. There can be menopause-like symptoms for some, resumption of the mestrual cycle for some, and other physical symptoms like fatigue or energy bursts. If you are post-gonadectomy, the fatigue effects may be more severe, and in the very long term there is a risk of osteoperosis, but not in the short term. There can be serious mental health effects for some people.

All of this will vary from person to person. You will not immediately lose all of your transition and can put a plan in place to deal with the issues.

Charing Cross GIC has some specific trans medical information which covers this eventuality, but which may downplay the physiological effects.

 

11. Are there any trans crisis funds?

Yes, there are crisis funds running for trans people:

If you have links to other trans crisis funds, please email us.

 

12. Where can I get gender-affirming supplies?

    • ScotBinders is a scheme to provide free binders to trans people in need in Scotland

If you have a resource that should be listed here, please email us.

 

13. Are there any trans helplines open?

Yes, there are many helplines which are still operating a service (click on the names of the organisations and services to find out more):

Stonewall has a very complete list of other support services, including for sex workers, homeless people and refugees and asylum seekers.

If we are missing any resources, please email us.

 

14. Are there any online trans social groups?

Yes, there are new and continuing online trans social groups which are providing social support:

If you know of more public online social groups, please email us.

 

15. Where can I get more advice?

Stonewall have a very full list of different types of pandemic-specific and general support for LGBT+ people, including sex workers, homeless people and refugees and asylum seekers.

For healthcare information, see the following resources:

      • Gender Kit has summary information on many aspects of transition, including hormones.
      • Transit has independent advice on many aspects of transition, including hormones. 
      • TransDIY has a thorough wiki on medical aspects of transition, targeted at trans people outside the GIC system.
      • Trans Actual has articles on specific areas of healthcarre
      • Trans Healthcare Intel has a map of trans-friendly GPs

 

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