We are working on a guide to navigating trans healthcare in the UK, including advice on working with GPs, harm reduction for self-medication, negotiating between public and private services, and dealing with the GIC.
In the mean time, here are some existing resources that can help you. They are focussed on the UK system and UK organisations, but have useful information for everyone.
We are always looking for more information to share. Please email us with whatever is useful to you.
Guides by Trans People for Trans People
Trans Healthcare 101 (doc) is a simple one page guide to how UK trans healthcare works, with advice on being an advocate.
Trans Healthcare Hacks (docx) includes frank advice for navigating UK trans healthcare, including things that doctors often don’t tell you.
Mascara and Hope (pdf) is a patient-written guide for trans women navigating UK trans healthcare, with very frank information and advice for dealing with the health system. It is focussed on standard transition models and is a few years out of date, but is still useful.
The Trans Lady’s Guide to Getting HRT in the UK (html / pdf) is a patient-written guide for getting HRT through a mix of private and NHS care. It has a lot of tips for getting through the system quicker.
My Clit Hurts (html) is a zine about genital pain and transfem sexual pleasure.
Accessing a Bridging Prescription (doc) is advice on how to get a GP to prescribe you hormones before the GIC has recommended it. It is written from a transmasculine perspective but is useful for all trans people.
Bridging prescriptions (webpage) has further advice on how to ask a GP for a bridging prescription.
Trans-Friendly GPs (and Shitlist) (google sheets) is a list of user-provided information on UK GPs. It was co-ordinated by Action for Trans Health nationally and may no longer be maintained.
NHS Protocols
Protocols define how the NHS is supposed to provide trans healthcare. Studying them can help understand the service you should receive, which can be useful in advocating to GPs and preparing for GIC appointments. Protocols vary across the UK.
Action for Trans Health wrote a NHS Interim Protocol Guide (pdf) for understanding and making your way through the earlier protocol from 2013. Although there are now new protocols, this remains the clearest and best guide, but studty the current protcols for variations:
Scotland
- Gender Reassignment Protocol (website)
- Gender Reassignment Protocol (pdf)
- Amendments to the Gender Reassignment Protocol (pdf)
England
- Gender Dysphoria Clinical Programme (website)
- Service Specification for Non-Surgical Treatments
- Service Specification for Surgical Treatments
- Service Specification for Children and Adolescents
- Clinical Guidelines for Cross-Sex Hormones for Children and Adolescents
- Primary Care Responsibilities In Regard To Requests by Private On–Line Medical Service Providers to Prescribe Hormone Treatments for Transgender People (i.e. official advice to GPs on dealing with GenderGP prescriptions)
Wales
Wales does not currently have a publicly available protocol for trans patients. The last public update on the protocol review was in 2019. Until a protocol is adopted, clinicians are likely to follow the English protocols.
Northern Ireland
We have not been able to source a separate protocol for Northern Ireland. Until a protocol is adopted, clinicians are likely to follow the English protocols.
Other Official Guidance
The General Medical Council has broad guidelines for treating trans patients (website). This can be useful for referring a doctor to if they are being obstructive.
The Royal College of Psychiatrists has a Good Practice Guide for treating trans patients (pdf). This is includes the strongest guidance for GPs on bridging prescriptions, encouraging their use as a harm reduction measure.
User Guides for Hormones
Hormones: A Guide for MTFs and Hormones: A Guide for FTMs are straightforward guides to hormone therapy from Vancouver Coastal Health. They were published in 2006, so new treatments are now available.
Hormones 2016 (pdf) is a comprehensive technical trans-written guide to different hormonal treatments.
Hormone Therapy for Transgender Women 101 (pdf printed 2020, website here) is a short trans-written technical guide to the latest approaches to standard feminising HRT.
Hormone Therapy for Transfeminine Non-Binary Individuals and Femboys 101 (pdf printed 2020, website here) is a short trans-written technical guide to the latest approaches to non-standard feminising HRT.
See the websites section below for further resources.
We know that the terminology used above may not reflect how you describe yourself. We have used the terminology from the guides themselves. In general, there is a shortage of guides to hormone usage written by trans people and sensitive to the complexities of trans identity and embodiment. There is a particular shortage of information on non-standard and non-binary transitions. If you can recommend guides, please email us.
Books
Transgender Health: A Practitioner’s Guide is a guide for doctors and clinical practitioners covering all aspects of trans health. It is trans-authored and written in a way to be useful to trans people. It is available to borrow from the Gender Community Library.
Understanding Trans Health is a book based on a research project into trans health outcomes and experiences in the UK. It is trans-authored and brings together trans activism, personal narratives and theory.
Genderqueer and Non-Binary Genders is one of the only clinical guides to multiple aspects of non-binary life. It includes the only contemporary survey of medical intervention we know of.
If you cannot afford these books, or access them through a local or university library, please email us and we will try to help.
Jessica Kingsley Publishers is the largest publisher on trans issues in the UK, and has a particular focus on guides for clinicians, including work across trauma and mental health, voice therapy, and neurodiversity.
Websites
- Gender Kit has summary information on many aspects of transition, including hormones, with a UK focus, and on GIC services.
- Transit has independent advice on many aspects of transition, including hormones, with a UK focus.
- TransDIY has a thorough wiki on medical aspects of transition, targeted at trans people outside the GIC system. It includes links to user reviews of online pharmacies.
- TransActual has information on UK trans healthcare.
- Trans Healthcare Intel has a map of trans-friendly GPs and is building more resources.
- Knowledge Is Power is a large set of resources from Gendered Intelligence covering many aspects of transition in the UK, including health.
- Transition FTM UK is a website for transmasculine people in the UK covering many aspects of transition, including health.
- UK FtM Information is a resource page focussed on answering user questions from transmasculine people in the UK, with good information on trans health.
- Transfeminine Science has trans-authored reviews of studies on transfeminine hormone therapy.
