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Seeking support from your GP A guide for trans people July 2021

Changing your name gender marker To change your name title and or the gender marker on your medical records you should ask your GP surgery for the form that allows you to change your details You will normally be asked to show that you have changed your name elsewhere but don t need to provide a deed poll There is an option to choose a not specified option if you do not wish to record your gender as male or female If you change the gender marker on your medical records you will be given a new NHS number Be aware that you will not be invited to some cancer screening procedures that are relevant to you read on for more information on that Find out more If your GP or surgery staff are unsure about any of this you can signpost them to the information on the General Medical Council s GMC website https www gmc uk org ethical guidance ethicalhub trans healthcare confidentiality and equality 1

Referral to a Gender Dysphoria Clinic If you would like to medically transition you should ask your GP for a referral to a Gender Dysphoria Clinic GDC previously called the Gender Identity Clinic or GIC You are entitled to choose which clinic you d like to be referred to If you re able to travel it is worth checking waiting times at different clinics Some GDCs ask for a blood test to check your hormone levels prior to your first appointment your GP will be able to help you with this If this is the case it is useful to take a printout of your blood test results to your first appointment Find out more You can find information on the different GDCs and their waiting times on the Gender Construction Kit website https genderkit org uk resources gender services 2

Bridging prescriptions Under GMC guidelines GPs are allowed to provide a bridging prescription This is a prescription for hormone treatment to bridge the gap between the referral to a GDC and the trans person being seen by the GDC and serves the purpose of harm reduction Find out more Read the TransActual guide to bridging prescriptions https www transactual org uk bridging prescriptions Find more information on the GMC website https www gmc uk org ethical guidance ethicalhub trans healthcare mental health and bridgingprescriptions Share this document with your GP https awmsg nhs wales files guidelines andpils endocrine management of gender dysphoria inadults pdf 3

Shared care If you are prescribed hormone treatment by a private service you can ask your GP to make a shared care agreement This may include your GP taking responsibility for prescribing hormones and arranging blood tests If you are referred to a GDC the clinic will typically ask your GP to sign a shared care agreement Then if you are prescribed blockers and or hormones the GDC will write to your GP asking them to prescribe the hormones and blockers as required The GP is then responsible for prescribing them and for organising regular blood tests If you re prescribed injections a nurse at your surgery should be able to administer these Find out more You ll find information from NHS England on shared care here https www england nhs uk publication responsibility forprescribing between primary and secondary tertiary care 4

Cancer screening If you have changed the sex marker on your medical records it is important to note that you will not be sent invitations to make appointments for cancer screening that you may need For example a trans man would not receive a reminder to go for a cervical smear People with breasts over 50 ought to be invited for breast cancer screening every 3 years If you are not automatically invited for this you can request a referral for a mammogram Anyone over the age of 25 with a cervix should be invited for a cervical smear People with a cervix should have a smear every 3 years between the ages of 25 and 49 then every 5 years after that If you are not automatically invited for this you can make an appointment at your GP surgery for a cervical smear Some trans specific services offer cervical smears to trans people that need them 5

GPs have to be mindful that trans woman and some non binary people might still have a prostate and the possibility of prostate cancer although rare is still a possibility If you are concerned you can request a prostate check from your doctor Find out more You ll find more information about cancer screening for trans people here https www gov uk government publications nhspopulation screening information for transgenderpeople nhs population screening information for transpeople And here https www healthylondon org resource good practicescreening guide breast cervical bowel 6

Your rights under the Equality Act Under the Equality Act 2010 trans people are entitled to freedom from discrimination when accessing healthcare From the moment they begin their social transition for example asking to be called a different names or starting to use different pronouns trans people of any age are protected under the gender reassignment characteristic There is no requirement to have obtained legal gender recognition or to have had any medical intervention Non binary people are protected from discrimination under the Equality Act 2010 as they are included within the gender reassignment characteristic Find out more You ll find information on the Equality Act here https www transactual org uk equality act 7

What happens if you encounter difficulties If you have a bad experience with your GP you can ask to see a different GP within your practice You are also entitled to switch GP surgery without providing a reason for changing If you are part of a local trans group you might find it useful to ask people for their recommendations Trans people are entitled to the same quality of care as everyone else If you experience discrimination when accessing healthcare or are not given proper support you can complain To complain you should write to the practice manager detailing the problem If your complaint is not properly handled you should write to NHS England NHS Scotland or NHS Wales Find out more There are details of how to make a complaint on the NHS website https www nhs uk using the nhs about the nhs howto complain to the nhs 8

Where can I find more information TransActual https www transactual org uk healthcare Gendered Intelligence http genderedintelligence co uk projects kip health General Medical Council https www gmc uk org ethical guidance ethicalhub trans healthcare Gender Construction Kit https genderkit org uk GIRES https www gires org uk category health LGBT Foundation http lgbt foundation who we help transpeople resources for trans people lgbt foundationresources for trans people Trans Health UK https transhealthuk noblogs org 9