Starting with GenderGP
Do I need a diagnosis to join GenderGP?
No. At GenderGP, we don’t “diagnose”, as we feel it’s disrespectful to your identity. You are the expert in your gender experience, and being trans isn’t a medical condition. However, before starting treatment, you are required to have an Information Gathering Session. This serves the purpose of establishing informed consent, which we require before giving you a Treatment Recommendation.
We understand that due to the institutional circumstances, you might require a formal diagnosis for whatever reason. You can book a Formal Diagnosis Session where a letter will be provided.
Where can I get a diagnosis of gender dysphoria?
We offer a formal diagnosis session.
While a GP can provide this, not many GPs feel that they have the necessary knowledge or training to “diagnose.” Much more work is needed in this area.
Other people who can help are local endocrinologists, GPs with a special interest or other gender specialists.
You can also get a diagnosis through a Gender Identity Clinic (GIC) but the waiting lists can be very long.
Counsellors and psychologists can all give you a diagnosis if that is what you require to achieve your goals.
I want to stop self-medicating. What should I do?
If you're obtaining your medication in this way, GenderGP can swap you onto safe prescription medication that best suits your gender-aligning desires. It can be the same one(s) or different.
We can also arrange for you to have your blood monitored. This way, we can make sure that your hormones stay within safe levels.
What do I need to do before I start hormone therapy?
Hormone treatment can be started once you have thoroughly thought out what you want to achieve from the therapy, understanding both potential consequences and potential benefits along with how they relate to your goals. Considerations may include whether you want to preserve your fertility.
You may already know this is the right time, and that it’s safe. Alternatively, you may need a doctor or some support to help you with this.
What assessments do I need?
GenderGP provides recommendations to people who satisfy the ICD-11 criteria for Gender Incongruence and who have the capacity to consent to treatment, or have someone who can consent for them.
How can I go really quickly?
We know that some people have been waiting years for this and want to go super quick. However, your first puberty took years and this one will as well.
Keep your hormone levels within the normal cisgender range to give you the best chance of natural development and physical changes.
How can I take things slowly?
Many people want to take things slowly for whatever reason, and that’s absolutely fine. You can start on a small dose of hormones, with or without a blocker.
But remember that our bodies do need hormones so if you are blocking your natural hormone production, make sure you are topping it up with enough supplementary hormones.
What should I do if I don’t know which medication to choose?
If you're filling out the gender-affirming care application and aren't sure which medication to choose, you need to book an appointment to speak to a doctor.
We work on an informed consent model, which means we need to know that you're confident in your decision and understand your options.
What’s an independent prescriber?
An independent prescriber is someone who has a license to prescribe medication.
The independent prescribers we work with already have an interest in trans healthcare and can prescribe for trans people. They are used to working with our Treatment Recommendations.
Why might my new specialist have a different opinion?
Different specialists may have varying experiences and interpretations of clinical guidelines. Gender-affirming care is a developing field, and while some professionals adopt progressive, evidence-based practices, others may be more conservative or less familiar with international standards. This doesn’t necessarily mean that either approach is wrong, but rather that they reflect differing perspectives on the best course of action.
Other Healthcare Services
Will the NHS refuse to see us if I access private care?
Sadly, due to the recent UK puberty blocker ban, there's little or no medical service in the NHS for trans youth. The chance of getting puberty blockers or hormones for people under the age of 18 is vanishingly small. Then, after the age of 18, the NHS waiting lists for gender services are years long.
Will I be penalised by NHS if I get private care with GenderGP?
No, you can’t legally be penalised for seeking private consultation.
The British Medical Association (BMA) policy states: “Patients who are entitled to NHS-funded treatment may opt into or out of NHS care at any stage. Patients who have had private consultation for investigations and diagnosis may transfer to the NHS for any subsequent treatment. They should be placed directly on the waiting list at the same position as if their original consultation had been within the NHS.”
Will I be referred to Social Services if I access private care?
Safeguarding referrals are acted upon if there are reasonable grounds to suspect that the child is suffering, or is likely to suffer, significant harm and whether further enquiries need to be made. Accessing necessary care for your trans child will not cause harm.
Does my doctor have to know?
We encourage you to share your gender journey with any healthcare provider who is also looking out for your health, but it is totally up to you if you wish to do this or not.
Why don’t GPs treat transgender (trans) people?
There are many reasons why GPs don’t feel able to treat trans people.
These reasons can vary from prejudice and religion to a general belief that they lack the knowledge to do so, and a lack of training resources available.
Prejudice or personal belief shouldn’t ever be accepted as a valid reason not to treat a person, whatever their medical needs. Lack of specialist knowledge is also becoming less accepted as an argument against helping trans people.
Fortunately, we’re seeing more GPs learning about the subject. As their knowledge and confidence grow, they’ll feel more comfortable helping trans people, if not directly then with the support of a gender specialist.
Can my case worker, parent, social worker, or someone else give consent on my behalf?
Yes, you can ask someone else to consent on your behalf. However, certain conditions must be met:
Express permission: In writing or in person, you need to explicitly give your permission for someone to make decisions and discuss your case on your behalf.
Personal attendance (and your signature on forms): If possible, you should attend sessions and sign any forms, with your designated person present.
Power of Attorney for health and welfare: If, for whatever reason, you’re unable to give explicit permission or attend sessions, your designated person would need a legal document showing that they have Power of Attorney to make decisions related to your health and welfare. This would also allow them to access your confidential information.
By meeting these conditions, the designated person can legally consent on your behalf.
Counselling
Will we need counselling?
Everyone and anyone who is struggling with their feelings can benefit from positive and affirmative counselling, but they have to be ready to access it. Counselling works best when the person is ready for it, wants it, and asks for it.
I don’t need or want counselling. Is it obligatory?
Counselling in the traditional sense of the word is not obligatory with GenderGP.
However, sessions are available with our excellent team of therapists. Many people find them to be hugely beneficial. However, it’s up to you to decide what psychological support you need.
We do require you to have a follow-up session every so often so that we can see how you’re doing. These are carried out by video consultation (or can be done in person, if you prefer).
Does online counselling work?
Emphatically, yes! Online counselling does work.
Counselling is a commitment made by two people to be there at the same time each week. Video calling means all you need to do is log on. The fact that you’re also surrounded by your own things, in the comfort of your own home, can help you feel at ease and add to the therapy experience. Travelling can also make an in-person commitment difficult to keep and online sessions are an easy solution for maintaining consistency.
Medication Effects
Can I limit breast growth?
Some people want to achieve a certain amount of feminisation while preventing too much breast growth. It isn’t always easy to tailor it to this level, but Selective Estrogen Receptor Modulators (SERMS) – specifically Raloxifene – have been used for this purpose.
How HRT impacts your voice – Will transition affect my singing?
Hormone replacement therapy (HRT) can bring significant changes, including impacts on the vocal cords, which is a concern for singers undergoing gender transition. While testosterone can masculinise the voice, leading to challenges in adapting to a new vocal range, estrogen generally does not affect vocal pitch.
What if I am overweight or obese or have a high BMI?
The most healthy way you can be is to have a healthy body weight, and this is regardless of whether you take gender-affirming medication or not. Some people actually find that their self-esteem improves with gender-affirming care and that can help you get the motivation to lose weight and exercise.
What if I take drugs? Will that affect my treatment?
We always advise against you taking recreational drugs. However, that would not stop us from being able to recommend gender-affirming medication for you.
What about alcohol? Will that affect my gender-affirming care?
Drinking excess alcohol to excess is bad for you. However, it isn’t a barrier to you having gender-affirming care.
Social Questions
Why do transgender (trans) people self-medicate?
Many trans people have been forced to start treatment on their own due to long waiting times.
Due to discriminatory practices within heathcare systems and a general lack of knowledge around gender-affirming care best practices among GPs, many trans individuals also struggle to access the right healthcare regime for them. They resort to taking matters into their own hands and doing it themselves.
Do I have to tell my partner about my transition?
Whom you tell, when you tell them, and why you tell them is totally up to you.
Of course, people will begin to notice if your body starts to develop. However, who you involve and when you involve them is entirely up to you.
If you think your partner would benefit from some support or some counselling or advice then you can recommend that they book a counselling session to speak to a specialist.