Common Medical Questions
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You don’t have to tell your GP that you’re trans unless you want medical treatment.
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A GIC is how you access medical treatment.
You’ll need to make an appointment with your GP and tell them that you are/think you might be trans and would like to be referred to a GIC. Your GP are not there to decide if you’re ‘trans enough.’ They should just refer you to a GIC when you ask them to, without trying to point you elsewhere.
A GIC is a gender identity clinic that employs gender specialists to help you figure out what medical treatment you would like to pursue.
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Yes! The purpose of a GIC is to help you figure out what kind of medical treatment you want, as well as the different aspects of your gender identity.
It takes a long time to get your first appointment at a GIC, so getting a referral sooner rather than later is one of your best options. By the time you’re there, you’ll have had enough time to figure out whether you’re trans or just on a different part of the gender spectrum, and whether or not you need a GIC in the first place.
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Unfortunately, GIC waiting times were long before Covid, and have only gotten longer. They used to be around 2 or more years long, and can now take as long as up to 6 years to get into a GIC and have your first appointment.
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They’ll get to know you, ask some questions about your person details such as who you live with, ask about your identity and how you came to figure that out, and they’ll try to figure out which medical treatments are appropriate for you personally.
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It’s faster, much faster than transitioning on the NHS. But it’s also much more expensive, whereas transitioning on the NHS is free.
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It can cost hundreds of pounds to transition privately just for first consultations, hormones, and prescriptions. Surgery can cost up to thousands of pounds depending on the type of surgery and the provider. Any type of private medical transition for trans people in the UK is not standardised in terms of cost, so will cost different amounts at different providers.
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Shared Care is when a private medical practise works with an NHS GP to deal with prescriptions, blood tests, and the application of hormones, such as getting a nurse to inject Testosterone.
A patient may decide to go private to access medical care because it’s faster, then try to bring their GP in to access things like blood tests for free.
Sometimes it can be difficult to get a GP to agree to Shared Care, at which point you could try to ask for help from charities like the LGBT Foundation who will help you find a new GP Practise or help you convince your current GP to do Shared Care.
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Change to a different GP Practise. It’s really not worth the hassle of trying to work with a GP that doesn’t know what they’re doing, or just isn’t interested in helping treat trans patients at all. It will make your life a lot easier in the long run if you move to a trans-friendly GP.
You can even complain to the CCG about your old GP if you feel like you’ve been treated incredibly poorly by them.
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Someone assigned female at birth has the option of Testosterone, which can be taken in multiple different forms to make the body more masculine.
Read all about Testosterone here.
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Prescriptions will cost the normal NHS amount, around £10. They might be free if you’re on certain benefits.
You’ll most likely use paper prescriptions. You’ll normally get a paper prescription from the nurse who does your injections (if you’re being injected with something) or from the doctor who’s managing your treatment, at each appointment where your hormones are injected.
You’ll have to take that paper prescription to the chemist of your choice and ask them to fill it. You’ll have to do this as your hormones run out if you’re taking Testosterone, as it’s a controlled substance in the UK so is difficult to get too much of at once.
You might also be able to get online prescriptions sent straight to your nominated pharmacy - you can nominate a pharmacy through the NHS app, or use the app of the nominated pharmacy of your choice, such as LloydsDirect for example. From there prescriptions can be sent to your house, instead of you having to go out and get them every single time you need one.
Alternatively, your GP can put you on a repeat prescription for certain hormones so that you can collect the paper prescription without having to make an appointment to ask for it every time you’re due to run out. Or the repeat prescription can get sent directly to you if your nominated pharmacy works that way.
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No, it’s illegal. It’s also a very bad idea for your health, especially if you haven’t told your GP you’re doing it.
If you tell your GP you plan on DIY-ing your hormones, they could offer you a bridging prescription whilst referring you to a GIC. It’s safer for them to do this than to knowingly let you DIY your hormones and possibly hurt your health or yourself long-term.
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That’s known as a bridging prescription – your GP can prescribe you hormones whilst you wait for a GIC referral to go through.
But they rarely ever feel confident enough to do this. Some of them don’t know how to care for trans patients, and some of them just don’t want to. Normally, they’ll just refer you straight to a GIC and tell you to wait until you get your first appointment.
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You’ll have to get at least one before you can actually start hormones. It’s so your GIC knows you’re healthy enough to start in the first place.
After that, you’ll get blood tests every 3 months or so for the first year of hormones, so that your GIC/Endocrinologist can alter your doses as needed. Then it’ll increase to every 6 months after the first year and for as long as you’re on hormones.
You should ask for your blood test results to be printed out each time so that you can have your own copy, just to keep a record of any changes and to make sure you have a copy in case your GIC doesn’t get sent one, or it gets lost somehow.
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It could take a few weeks to a few months, as you need to get your blood test, your GIC needs to see them and you’ll probably need an appointment with an Endocrinologist to discuss your results. They’ll then be able to sign off on you starting hormones.
You’ll then need to get your prescriptions and make an appointment with your GP if you’re starting something like Testosterone which would need to be injected by a nurse.
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Unfortunately, this is also via a GIC, in the same way that you start hormones. You’ll have to be referred to a GIC, which has years long waiting lists, and then have been there for quite a while to get access to surgeries. Unless you started medically transitioning before you got to the GIC.
You’ll likely already be at a GIC by the time you want surgery, as the GIC typically only offers surgeries after you’ve started hormones and been on them for at least a year.
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Top surgery – To flatten the chest and make it look more typically male in appearance. Double Incision and Periareolar are the most common techniques used by surgeons.
Hysterectomy - To take out parts of the female reproductive system.
Vaginectomy - To close up the vaginal hole and likely alter the urethra through UL at the same time.
Bottom surgery – To have genitals that look closer to that of a cis man. Metoidioplasty and Phalloplasty are the two most common types of surgery that people get.
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Ideally, yes. Although it is understandable if this is difficult, and you can get help with these processes and advice from other trans people if you feel like you need it.
