Your first appointment will be an hour long. We are very happy to use video consulting to reduce travel and access issues however face to face is in an option should you prefer this.

We’ll ask you if this is ok when we’re booking your appointment. Don’t worry about fancy technology simply having a mobile phone with Wi-Fi or data, a camera, and a quiet place to talk is all we need! If you do not have a phone or would prefer a face-to-face appointment this will be arranged when we book your initial consultation.

You will be contacted by one of our specialist general practitioners on the day of your appointment. We normally send a text message to remind you and we do the best we can to run exactly to time. This consultation is an opportunity for you to explore the services we offer in more detail and to ask questions about various aspects of social or medical transition. During this initial discussion, we would

also like to learn a bit more about you. This helps us to offer the most appropriate information and support.

  • Your gender identity, your feelings about it and how it may have changed and developed over time.
  • Your hopes and goals for the future.
  • Various aspects of your life, such as hobbies, work, or education.
  • Your wellbeing, including your mental health (both currently and in the past)
  • Your relationships and support networks.
  • Your next steps. (You will be required have a set of bloods taken at your GP practice)

  • Bring a list of questions you would like to ask us.
  • Take notes during the appointment.
  • Slow us down or ask us to repeat anything that wasn’t clear.
  • Consult us with a friend, family member, case worker or partner present in the room.

When we book your initial appointment, we will ask you for consent to access your existing NHS records, this includes your general practitioner’s clinical system. If you are hoping to access physical interventions such as hormone therapy or referral for surgery, we will be using this system to check your medical history (including any health conditions and/or medication you might be taking). We’ll also review your height, weight, and blood pressure, and request some blood tests. This health check does not involve a genital or chest examination.

Your second appointment will be with a different clinician from your first appointment to make a diagnoses of gender incongruence as this needs to be two separate opinions.

By undertaking the health check during your first appointment, we can be ready to start hormone therapy at your second appointment if:

  • The second clinician agrees it is in your best interests.
  • You’ve read and understood the information we gave you.
  • You’re feeling ready to start hormones therapy.
  • You will read through the hormone consent form and return prior to next appointment.
  • It’s medically safe for you to do so.

There’s no set way to dress ‘like a man’, ‘like a woman’ or ‘like a non-binary person’ and we strive to provide a service where all trans/non-binary people can be themselves. We recognise that gender identity is very different from gender expression, please dress how you feel most comfortable on the day, because we are usually using video consulting you in your own home, or wherever you have access to the technology.

At your first appointment and second appointment you will see a specialist gender clinician. There may be additional appointments depending on your level of care where you may need to meet with our nurses/psychologists/care coordinator. We will always ask your permission for either a colleague or a supervisor to sit-in on some of your appointments with us if it is required as part of our training. We will ask your consent when booking your appointment and you are welcome to decline.

You will need blood tests as part of the safe prescribing and monitoring of hormone medication. These tests are requested by our clinicians, what can be carried out at your local phlebotomy service, or practice.

It is important to have regular blood tests to check your hormone levels, your liver and kidney function, and your full blood count. If and when you start taking new medications as part of your care, we will most likely check your bloods at 3 months. Once people are stable on their hormones, blood tests are required every 6 months to 1 year.

We will start you on your medication and take responsibility for monitoring in the early stages. However, we will work to ensure your GP surgery feels competent and confident in carrying out your blood monitoring (and injections – if needed) in the long term. Depending on circumstances we may need to arrange for injections at one of our clinical locations.

It is of great importance that we can monitor your bloods levels, so please be aware that if you fail to have your bloods taken as required, you are at risk of your hormone treatment prescription not being issued. If you are struggling to get your bloods taken, please let us know as soon as possible so we can support you with this. 

At your first consultation we’d like for you to undertake a virtual health check with our clinicians. This will include taking your medical history. We’d also like to review your blood pressure, height, and weight from your GP clinical record, and arrange for a set of blood tests. We’ll also give you some information about hormone therapy to take away with you and read before your next visit this will be in the form of a consent form.

If the clinician agrees it is in your best interests at your second appointment, you’ll have the option of starting hormone treatment on that day. This is also the case for people who have already received a diagnosis of Gender Incongruence from an NHS-approved practitioner elsewhere.

We understand that some people may wish to wait and/or access additional support before starting hormone therapy (if they choose to take hormones at all). We can signpost to a range of services designed to support our service users to make the best possible choices about their gender care (including peer support, clinical psychology, Butterfly clinic for sexual health and psychosexual therapy), and those decisions will always be led by you.

This is dependent on several factors. For instance, some people may be seeing the service having already received a diagnosis of Gender Incongruence from an approved provider elsewhere. If this is the case, it may take less time for that person to be assessed for surgery compared to a person who has never had any formal support around their gender incongruence.

Several people will be on the specialist waiting list at various life and transition stages, if you are unsure please reach out and we will look into this for you.