Gender Dysphoria Prescribing Policy
​
​
​
For new patients, we do not accept 'shared care' requests from NON-NHS PROVIDERS to prescribe or monitor medications for gender dysphoria. This is for existing patients who newly request shared care, as well as patients joining us from other practices.
We will continue taking on prescribing and monitoring under shared care agreements for gender dysphoria for patients that have been started on treatment by an NHS gender identity clinic or endocrine clinic.
These are multi-disciplinary NHS clinics consisting of doctors, nurses and psychologists, and cover issues such a fertility preservation, psychological support, medication, and surgery.
Unfortunately, these clinics cannot keep pace with the growing demand for these services and the average waiting times are currently more than three years. As GPs, we feel this is an unacceptable level of service, and we believe there should be more equitable care for the transgender community. This would involve not only more timely access to specialist care, but also continued resources to fund and train GPs to maintain prescribing and monitoring.
As a result of these long NHS waiting times, people are seeking private treatment, often through on-line providers. Many private transgender clinics will initiate medication but then request that further prescriptions and monitoring are accessed from the GP.
As a practice, we have carefully considered these requests and unfortunately, we cannot support the prescribing and monitoring of transgender medications from private clinics. There are several reasons for this:
1. It is challenging for us to be assured of the quality and governance aspects of private clinics.
2. These are specialist medications which need to be shared between GPs and specialists, and there is no guarantee of enduring specialist care within the private sector. It is highly specialised treatment and is outside the scope of practice for our clinicians.
3. General practice does not currently have the capacity to meet this additional demand from the private sector. There is no funding available to cover this extra clinical and administrative work.
We are aware that this is an unwelcome position for those who are struggling to access the care that they need, but feel it is not safe for us to continue to take on this clinical work from private providers.
We can refer new patients to the local gender identity clinic although the waiting list for these services are extremely long. Please feel free to make a GP appointment to discuss this, or if you need support with your mental health.
You can also access help and information from the Rainbow project.
https://www.rainbow-project.org/
William Street Surgery
Reviewed Sept 2024