This report is only available online –
there are no printed copies available to buy.
Please use the link above to view and download a PDF
file of the report.
Correction: p. 41 of this
document has been corrected since first publication, in respect of
an error in the dose of testosterone ethanoate recommended. The
document is correct as now published.
Gender variance is not uncommon, and the
number of people seeking treatment in Gender Identity Clinics is
increasing rapidly. A survey of 10,000 people undertaken in
2012 by the Equality and Human Rights Commission found that 1% of
the population was gender variant to some extent – though this
figure cannot be assumed to be representative of the whole
population. Historically, more women sought treatment than men, but
this difference is reducing.
People often find it difficult to confide
their feelings of gender dysphoria to their GP because they fear
ridicule, guilt or shame, or are concerned about delays in getting
treatment on the NHS. This has led to increasing numbers of people
self-medicating using hormones and hormone-blockers available via
the internet. It is estimated that up to 40% of people with gender
dysphoria may not be receiving appropriate help.
This report makes a series of recommendations
to ensure gender dysphoria patients get the best possible care. It
covers the areas of hormone treatment, surgical interventions,
speech and language therapy, and general medical care.
The provision of care for patients
experiencing gender dysphoria is an excellent example of an area
where multidisciplinary and interdisciplinary care is not only good
practice but ensures that a wide choice of treatment pathways are
offered, tailored to the needs of the individual patient. This
report aims to optimise the clinical care pathways for patients who
may need to access several medical and allied health
The best practice guidelines – which are
endorsed by 13 separate organisations – have been drawn up by a
multidisciplinary working group that included representation from
psychiatry, endocrinology, gynaecology, urology, general practice,
nursing, psychology, psychotherapy and speech and language therapy,
as well as representation from patient groups. It is the first time
that so many different groups have come together to agree a common
set of guidelines.
- Working group
- Executive summary and recommendations
- Good practice
- Overview of recommended procedure