Gender Identity Service

Changes to our service due to the coronavirus pandemic

We are updating this page with information about how our service is operating during the pandemic page updated on 7 June 2022


Oestrogel shortage – update on 24 March 2022

We’ve been made aware that there is currently a shortage of Oestrogel which is likely to affect our service users. We have been advised that, whilst this is the case, the approximate (as absorption of each can be variable) equivalent doses are as below:

Equivalent doses

Patch Gel-pump (Oestrogel) Gel – sachet (Sandrena) Spray (Lenzetto)
Half a 25mg patch Half of a pump Half of a 0.5mg sachet
25mcg patch 1 pump 0.5mg sachet 1-2 sprays
50mcg patch 2 pumps 1mg sachet 2-3 sprays
75mcg patch 3 pumps 1.5mg sachet More than 3 sprays
100mcg patch 4 pumps 2mg sachet

We recommend that you revert to Oestrogel as soon as it becomes available again. If you are on an alternative preparation for more than one month then get your GP to check your Estradiol level to make sure the dose does not need adjusting.

Service update

We are offering appointments either by telephone, Attend Anywhere, our virtual consultation platform, or face to face at the clinic. We are now able to recommence booking face to face appointments following temporary suspension of these appointments due to Covid.

Please could we ask you to wear a face mask if you are attending our clinic. As a healthcare site, this is mandatory. If you cannot wear a face mask due to being exempt, we understand. If you can please let us know prior to your appointment, then we can discuss alternative arrangements with you. If you do not let us know before your appointment, unfortunately we may not be able to go ahead.

Contact details

We will continue to have our phone lines open for set hours throughout the day (Monday to Friday from 10am-2pm). We also have our email address gid.lypft@nhs.net.

Please don’t send personal information through this email address without completing a permission form that you can attach to your email. Please be aware that if your email address is outside of the NHS, we cannot guarantee the security of any communication sent to us via email and communication via email is entirely at your own risk.

We are trying to answer your queries in a timely way, however we may be delayed in responding to emails. If you’re experiencing any urgent concerns in relation to your mental or physical health, please contact your GP, your local mental health team or call 111 for advice.

About the service
The following information relates to normal service operating conditions

The Leeds Gender Identity Service offers assessment and support to people aged 17 and above with Gender Dysphoria.

Gender Dysphoria is a condition where a person experiences discomfort or distress because there’s a mismatch between their biological sex and gender identity. It’s sometimes known as gender incongruence. You can find out more about this on the NHS website.

Our team will complete a full assessment of people referred to us which includes looking at mental, social and physical health.

Once the assessment stages have been completed and you have a diagnosis, and you are ready to move forward with treatment, we can start you on our care pathway.

The care pathway includes a prescribing clinic that can start hormone treatment. We can refer individuals to voice and communication therapy, discuss surgical opinions and gender reassignment surgery as appropriate.

You can find out more by expanding the different sections on this web page.

Ben’s gender identity journey – a service user story

Ben Brookes is a service user of the Leeds Gender Identity Service. He has kindly volunteered to share both the good and challenging aspects of his continued journey with his gender transitioning. In this video he speaks both about his own gender identity challenges and about how he experienced the NHS system.

Kerry’s gender identity journey – a service user story

When Kerry Bayley first visited the Gender Identity Service in August 2014, she despaired for her life. When we spoke to her three years later, she was happier than ever. In this short video Kerry bravely shares her journey and talks about the support she received from us. We are most grateful to her for allowing us to do this.

 

Our Care Pathway - what to expect

Our care pathway is quite complicated so we’ve tried to capture it all simply in this document.

You can also watch this short video which summarises it.

Waiting times explained

In line with other Gender Identity Clinic (GIC) services across the country, there is increasing demand with rising numbers of people expressing uncertainty about their gender. Nationally, there is a shortage of appropriately trained professionals. This plays into the long waits people in Leeds and across the country are experiencing. We know this is far from ideal for people and we’re sorry for any anxiety this may cause.

In the meantime, we’ve published some information called ‘other sources of help’ for people who are either struggling with gender identity issues or might be on our waiting list, further down this page.

Care pathway

The following is an overview of the current waiting times and numbers waiting for each element of the service. Please note it is an estimate guide – there are many factors that could affect this and it will not be the same for everyone. This information has been updated on 10 February 2022.

Screening appointments

We are not currently offering screening appointments in the service.

Referral acknowledgement

When we receive your referral, this will be reviewed and then added to our waiting list if further information is not required. Both you and your GP will receive an acknowledgement letter once this has been completed. This letter will also include forms to be completed and some further useful information.

Waiting times until first appointment – updated 6 June 2022

There are currently 3440 people on our standard waiting list to be seen. We are currently booking appointments for people who were referred in approximately September 2018.

There are 41 people on our priority waiting list who are either waiting for an appointment to be booked or have not yet reached the age of 18.

For appointments such as the second assessment appointment and surgical opinions for surgery, there are waits of under six months.

For a hormone appointment, there are currently 99 people waiting. The next person to be allocated an appointment was placed on this list in January 2021.

Gender Identity Referrals Discharges Attendances and DNA report.

The Trust takes the issue of waiting times very seriously. The Leeds Gender Identity Service waiting times are currently reported to our Trust Board in the Board papers for each meeting.

Gender ID outreach workers and other sources of help

Supporting trans, non-binary and gender diverse people on the Leeds Gender Identity Service waiting list and care pathway.

You may have questions. You may have heard conflicting information. You might want to talk with a group of people in a training room clapping in a circle someone with lived experience. Gender outreach workers can offer advice and support from the point of your referral to Leeds Gender Identity Service. We can also provide advice and information to people thinking about referral to the service. Gender outreach workers aim to support people accessing Leeds Gender Identity Service across England.

Information and advice line

You can call our information and advice Line on 0800 183 1486. We can help with a range of needs related to your transition, including practical advice on name change, document updates, learning more about the Gender Identity Service and signposting to other organisations and support near you. We can arrange a one-to-one session if you need more time to talk.

One to one sessions

We offer one to one support sessions by online video, by telephone or in person. We can provide practical advice and discuss your individual needs and support available. Feel free to ask questions. Contact us to learn more.

Peer support and social groups

People tell us that groups can be a good way of accessing information and support from peers who share similar lived experience. We offer a variety of groups in-person and online. Groups can provide an opportunity to receive support or just listen to other people’s journeys and life experience. This has helped people on their own personal journey. You can take things at your own pace and involve yourself as much as you like.

The groups have sometimes helped people make new connections, increase confidence and provided a sense of wellbeing. Contact a gender outreach worker to learn more or check out our Facebook page.

We are pleased to work in close partnership with Yorkshire MESMAC, Lancashire LGBT and others to bring peer support to you. This is what some people have said about gender outreach:

“It was really good to speak to someone who really understands what you are going through. She was also very informative and pretty much put me at ease”.

“This has all been very helpful because of where I was and where I am now. I feel more confident in myself. The knowledge of the steps and services has increased”.

“I will attend the groups she organises and hopefully will make new friends along the way. I really cannot recommend this enough, especially if you feel all alone like I did”.

“Extremely helpful and relieved some of my anxieties about progressing. Great information. Feeling secure about myself and my future”.

“It’s always difficult for me to meet new people as I can be very shy and lack confidence but I’m glad I attended our meeting. It was really good to speak to someone who really understands what you are going through”.

“When I attended my first session, I felt I was at a low point. As the sessions progressed, my health and wellbeing has improved”.

“It’s easy to bottle things up when they’re floating around in one’s own head. I feel like I made some progress towards me working things out”.

“A very big thank you for all your help and support 😁”.

For more information

Contact our gender outreach workers

Our gender outreach workers aren’t counsellors but sometimes it just helps to talk.

Contact our gender outreach worker information and advice line on 0800 183 1486 (closed weekends, bank holidays and some holiday seasons).

You can also email genderoutreachworker.lypft@nhs.net with your name, date of birth, address and telephone number. Clients of Leeds Gender Identity Service and LYPFT will need to complete an email permissions form if they have not already done so. Find out more in our Get in Touch section.

What is Yorkshire MESMAC?

Yorkshire MESMAC offer services to various communities across Yorkshire including men who have sex with men, African and other BAME people, people misusing drugs, sex workers and LGBT+ young people and adults.

They have bases in Leeds, Bradford, Rotherham and Hull. They also run LGBT groups across the Yorkshire region. Visit the MESMAC website or call 01132 444 209 to learn more.

What is Lancashire LGBT?

Lancashire LGBT are a registered charity and their aim is to support Lesbian, Gay, Bisexual and/or a person wearing a white rainbow vest top leaning on someone with a blue shirt and black tshirt Trans people to be happier, healthier and well connected. Their core work is aimed at improving the health and wellbeing of LGBT people, reducing health inequalities and providing social and support activities to reduce social isolation.

Lancashire LGBT work to improve services for LGBT people as well as reduce the barriers many LGBT people experience accessing services. They regularly deliver awareness training to professionals and work in partnership with health, education and criminal justice sectors. Visit their website or call 07788 295 521 to learn more.

The TranzWiki Directory

If you’re based outside West Yorkshire and Lancashire, check out the TranzWiki Directory. This is a comprehensive directory of groups campaigning for, supporting or assisting trans and gender non-conforming individuals. For more information, visit their website.

Frequently asked questions

We get a lot of people making enquiries about transgender issues and we sometimes struggle to answer all of these. Therefore we’ve compiled a list of common questions we get from people like yourself and some responses, we hope they are helpful.

Q. If I’ve got to wait a long time to get a prescription for hormones, should I buy them online?

A. We would recommend that people do not obtain medication privately and wait to see our specialist hormone prescribers. They will discuss with you the risks, side effects and benefits of hormone treatment, and will tailor your treatment to your specific needs. You should have blood tests prior to starting hormones, and also regular monitoring blood tests whilst taking hormones. There are potentially life-threatening risks associated with hormone treatment – be aware of these and how to minimise the risks before you start taking hormones.

Drugs bought online can vary enormously in quality and safety. Our hormone specialists prescribe in accordance with the Endocrine Society Guidelines.

Q. What are Testosterone Intramuscular (IM) Injections?

An intramuscular injection delivers medication directly into the muscle. This allows the medication to be quickly absorbed into the bloodstream.

Once you are established on hormones, it may be appropriate for you to self administer hormones with the support and training of the health care provider (doctor or nurse) who normally undertakes your injection.  Your GP surgery may be able to provide the equipment required.  This guidance is suitable for Enantate or Sustanon but NOT for Nebido.

To self administer hormones, please follow our How to give a Testosterone Intramuscular (IM) Injection guidance.

Q. How do I change my name?

A. If you’re transgender and you want to change your name, you’ll need to change your name by deed poll. This can be done for free – simply search free UK deed poll online.

If you’re non-binary and you want to change your name, you’ll also need to change your name by deed poll. However, bear in mind that UK law currently only recognises two legal genders (male and female).

If you haven’t been issued a Gender Recognition Certificate
If you haven’t been issued with a Gender Recognition Certificate (GRC) then you’ll need to change your name by deed poll. In fact, changing your name could be an important step in proving that you’re living in your new gender, before applying for a GRC.

A deed poll will be enough to change your name in your passport. However, if you want your passport to be in your new gender as well, HM Passport Office will need to see:

  • your deed poll, showing that you’ve changed your name to one that’s associated with your new gender
  • medical evidence showing that your change of gender is “likely to be permanent”. This can be a letter or report from a medical practitioner (such as your consultant or GP), or a chartered psychologist practising in the field of gender dysphoria.

You don’t need a GRC to have your passport updated to show your new gender, and you don’t need to have had gender reassignment surgery.

Please note that changing your passport (or other records) to be in your new name and gender doesn’t give any legal recognition to your change of gender. It’s merely recognition by those record holders that you’ve adopted a new identity. However it does provide supporting evidence to the Gender Recognition Panel (and other record holders) that you’re living in your new gender.

If you want to change your title you don’t need a deed poll. You’re free to use any social title unless it is a restricted title (Princess, HRH, Sir, Lord etc.) and, assuming the new title is part of a change of gender, you simply need to inform record holders of the new title. The important matter is your change of gender. HM Passport Office for example doesn’t list social titles in passports at all, it isn’t considered to be a legal part of your name.

You can use any name or title unless it is to “obtain good or services by deception”.  It’s important that if you change your title or name, you shouldn’t deceive anyone as to your birth gender in order to gain a financial advantage as this would be considered fraud. Once you’ve been issued a GRC you’re under no such obligation and your birth gender is legally considered to be your new gender.

If you have been issued a Gender Recognition Certificate
If you’ve been issued a full GRC, then this will be sufficient evidence of your change of name (and gender, for passport purposes), and you won’t need a deed poll.

If you’ve been issued an interim GRC, then it’ll likewise still be sufficient evidence of your change of name (and gender, for passport purposes) — you won’t need a deed poll.

If your interim GRC has expired (i.e. after six months) and you haven’t been issued a full GRC because your marriage hasn’t been dissolved, HM Passport Office may still accept this as sufficient evidence of your changed name and new gender, because the important point is that you should be living in your new identity for all purposes, not that you’ve been issued a GRC. However, you should check this first with HM Passport Office.

If you’ve been issued a new birth certificate
If you’ve been issued with a new birth certificate, then this is proof of your name change and new gender, for all purposes — you don’t need a deed poll.

Q. How do I change my name on my passport?

A. Once you have a diagnosis of gender dysphoria, we can provide you with a letter to use to change your gender on your passport (see also ‘How do I change my name?)

Q. How do I get a gender recognition certificate?

A. Mermaids and GIRES have written excellent guides to this.

Q. What services do you provide on the NHS?

A. Hormone treatment, facial hair removal, genital hair removal prior to surgery, voice coaching, speech and language therapy and psychological support.

Q. What services do you NOT provide on the NHS?

A. Breast implants, breast augmentation, voice/laryngeal surgery, facial feminisation surgery.

Q. Can I claim back my travel expenses?

A. You can claim help with the cost of travel if you are on a low income and have made an additional journey to the Leeds Gender Clinic. We can help you with this when you attend for your appointment – ask your Lead Professional.

Q. Who can refer me to the Gender Clinic?

A. Your GP can refer you. There is a GP referral form for them to complete in the “How to refer to the Leeds Gender Identity Service – Information for Professionals” section of this page.

Q. What can I do whilst I wait to be seen?

A. Lots! You can start your social gender transition at any time and you do not need a diagnosis of gender dysphoria to do this. Some people call this ‘coming out’. Your Lead Professional and our support workers can offer advice on this.

There is also a lot of online information about how to do this. Changing your name and pronouns is one way to start. For other people, it’s about getting the right clothes. It is important you do this at your own pace and in a way that you find comfortable. Check out the section called ‘Other Sources of Help’.

Q. Do I have to dress a certain way?

A. Dress how you feel comfortable. Your appearance will not have a bearing on the outcome of your assessments. Wear whatever you feel comfortable wearing. However, it is an opportunity to dress as your preferred gender. We have changing areas onsite if you wish to arrive early and get changed in time for your appointments.

Q. What do I do if I can’t get to my appointment?

A. It’s very important you let us know as soon as possible by calling us on 0113 8556346 or by emailing gid.lypft@nhs.net

If you are more than 15 minutes late for your appointment you will not be seen. This is because your appointments take one hour, and each patient is booked on the hour, every hour. It is not safe to do an assessment in less than one hour, especially given the life-changing treatments on the care pathway.

Q. I have mental health problems. Can I still be seen and treated by the Gender Identity Clinic?

A. Yes. We do require that you are engaging with treatment and that you have been stable for a reasonable period of time. This is again to keep you safe, and ensure that you are able to understand and consent to the life-changing treatments on the care pathway. We have psychologists working within the team who are specialists in gender dysphoria and who are experienced in treating transgender people.

Q. How long does it take to transition?

A. Your physical transition can start with hormone therapy but it doesn’t always. Hormone therapy is not a requirement for chest surgery, for example. Hormone therapy can take up to two years (sometimes longer) to reach its maximum effect. Some surgeons prefer that you have reached this stage but the guidelines for having lower surgery are that you have been on monitored hormone treatment for at least 12 months. Given current NHS waiting times, it is likely that your transition will take 4-5 years.

Q. What can I expect at my first visit to the clinic?

A. Your screening appointment will involve a lot of detailed questions about your life story, particularly relating to your gender. This will involve some personal questions about your body, your sexuality, and your feelings. You will also be asked about your mental and physical health, and your medication. It is important we have a full picture of you as a person in order to make tailored recommendations for your ongoing treatment. All the information you give is confidential.

Questions and answers last updated: 26 February 2019

Frequently Asked Questions - COVID-19

Frequently asked questions

I cannot get blood tests done during the Covid-19 pandemic, can I still get my hormones?

In some cases, it may not be possible to continue to prescribe safely if you are unable to have routine monitoring blood tests done, particularly if you have had abnormal results previously. Following up abnormal blood tests may be considered urgent, rather than routine, and you should be guided by your GP.  If your GP is concerned they can email us at gid.lypft@nhs.net.

Physical harm is unlikely to occur if your hormone therapy is temporarily reduced or stopped. There may be a slight return of characteristics of birth assigned sex but these should revert when hormone therapy resumes. For people who have had genital reconstructive surgery, physical health complications are unlikely unless you are off hormone therapy for more than two years.

 I am having difficulty arranging an appointment at my GP surgery for my Sustanon / Testosterone Enantate injection, what should I do?

You can ask your GP to consider switching you over to testosterone gel. There is prescribing information to help with this in the Prescribing section on our website.

 I cannot arrange an appointment for my Nebido injection, what should I do?

As Nebido is a long-acting testosterone injection it is unlikely that testosterone levels will drop too low if an injection is delayed by a few weeks. It is not advisable for injections to be given too early.  Again, you can ask your GP to switch you over to testosterone gel.

I cannot arrange an appointment for my blocker injection (e.g Leuprorelin), what should I do?

Blocker injections are long-lasting so even if they have to be delayed your hormone levels will stay suppressed for quite some time.  The longer you have been on the injections, the longer the effect will last.  Try to arrange an injection for as soon as you can after it was due.

Due to the hormone shortages I cannot get my usual prescription, what should I do?

Firstly, you can ask your pharmacist about alternative hormone products.  Your GP may also be able to prescribe generically i.e. with the hormone name, rather than the brand name, then the pharmacist may be able to access a different brand of the same type of drug.  In most cases, the type and dose of your hormones are more important than the brand.

Our team

Gender ID three person image

We’re a diverse bunch at the Leeds Gender Identity Service. Our team consists of:

Consultant Clinical Psychologist (who is also the Service’s Clinical Lead) and, like the Consultant Psychiatrist, assess for a diagnosis of Gender Dysphoria and eligibility to progress on to the care pathway. In addition, opinions for surgery are also provided by them.

Consultant psychiatrists who assess for the diagnosis of Gender Dysphoria and the readiness and eligibility to progress on to the care pathway. They also provide the medical opinions for surgery as appropriate.

Two consultant endocrinologists (doctors that specialise in hormone treatment) that hold a combined clinic for individuals alongside the doctor with a specialist interest in this area.

A doctor with special interest in endocrinology, who is responsible for the running of the prescribing clinic. The doctor sees clients referred for hormone treatment initially for assessment and if all is well will initiate hormone treatment.  The service requests that blood tests are completed by the GP practice to ensure safe prescribing can occur. Once an individual’s hormone levels are stable, the client will be transferred to their GP for continued hormone prescription.

Our pharmacist works alongside the prescribing clinic providing support when needed and sees individuals on a one to one basis for counselling in relation to hormone treatment. The pharmacist also has a non-medical prescribing role, seeing individuals in the prescribing clinic for the initiation of hormone treatment. It would be expected that the individual’s GP would take over this role once hormone levels are stable.

Clinical nurses who see clients through the assessment process and act in the role as lead professional to those clients moving into the care pathway. Some of our clinical nurses also prescribe medication.

A speech and language therapist who provides one-to-one voice and communication therapy sessions to help you to develop your best authentic voice and with communication to use in ways that fit you.

Referral information

We accept referrals from your GP or NHS healthcare professional. We also accept self-referrals to the service. Referrals can be made using the referral form found on the link below. Please note that we only accept referrals for people aged 17 and above. If you are self-referring we would ask that you discuss this referral with your GP as if they are not in agreement with long-term prescribing and monitoring this may affect future care.

Download a copy of our Gender Identity Service referral form.

The completed referral forms should be emailed to gid.lypft@nhs.net.

If you are emailing from outside of the NHS, please note that we cannot guarantee the security of any communication sent to us via email, and that communication via email is entirely at your own risk. There is a postal address on the referral form should you prefer to send by post due to this reason.

Information for GPs on hormone prescribing

Please find the below useful links:

The following documents are available for download:

Shared care agreements for prescribing drug treatments

A shared care agreement outlines suggested ways in which the responsibilities for managing the prescribing of a drug, such as hormone therapy, can be shared between NHS specialist services, like the Leeds Gender ID service, and GPs. Sharing of care assumes communication between the specialist, GP and patient (and/or carer). The intention to share care should be explained to the patient by the doctor initiating treatment. It is important that patients are consulted about treatment and are in agreement with it. Patients receiving the given drug must be under regular follow-up, which provides opportunities to discuss drug therapy.

The Leeds Gender ID Service is happy to discuss shared care arrangements with GPs. However our general advice to all GPs is to only enter into such agreements with licensed NHS providers.

Consent forms for hormone treatment

The following are our consent for treatment documents:

Informed Consent Estradiol
Informed Consent Testosterone

Surgical and hair removal information

When you and your clinical team agree that you are ready for surgery, the Gender Dysphoria National Referral Support Service (GDNRSS) will process your referral to your chosen surgical provider. The GDNRSS team have Clinical Nurse Advisors who can provide information on the following:

  • Surgical techniques used by various providers and surgeon teams
  • Typical recovery times following surgery
  • Potential post-surgical complications
  • Surgical eligibility criteria, where providers have these in place
  • Waiting times for surgical providers
  • Supporting patients to change provider

They can provide virtual consultations and also have a Single Point of Access support line that you can call for information about your referral, the status of your chosen provider and practical information such as travel and parking, who can accompany you, what to take with you and where to report to when you get there. For more information about this service, download this leaflet. 

The GDNRSS have created the following information leaflets to help provide information to service users about their options for feminising surgery:

You can contact the Gender Dysphoria National Referral Support Service by calling 01522 857799 or by emailing agem.gdnrss@nhs.net.

Students, placements and training opportunities

The Leeds Gender Identity Clinic has students and health care professionals who attend to gain experience and knowledge about the service. Unfortunately we are limited as to how many health care professionals can access the service due to capacity and time available.

We have an established relationship with a number of universities in Leeds and York and have allocated placements each year for occupational therapy students, nursing students and medical students.

If you are part of a healthcare professional body and would like the opportunity to spend a day with the service we would ask that your course tutor or professional manager write to our service outlining the reasons for your visit and the benefits you will gain.  We will try to accommodate day visits where appropriate however this may not always be possible.

If you are interested please email gid.lypft@nhs.net

Have your say - patient feedback

Since 23 April 2021, as part of a new Leeds and York Partnership NHS Trust (LYPFT) initiative, the Gender Service has started to collect feedback from people accessing our service via ‘Have Your Say’. This is as new way people accessing the service can give feedback on the appointments they attend.  LYPFT have worked with staff and service users  to co-produce the survey.

“Have Your Say” is  aligned to the Friends and Family Test, asking about “experience of care” so provides anonymous patient feedback specifically for the gender service.

 

Get in touch

The Leeds Gender Identity Service is based at The Newsam Centre and can be contacted by Calling 0113 8556346.

This number is answered between 10am and 2pm Monday to Friday. Unfortunately we are unable to respond to voicemail messages.

We do also have our email address gid.lypft@nhs.net.

Please do not send personal information through this email address without completing a permission form, which can be attached to your email. If you choose to not complete this form, you need to be aware that, if your email address is outside of the NHS that we cannot guarantee the security of any communication sent to us via email, and that communication via email is entirely at your own risk.

Follow us

You can join our Facebook communities to find out more about what our Gender Outreach workers are doing in your area:

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