Gender Identity Service
Located in - leeds
Changes to our service during the Coronavirus Pandemic
Our team is offering a reduced service during the Coronavirus pandemic. This is due to staff being redeployed to critical NHS services. We recognise that this makes things difficult for everyone, whether you are on the waiting list or are receiving treatment or support from us. We are really sorry that we are not able to offer our service at this time and want to reassure you that as soon as this is possible, we will return to offering appointments.
We are updating this page with information about how our service is operating during the pandemic.
Information updated: 18 May 2020
Although we are still unable to provide new patient hormone appointments, we are offering follow up hormone appointments by telephone for existing service users in our hormone clinic. We continue to offer advice and support to GPs and service users as listed below.
We have started to send out letters to service users and GPs to acknowledge referrals that have been made by GPs since the start of the Coronavirus pandemic.
One of our clinical nurses will be returning to the service week commencing 15 June 2020 and will be completing telephone screening appointments. If you should have had a screening appointment, or receive a letter requesting you contact us to book, please contact the service and we will be able to book this for you.
Gender Outreach Workers
We have two gender outreach workers who are now able to offer some 1 to 1 telephone support and advice across the North of England. Please see below for further information about our Gender Outreach workers.
Use of technologies
We are working alongside NHS England and other gender clinics to look at different technologies for video conferencing as part of a consistent approach across all gender services. Once again, thank you for your understanding and support during this time; we do appreciate this. We will continue to provide updates of any changes to our service provision.
Information posted: 5 May 2020
At present, all of our named professionals (nurses) have been redeployed to other services as have a number of our doctors. We anticipate that other members of our team will be redeployed to respond to the crisis.
In line with other gender services, and BAGIS (British Association of Gender Identity Specialists) we are now not able to offer any face to face appointments. We have had to put on hold appointments with named nurses and the doctors in our team which includes, end of assessment (diagnostic) appointments, and medical opinions until we are able to reopen.
As our hormone clinicians have not as yet been redeployed to other services, any appointments that we currently have booked will go ahead by telephone. We will be contacting people on a week by week basis to confirm. We understand that due to the current situation that you might not have been able get your blood test completed. If you have an appointment and have been able to get your blood results, please email us at email@example.com.
We will be reviewing this situation on a weekly basis depending on the staff that we have available. We are not in a position that we can start hormone treatment over the telephone.
We understand that many of you will have concerns about how this might impact upon your care. We anticipate that there will be unavoidable delays to appointments with our clinic or for other services such as surgical providers. We recognise that this is far from ideal, but please be assured that as soon as our staff are able to return to their usual roles, that we will recommence with appointments.
We will not be able to send out letters confirming that we have received your referral. As we request that all referrals are sent to us electronically, your GP should receive an auto reply from the clinic to say it has been received. Administrative staff will continue to receive referrals and place these on our waiting list in the order that they were received, but these might not be reviewed by clinical staff until they can return to the service.
We have been contacting those people who have appointments by telephone (and letter if we have been unable to get in contact) to let you know individually if your appointment has had to be cancelled. We continue to work through this list. If you have an appointment coming up, and have not heard whether this is going ahead, please contact the clinic on firstname.lastname@example.org. Currently, we will not be making any new appointments, but we will update the website when this changes.
Changes to address/contact details
We recognise that many of you may change your name or contact details during this period, and will be keen to ensure that when we are back running, that we are able to contact you. Please could we ask, that if you have changed your contact details that you let both us, and your GP know.
We will continue to have our phone lines open for set hours throughout the day (Monday to Friday 10am – 2pm) for as long as we are able to maintain this. We do also have our email address email@example.com. Please note that due to reduced staffing numbers, we may be delayed in responding to emails. We will not be able to give any clinical responses, as it will be the administrative team who will be responding. We would ask, that if you are experiencing any urgent concerns in relation to your mental or physical health, that you contact your GP, your local mental health team or NHS 111 for advice.
During the Covid-19 pandemic there will unfortunately be a degree of disruption to all aspects of gender identity services, including in relation to hormones. We will not be able to start anyone on hormones until we can resume face to face consultations but we will do our best to support clients and their GPs to maintain hormone prescribing during this difficult time.
If you have questions regarding your hormone treatment, please could we either direct you to the information on our website (as below), or ask you to discuss these with your GP or healthcare professional in the first instance. Your GP/healthcare professional might be able to provide you with a more timely response. If they cannot advise you, we would then welcome your GP or healthcare professional to contact the clinic via our email address firstname.lastname@example.org.
Please note that at present, we only have the capacity to respond to hormone queries from your GP/healthcare professional. However, if you do continue to have difficulties, and your GP or healthcare professional is unable to support, please contact the service via our email address or by telephone during the hours of 10am – 2pm and we will try our best to support you.
Please see further information below regarding hormones which may support you.
- About the Service
The following information relates to normal service operating conditions
The Leeds Gender Identity Service offers assessment and support to people aged 18 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 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, which in part plays into the long waits people in Leeds, and across the country, are experiencing. To put this in perspective, we are funded to support 27 referrals per month but we actually receive over 100.
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.
It currently takes between three to four years from initial referral to complete our care pathway. The following is a broad overview. Please note it is an estimate guide, there are many factors that could affect this and it will not be the same for everyone.
- In March 2020 we received 44 referrals for new patients.
- During March, there were 707 appointments with service users.
- Of these appointments, 68 were cancelled due to the service user not attending.
Gender Identity Referrals, Discharges, Attendances and DNA’s – Updated May 2020
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 Combined Quality Performance Reports.
Waiting time information last updated: 01 August 2019
- Gender ID Outreach Workers and other sources of help
Leeds Gender Outreach Workers
We have two Gender Outreach Workers based at Yorkshire MESMAC, who provide one to one support sessions, a drop-in space, and support groups for waiting list clients living in post code areas: LS, BD, HU, WF and YO. Find out more about us on Facebook page or follow Sophie MESMAC on Twitter.
Lancashire Gender Outreach Workers
We have two Gender Outreach Workers based at Lancashire LGBT in Preston, who provide telephone and face to face support sessions, a drop-in space, and support groups for people living in post code areas: BB, FY, LA and PR.
For more information
Our Gender Outreach Workers offer a range of support from one-to-one sessions, to drop-in sessions and social groups.
One to one sessions are available while you’re on the waiting list at Leeds GIS. During these sessions you can ask for information and we will do our best to signpost and provide you with the support you need. These sessions can either be face to face or over the telephone.
Our drop-in sessions are friendly and open and you’re welcome to pop in and ask questions or discuss issues that interest or worry you. Peer support groups are another informal way of meeting other trans and non-binary people. You’ll gain lots of insights, know-how and support from people who understand how you might be feeling.
Contact our Gender Outreach Workers
Our Gender Outreach Workers aren’t counsellors but sometimes it just helps to talk.
Leeds Gender Outreach Workers
Sophie Bracewell and Natasha Cornwell can be contacted at Yorkshire MESMAC on 0113 244 4209
or via the Leeds Gender Outreach Worker FaceBook page
Lancashire Gender Outreach Workers
Contact Lancashire LGBT on 07788 295 521.
You can also call Danielle Hopkins on 07989 412 742 or Leah Emerson on 07973 638 119.
You can also email email@example.com with your name, date of birth, address and telephone number and we can forward your details to workers in your area.
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, York, Northallerton, Bradford, Wakefield, Rotherham and Hull. They also run a number of LGBT groups across the Yorkshire region. Visit https://www.mesmac.co.uk/ or call 0113 2444209 to learn more.
What is Lancashire LGBT?
Lancashire LGBT are a registered charity and their aim is to support Lesbian Gay Bisexual and/or 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 https://lancslgbt.org.uk/ or call 07788 295521 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 www.tranzwiki.net
- 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. 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’ve 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 firstname.lastname@example.org
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 email@example.com.
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.
- Who we are – our team
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 voice group facilitator to help support individuals using their voice in a way which will provide individuals with confidence.
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.
- How to refer to the Leeds Gender Identity Service - Information for Professionals
All requests for referral must come via your GP. This shows the GP is in support of their client accessing our specialist service and shows commitment to shared care arrangements for hormone treatment.
Download a copy of our Gender Identity Service referral form.
GPs should email completed referral forms to firstname.lastname@example.org.
Download a copy of HRT Guidance – Transmen.
Download a copy of HRT Guidance – Transwomen.
- Information for GPs on hormone prescribing
We are currently developing detailed guidelines on hormone prescribing. In the meantime, here are a few useful links:
- The GMC’s Trans healthcare page with guidance on prescribing
- The GMC’s Trans healthcare page with guidance on mental health support and bridging prescriptions
- The Royal College of Psychiatrists’ Good practice guidelines for the assessment and treatment of adults with gender dysphoria (published October 2013).
The following documents are available for download for GP’s
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.
- 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 email@example.com
- 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 12noon, and 2-4pm Monday to Friday. Unfortunately we are unable to respond to voicemail messages.
You can also email us: firstname.lastname@example.org. We will aim to respond to relevant queries within five working days.
You can join our Facebook communities to find out more about what our Gender Outreach workers are doing in your area: