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Gender incongruence is the term used to describe the experience of having a gender different to the sex you were born with.
Gender dysphoria describes the distress or discomfort associated with gender incongruence.
We want to support you as best we can if you think you may have gender dysphoria. We hope the following information is useful, but please let us know if you think we may have incorrect information or we have left out something important.
I think I might have gender dysphoria, what should I do?
- If you’re generally struggling a bit and want to talk things through with someone, it’s worth contacting NHS Talking Therapies or Mind
- For more specific information about transgender issues, Tranzwiki has a list of more local support services (though bear in mind that these are more limited in Oxfordshire).
- If you are aged 16-25, Talk for Support run a support group, one to one sessions and advocacy in Oxfordshire.
- If you’d like to come and talk to one of the health care professionals in the surgery, complete an appointment request
Some people feel that they want to start living as the gender they feel they identify with. You don’t need anyone’s permission to do this! It can be difficult having conversations with family, friends and colleagues about this and this is often where the organisations above come in useful.
I know that I have gender incongruence, what should I do next?
Gender dysphoria diagnosis
A diagnosis of gender dysphoria is required for NHS therapies including hormone treatment, speech and language support, facial hair reduction, gamete (egg or sperm) storage and surgery. This diagnosis can only be made by a specialist in gender care – i.e. not your GP.
We are happy to refer you to an NHS gender specialist but please be aware that waiting times are growing at an extreme rate – current wait times are around 8 years.
There are 7 adult NHS gender clinics in England and you can be referred to any one of them.
There are also a number of other clinics in London, Manchester, Sussex and Liverpool but they are currently limited in who they can see and don’t offer a service to Oxfordshire residents yet.
- Sheffield Partnership University NHS Foundation Trust
- Leeds and York Partnership NHS Foundation Trust
- Northamptonshire Healthcare NHS Foundation Trust
- The Nottingham Centre for Transgender Health
- Devon Partnership NHS Trust
Some of the clinics even have a self-referral form that you can complete and then bring to us for some basic medical information to be completed prior to referral. It’s worth checking their websites for information on this.
If you are under 18 things get more complicated as the only young person’s clinic currently in England is not accepting new referrals. It would be best to come in and talk to us about options.
Getting support
For general emotional support, contact NHS Talking Therapies or Mind
- For information on trans-specific services, visit Tranzwiki.
- If you’re aged 16 to 25, Talk for Support offers groups, one-to-one sessions, and advocacy in Herefordshire.
- You can also book an appointment with one of our clinicians to talk things through
You don’t need anyone’s permission to live as the gender you identify with, though it can help to have support while making social changes.
Referral to a Gender Identity Clinic (GIC)
- A diagnosis from a specialist gender clinic is required for NHS treatments such as hormones or surgery.
- GPs can refer you, but NHS waiting times are currently several years.
- There are seven main adult NHS gender clinics in England – details are on the NHS website.
- Some clinics offer self-referral forms you can download.
- If you’re under 18, please speak to a GP for advice as services are currently limited.
Changing your name
You can change your name by deed poll – you don’t need to officially change your gender or see a gender specialist to do this.
Changing your name and gender at the surgery
You have a legal right to change your name, title and gender marker on your medical records. You don’t need a gender recognition certificate or a new birth certificate to do this.
When you ask us to change your name, title and gender, we will apply for you to have a new NHS number. We then re-register you as a new patient with your updated details. It is important to note that if you ever want to change your gender back again, you would need another new NHS number – you can’t go back to the original one.
We will transfer medical information across from your existing notes, but your original name, title and gender will not appear in your new notes.
If you’d like to go ahead and change your details on your medical records, we ask that you make an appointment with a GP as the first step to go through some of the points above in more detail.
The new registration process should be completed in five working days.
If you don’t wish to change your name or gender on your medical records, but do wish to be called something specific when we contact you or call you in from the waiting room, please let us know and we will do our best to ensure this happens.
Passport and driving license changes
Passport
You don’t need a gender recognition certificate to change your name and gender on your passport but you do need a letter from a doctor to confirm that this is a permanent change of gender.
Driving Licence
You don’t need a certificate or a letter to change your driving license
Getting a gender recognition certificate (GRC)
You need to have seen a gender specialist before this can be issued. The GRC allows you to change your gender on your birth certificate, have your affirmed gender on your death certificate when you die, and either get married in your affirmed gender or have your gender changed on your existing marriage or civil partnership certificate.
Remember that you don’t need a GRC to be a recognised transgender person. Many people choose not to get one.
NHS screening
This is really important. If you change your gender with us at the surgery, you will not be routinely called for some cancer screening tests. So as a trans man, we would not call you for a cervical smear test or breast screening mammograms, but if you still have a cervix or breasts, it is really important that you have access to these tests. As a trans woman, you would be entitled to aortic abdominal aneurysm screening after the age of 65 and if you are taking oestrogen, you should have breast screening from age 50 to 70.
You need to contact us to have screening tests if you are registering as a different gender than that assigned to you at birth. Additionally, you can opt out of having screening invitations sent (for example if you are a trans woman, or a trans man who has had their cervix removed, you may not want to be sent cervical smear invitations).
Private clinics and hormone treatment
NHS waiting times are long, but we do not recommend buying hormones online — this can be unsafe
- If you’re considering a private clinic:
- Choose one that is UK-based, CQC-registered, and ideally run by NHSgender specialists.
- They should provide a Shared Care Protocol if they want your GP toprescribe ongoing treatment.
- If you have already started hormones, please book a GP appointment — we’llfocus on keeping you safe and monitoring your health
While you’re waiting
- Consider making social changes if ready (name, pronouns, clothing, etc.).
- Stop smoking (required before hormone therapy).
- Keep healthy — surgery referrals usually require a BMI under 31
- •Manage any long-term health conditions (e.g. diabetes, asthma, heart disease)
What happens at a gender identity clinic?
Gender identity clinics are where we refer you if you wish to:
- Obtain a gender recognition certificate
- Start hormonal treatment
- Access some gender reassignment surgical treatments, speech therapy or NHS funded facial hair removal (body hair removal not available on NHS)
The first appointment will usually involve a detailed talk with the clinician, and then possibly some blood tests and information on what happens next. You usually won’t be prescribed hormones on your first visit
Gender dysphoria diagnosis
A diagnosis of gender dysphoria is required for NHS therapies including hormone treatment, speech and language support, facial hair reduction, gamete (egg or sperm) storage and surgery. This diagnosis can only be made by a specialist in gender care – i.e. not your GP.
We are happy to refer you to an NHS gender specialist but please be aware that waiting times are growing at an extreme rate – current wait times are around 8 years.
There are 7 adult NHS gender clinics in England and you can be referred to any one of them.
There are also a number of other clinics in London, Manchester, Sussex and Liverpool but they are currently limited in who they can see and don’t offer a service to Oxfordshire residents yet.
- Sheffield Partnership University NHS Foundation Trust
- Leeds and York Partnership NHS Foundation Trust
- Northamptonshire Healthcare NHS Foundation Trust
- The Nottingham Centre for Transgender Health
- Devon Partnership NHS Trust
Some of the clinics even have a self-referral form that you can complete and then bring to us for some basic medical information to be completed prior to referral. It’s worth checking their websites for information on this.
If you are under 18 things get more complicated as the only young person’s clinic currently in England is not accepting new referrals. It would be best to come in and talk to us about options.
Getting support
For general emotional support, contact NHS Talking Therapies or Mind
- For information on trans-specific services, visit Tranzwiki.
- If you’re aged 16 to 25, Talk for Support offers groups, one-to-one sessions, and advocacy in Herefordshire.
- You can also book an appointment with one of our clinicians to talk things through
You don’t need anyone’s permission to live as the gender you identify with, though it can help to have support while making social changes.
Referral to a Gender Identity Clinic (GIC)
- A diagnosis from a specialist gender clinic is required for NHS treatments such as hormones or surgery.
- GPs can refer you, but NHS waiting times are currently several years.
- There are seven main adult NHS gender clinics in England – details are on the NHS website.
- Some clinics offer self-referral forms you can download.
- If you’re under 18, please speak to a GP for advice as services are currently limited.
Changing your name
You can change your name by deed poll – you don’t need to officially change your gender or see a gender specialist to do this.
Changing your name and gender at the surgery
You have a legal right to change your name, title and gender marker on your medical records. You don’t need a gender recognition certificate or a new birth certificate to do this.
When you ask us to change your name, title and gender, we will apply for you to have a new NHS number. We then re-register you as a new patient with your updated details. It is important to note that if you ever want to change your gender back again, you would need another new NHS number – you can’t go back to the original one.
We will transfer medical information across from your existing notes, but your original name, title and gender will not appear in your new notes.
If you’d like to go ahead and change your details on your medical records, we ask that you make an appointment with a GP as the first step to go through some of the points above in more detail.
The new registration process should be completed in five working days.
If you don’t wish to change your name or gender on your medical records, but do wish to be called something specific when we contact you or call you in from the waiting room, please let us know and we will do our best to ensure this happens.
Passport and driving license changes
Passport
You don’t need a gender recognition certificate to change your name and gender on your passport but you do need a letter from a doctor to confirm that this is a permanent change of gender.
Driving Licence
You don’t need a certificate or a letter to change your driving license
Getting a gender recognition certificate (GRC)
You need to have seen a gender specialist before this can be issued. The GRC allows you to change your gender on your birth certificate, have your affirmed gender on your death certificate when you die, and either get married in your affirmed gender or have your gender changed on your existing marriage or civil partnership certificate.
Remember that you don’t need a GRC to be a recognised transgender person. Many people choose not to get one.
NHS screening
This is really important. If you change your gender with us at the surgery, you will not be routinely called for some cancer screening tests. So as a trans man, we would not call you for a cervical smear test or breast screening mammograms, but if you still have a cervix or breasts, it is really important that you have access to these tests. As a trans woman, you would be entitled to aortic abdominal aneurysm screening after the age of 65 and if you are taking oestrogen, you should have breast screening from age 50 to 70.
You need to contact us to have screening tests if you are registering as a different gender than that assigned to you at birth. Additionally, you can opt out of having screening invitations sent (for example if you are a trans woman, or a trans man who has had their cervix removed, you may not want to be sent cervical smear invitations).
Private clinics and hormone treatment
NHS waiting times are long, but we do not recommend buying hormones online — this can be unsafe
- If you’re considering a private clinic:
- Choose one that is UK-based, CQC-registered, and ideally run by NHSgender specialists.
- They should provide a Shared Care Protocol if they want your GP toprescribe ongoing treatment.
- If you have already started hormones, please book a GP appointment — we’llfocus on keeping you safe and monitoring your health
While you’re waiting
- Consider making social changes if ready (name, pronouns, clothing, etc.).
- Stop smoking (required before hormone therapy).
- Keep healthy — surgery referrals usually require a BMI under 31
- •Manage any long-term health conditions (e.g. diabetes, asthma, heart disease)
Local Support
Tavistock and Portman Gender identity Clinic
Accepting referrals from all over the UK for people with issues related to gender.
Visit the Tavistock and Portman Gender identity Clinic website
National Support
Tranzwiki
TranzWiki is a comprehensive directory of non-commercial groups and organisations supporting or assisting trans and gender diverse individuals, their families and friends across the UK.
Human Fertilisation & Embryology Authority
Information for trans and non-binary people seeking fertility treatment
Visit the Human Fertilisation & Embryology Authority website