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Frequently Asked Questions

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What is Gender Dysphoria?

Gender dysphoria is the term used to describe the sense of discomfort experienced by people who do not identify with the gender they were assigned at birth. The discomfort may be constant or sporadic and it may vary in terms of severity.

What causes someone to be trans?

We are not absolutely sure what causes someone to be trans, and it is probably a variety of factors combined. We do understand that it is not something that can be forced on someone, or something that someone can choose to be. It is not something that happens because of childhood experiences and it is not a personal choice. It is inherent, in the same way as sexuality or eye colour.

Is there a way of diagnosing someone as trans?

As it is a subjective experience, the only person that can actually know whether or not they are trans is the person living with feelings of gender incongruence (the feeling that one’s gender does not align with the one they were assigned at birth). There is no psychological test, blood test or medical scan. It is not something someone chooses to be, and it is certainly not a mental disorder.

Why don’t GPs treat trans patients?

There are many reasons why GPs do not feel able to treat trans patients. These can vary from reasons related to prejudice or religion, to a general belief that they lack the knowledge to do so, and a lack of training resources available. Prejudice or personal belief should never be accepted as a valid reason not to treat a patient, whatever their medical needs. Lack of specialist knowledge is also becoming less accepted as an argument against helping trans patients. We are seeing more GPs learning about the subject and as their knowledge and confidence increases, then they will feel more comfortable in helping their patients better, if not directly then with the support of a gender specialist.

Do I need hormones to transition?

Everyone has a different perspective on what they want to achieve in terms of their transition. For some, social transition, which involves presenting themselves in line with the gender with which they identify, is sufficient. For others, looking for physical changes, hormone therapy is enough to give them the inner peace that is missing. For others, surgery is their desired route.

What do I need to start hormone therapy?

Hormone treatment can be started once you have gone through things and worked out the best and safest route for you to take. You may already know this is the right time, and that it is safe, or you may need a doctor or some support to help you with this.

Where can I get a diagnosis of gender dysphoria?

While a GP is able to provide this, not many GPs feel that they have the necessary knowledge or training to ‘diagnose’. Much more work is needed in this area. Other people who can help are local endocrinologists, GPs with a special interest or other gender specialists. You can also get a diagnosis through a Gender Identity Clinic (GIC) but the waiting lists can be very long. Counsellors and psychologists can all give you a diagnosis if that is what you require to achieve your goals.

What is self-medding?

Self-medding is the term used to describe the process whereby a trans individual carries out their own research via trans forums and support groups to try to understand what levels of hormones might be right for their needs. The individual then obtains the “medication” (often without a prescription) and begins to follow a treatment regime. This approach is often not monitored and the medication is often questionable which can carry worrying negative health implications.

Why do people self-medicate?

Many people have been forced to start treatment on their own due to long waiting times and a struggle to access the right healthcare regime for them.

I want to stop self-medicating, what should I do?

If you are obtaining your medication in this way, GenderGP can swap you onto safe prescription medication as well as arranging to have your bloods monitored to check your hormone levels are safe.

Will I be penalised if I get private care?

The British Medical Association policy states: “Patients who are entitled to NHS funded treatment may opt into or out of NHS care at any stage. Patients who have had private consultation for investigations and diagnosis may transfer to the NHS for any subsequent treatment. They should be placed directly on the waiting list at the same position as if their original consultation had been within the NHS.”

I have other health problems, does this mean I can’t have hormone treatment?

A history of liver, heart or blood clotting problems, in you or your family, does not preclude you from accessing hormones but it does mean that your case may require additional monitoring.

Do you treat children and adolescents?

We use the medical definition of child which means prepubertal. Before the onset of puberty children do not require medical treatment and any transition should be managed socially (allowing the child to dress and identify as they wish). Medical treatment other than belief and support is not needed until puberty starts.

At what age do you begin treatment?

We do not classify according to age but rather in line with the onset of puberty. Once an adolescent has reached Tanner stage 2 (the starting phase of puberty), we can work with the adolescent and parent or guardian to support any child suffering with gender dysphoria.

What treatments do you offer to younger people?

Each individual is considered on a case by case basis. Treatments available to adolescents, in line with international best practices, are puberty blocking medication and when indicated, gender affirming hormones.

Are puberty blockers reversible?

Medication to stop puberty is totally reversible. Please see our myth buster for more information.

Are cross sex hormones reversible?

No. Prescribing these hormones has long-lasting and irreversible implications, however these changes do not occur overnight. Gender affirming hormones are classed as being partially reversible. No doctor would ever choose to actively prescribe such medication unless it was in the best interest of the patient.

How much does the service cost?

Please see our fees page for a breakdown of fees.

How long does the process take?

This varies with what you are trying to achieve. If you are sure of your gender and the steps you wish to take, have access to blood tests and support, then the process can take as little as four weeks.

I am having regular counselling, do I still need to pay for regular follow up sessions as well?

We just need to know that everything is going well for you and that you are happy and safe. If your counsellor is happy to give us a report to say that then that is all we require.

Does a family member have to be involved in my treatment plan?

We want everyone to be supported in their gender journey, some have more support than others. If you don’t have someone close to you to help then we will be there to support you. Not having someone who understands this is not a reason why we would not give you care.

How often do my bloods need to be tested?

Some people like to have their bloods measured very closely while we get to the dose that is right for them. For some this happens quickly and bloods can then be monitored every three months or sometimes less if everything is very stable.

What is included in the monthly subscription?

Your monthly subscription fee covers the cost of any ongoing support and advice we provide to you or your GP, or your specialist. It covers the monitoring of your blood results and your prescription creation (NB: this does not include the medication which is purchased separately), as well as all advice and information from the team.

What is an IGS? Why is it necessary?

IGS is short for Information Gathering Session, which is carried out with our therapy team, either in person or over video. The IGS enables us to meet you ‘face to face’ and learn more about your situation and how we might be able to help. The information is shared both ways, you tell us about you and we tell you about us.

I don’t need or want counselling, is it obligatory?

Counselling in the traditional sense of the word is not obligatory with GenderGP. Counselling sessions are available with our excellent team of therapists and may people find it to be hugely beneficial. However, it is up to you to decide what psychological support you need. We do require you to have a follow up session every so often so that we can see how you are doing and ensure we have regular contact outside of email conversations. These are carried out by video consultation, or can be done in person if you prefer.

Why do I need a follow up session?

These appointments provide an opportunity to see what physical and psychological changes service users might be experiencing and to see if there is any help, advice or sign posting we can offer to enhance their transition and progress. We want the best for you and to keep an eye on how things are going.

Do I need a diagnosis to access hormone therapy?

At GenderGP we do not ‘diagnose’, as we feel it is disrespectful to your identity. You are the expert in your gender experience. Instead, what we do is take each of our service users through our Appraisal Pathway which includes getting to know you, taking a thorough history and exploring your relationship with gender to ensure we are able to provide you with the best possible recommendations for your treatment. Whether that is being provided via GenderGP or your directly through your doctor. If you want a formal diagnosis, however, then we can provide you with a confirmation of that.

Do I have to live in a particular role to get treatment through GenderGP?

People should be allowed to express themselves in a way that makes them feel most comfortable, and to transition as slowly or quickly as is medically safe. They shouldn’t have to dress in a particular way or live in a way that makes them feel uncomfortable in order to gain the correct treatment. This is not something we enforce at GenderGP.

Why do I need to have my bloods tested?

Regular blood testing enables us to monitor your hormone levels to ensure you are within the required range for the gender with which you identify.

I am struggling to get advice, can you recommend any trans friendly organisations that might help me?

There are lots of lovely support groups.

My doctor won’t help and I don’t know what to do

Sadly, it’s not always easy for transgender people to get the support they need from their GP. Many of the issues come from the fact that there is still so much uncertainty on the part of GPs and this leads to a reluctance to treat patients. As such they are referred to specialist services and may be subject to long delays. We have lots of resources which will help you to better understand the barriers that are often (wrongly) put in place and what you can do to navigate these. Visit our support services.

What is Vaniqa cream?

Vaniqa is otherwise known as eflornithine. It is a facial cream which has been licensed for use in the UK for the reduction of facial hair in women. Its recommended use is only on the face and surrounding areas such as the underside of the chin and upper neck. Whilst there have been no proper studies of use in men or in trans women, anecdotal studies and case reports have suggested that using Vaniqa in these patient groups does reduce hair growth velocity and the need for regular shaving. It has also been prescribed for use on body hair, with similarly favourable results. A limiting factor for this type of use is the relatively small size of the tube and the associated cost.

Are there any side effects from using Vaniqa?

Side effects are mostly localised with acne, rash, tingling and skin sensitivity being described, but also headaches in a few. Find out more

What counselling services do you provide?

We have a wonderful team of people who can offer support, counselling, therapy and a shoulder to lean or cry on. View our counselling services.

How did GenderGP start?

GenderGP started when Dr Helen Webberley was an NHS GP at a small practice in Wales and a couple of transgender patients approached her for help. She soon realised that there were various factors which made accessing healthcare a challenge for this group. These included:

– long NHS waiting lists

– no transgender provision in Wales, therefore people had to travel to London

– rigid protocols that didn’t suit everyone

It soon became apparent that patients wanted more than information and so Dr Webberley set up GenderGP to provide access to advice to those who needed it.

Are the doctors working with GenderGP qualified to treat transgender patients?

Gender specialists can come from any medical specialty. In the NICE Document “clinical models operated by England’s gender identity clinics” it states that “Gender specialists may be from many different clinical backgrounds, some specialising in mental health: psychologists, psychiatrists, counselors or therapists, but they may also be GPs, endocrinologists, nurses etc

Don't you have to be an endocrinologist to treat transgender patients?

There is no mandatory training for transgender care although, historically, it has been delivered by psychiatrists and endocrinologists. We work with doctors who are experienced in managing hormonal manipulation in transgender patients.

How do I get my blood tests done?

There are many ways that GenderGP patients can get blood tests done:

a) via their GP

b) via home finger-prick tests using our private laboratory

c) via a venous sample by other private services.

It is important that all medical conditions are properly monitored and we are very happy to help with all aspects of monitoring. We also liaise directly with NHS GPs to support any patients having difficulty accessing the tests they need.

Does GenderGP have a multi-disciplinary team?

Yes. We work with a highly professional team of people including our Pathway delivery team, counsellors, psychotherapists and family doctors. The need for therapy is assessed and offered on a case-by-case basis. Patients are not required to have months of therapy, but we do have experts in place to suit everyone’s needs, should they be required.

Is it safe to treat people over the Internet?

Everyone is different and has different needs. Modern technology enables us to really open up access between patients and healthcare workers to provide the best care. Not all cases are appropriate for ‘remote healthcare’ but it is surprising just how much progress can be made with patients when they feel protected in the comfort of their own home. The GMC has clear guidelines on this issue.

Why is there some controversy surrounding GenderGP?

Transgender care has always been a contentious area of medicine, which has attracted significant attention. This has led to many doctors shying away from practicing in this field and subsequently to patients struggling to get timely access to the help and treatment they desperately need. GenderGP believes in affirmative care – we believe that when a patient comes to us for help, help should be provided – and operates according to a model of informed consent – we believe the patient is the expert in their gender experience – irrespective of the age or status of the individual. This is in line with best practise coming out of international Centers of excellence in transgender care but is at odds with the approach taken in less progressive countries, including the UK.

What guidelines does GenderGP work to?

GenderGP works to a number of excellent, well-researched and evidence-based guidelines.

Why should I seek counselling?

Counselling is a safe and confidential environment in which you are free to explore the issues that may be troubling you. It is a professional friendship which will help you to find the language you need to talk about your feelings and which will give you a greater understanding of your situation, empowering you to make the choices that matter.

What is different about GenderGP’s counselling team?

While some counsellors may claim to be experienced in helping with feelings surrounding gender, many are very new to this area. GenderGP’s specialist gender counselling team is headed up by a trans woman and the team has been supporting gender expansive people and their loved ones for the past five years.

The volume of clients with whom they have interacted during this time makes them the most experienced specialist gender counselling team in the UK.

All of our counsellors are qualified and registered with the BACP or equivalent, and work to the highest standards. They have regular supervision outside of GenderGP and are bound to the counselling ethical framework.

Furthermore, the specialist gender counselling team are heavily involved in advocacy work and actively seek out the trans community, frequently attending events and support groups.

I know who I am, how can counselling benefit me?

Knowing who we are and understanding our gender identity is only the beginning for many transgender people. Creating a pathway and a safe environment to explore their identity fully, without prejudice, can be a challenge.

Specialist gender counselling is the perfect place to start this exploration. Gender affirmation is a journey and having a counsellor in your back pocket to help when the ride gets a little bumpy can make all the difference. Counselling is not there to tell you who you are, it’s there to support you, whatever your gender identity, and to offer emotional support and exploration.

I am worried you will try to talk me out of my feelings in relation to my gender

Good counsellors, who understand gender, are only there to help you to discover your true identity, not to convince you to be something you are not. If you have questions, our team of specialist gender counsellors can help you to find the answers. The counselling team acts as a professional sounding board, someone completely unbiased and impartial with whom you can share your deepest darkest secrets, without being judged.

What ages do you support?

Everyone! We all need support at different stages in our lives, this is no different if you are questioning your gender. Age should never be a barrier to accessing counselling, so at GenderGP we help people of all ages.

Do you offer support for parents?

Yes! Experience has shown us that while many parents may be accepting and supportive of their child, whatever their age, helping their child to safely navigate their gender journey can be challenging at times. Being able to talk through their thoughts, fears and even prejudices, in a non judgemental environment, can be a hugely positive step for everyone involved.

What if I change my mind?

Gender is a journey which is personal to every individual. Changing your mind suggests going backwards but change is always a movement forward. The same can also apply to someone’s relationship with their gender, it keeps moving forward. We can change the road, or the direction we are on, but it is not about going backwards. No matter how you are feeling, counselling can help you to make sense of your situation.

Can you talk me - or my child - out of being trans?

No, we can’t and we would never try to talk you out of accepting your gender identity, but we can help you to come to terms with it. Our gender identity is not a choice, it is inherent in who we are.

Do I need to have a session with a counsellor to access medication?

Counselling is not mandatory with GenderGP, though we do feel everyone – trans or cis – can benefit from support! We do ask all service users to take part in an Information Gathering Session (IGS) which is carried out by a member of the counselling team, and this is mandatory.

How many sessions would I need to have with you to feel the benefits?

It is entirely up to you. The amount of sessions is not fixed, many people enter counselling for three or four sessions, others continue for months. It all depends on how you experience the process and if you are finding it beneficial. Working with the right counsellor is really important and can have a big impact on your experience, which is why we have a team for you to choose from.

Does online counselling work?

Emphatically yes! Online counselling does work. Counselling is a commitment made by two people to be there at the same time each week. Travelling can make that commitment difficult for the client and they can falter if logistics prove too challenging. Video calling means all they need to do is log on. The fact that they are also surrounded by their own things, in the comfort of their own home, can make them feel at ease, adding to the therapy experience.

How much does a session cost?

The standard rate is £60 per session. If you are struggling to afford this, speak to our counsellors who may be able to work out an individual plan which fits within your budget.

How long do sessions last?

Sessions are a standard 50 minutes in length.

What happens if I miss a session?

We ask that 24 hours notice be given if you are unable to make your session, in this event a full refund will be given. If you are not able to cancel within this timeframe, we will be unable to rebook your slot and as such payment may be required.

How do I book a counselling session?

You can book a session by clicking on the links which can be found on the counselling page. We have listed all of our counsellors individually, so just choose the one you would like to speak to and click on the link. You can also request to book by by emailing info@gendergp.com

What if I don’t like my counsellor?

A massive 80% of the success rate of your counselling session can be attributed to the connection you have with your therapist. We have a diverse team which can be found here. Have a look and see who you feel might be a good fit for your particular needs. If you don’t feel the match is quite right, you are free to try another member of the team.

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