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Pharmacy Hub

The Pharmacy Hub at GenderGP provides pharmacies and chemists with all of the relevant information need for dispensing medication to your transgender customers.

Together We Will Provide World Leading Trans Healthcare With the Pharmacy Hub

 

In order to ensure our service users get access to the best standards of care, we work with pharmacists who are regulated in their country and who can ensure the medication they dispense is legitimate and safe. This is all achievable with use of our pharmacy hub.

The Pharmacy Hub section of our website aims to inform our pharmacy colleagues about our approach and provide any reassurance, should it be needed, about the role they can play in providing care to this population.

If you believe that trans patients should be able to access safe, effective, well-led, responsive care, and you would like to join our network of pharmacies to receive direct referrals from us, please leave us your details and become a trusted partner at The Pharmacy Hub.

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Trans Healthcare
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How GenderGP operates
GPhC Guidance

Pharmacy FAQs

I Thought Testosterone Was a Controlled Substance and Therefore We Couldn’t Accept EU Prescriptions for Testosterone Here in the UK?

Testosterone is considered as a Class C, Schedule 4 Part2 controlled drug because it is in the same class as anabolic steroids which have been open to abuse because of their body enhancing properties.

There has historically been some concern by pharmacists that they are not allowed to dispense controlled drugs against an EU prescription, however the British National Formulary (BNF) gives very clear guidance on prescribing and dispensing laws in the UK and it advises:

Schedule 4 Part II includes androgenic and anabolic steroids, clenbuterol, chorionic gonadotrophin (HCG), non-human chorionic gonadotrophin, somatotropin, somatrem, and somatropinControlled drug prescription requirements do not apply and Schedule 4 Controlled Drugs are not subject to safe custody requirements.

Testosterone used to achieve masculinisation in trans masculine people is a core part of the medication used for medical transition. Used in this context it is a safe and well evaluated aspect of gender-affirming care.

How Do I Raise Concerns About a Patient?

If you have any concerns please complete the following form and a member of the team will contact you.

Incident reporting Safeguarding queries

Who is your prescribing lead?

All decisions are made by a multidisciplinary team which includes several doctors. If you would like details of the specific doctor related to a specific patient then, you can request that information here.

Why Have There Been Issues Around Chemists Prescribing for Trans Patients?

A lack of education and awareness around trans issues has led to a culture of fear. This hampers safe and effective provision of care for this patient group. Active anti-trans lobbyists have raised unnecessary and unfounded concerns, particularly in relation to trans youth, and this has made regulators very concerned. Although this concern appears in other countries, it seems that the UK is falling behind in understanding the need for equality in healthcare for trans patients.

Can I verify your clinic?

We are owned by GenderGP PTE Ltd and trade as GenderGP.

Why Is There So Much Controversy Around Trans Healthcare?

In recent years, understanding around what it means to be transgender has increased significantly. This has led to many more people stepping forward and asking for help with their social, medical and legal transition. In many countries, medical services have failed to keep up with demand, with too few healthcare professionals feeling able, or willing to help. A reluctance all too often driven by social, medical and political prejudice. These factors have also driven the wider narrative on trans healthcare with very strong opinions coming to the fore from prominent figures who do not support the notion that trans people exist, much less that they should be affirmed.

Is It Legal To Provide Trans Healthcare?

Yes! The NHS has a legal duty to provide this care. While the UK is falling behind in its provision to the trans community and specifically trans youth, leading centres of excellence worldwide have issued clear guidance in recent years which promotes the benefits of affirmative care. At GenderGP we follow this best practice to ensure all trans individuals, wherever they are in the world and however old they are, have access to the care they need.

What Was the Recent Determination About Blockers?

In December, a high court ruling determined that it was unlikely that those under the age of 16 could consent to treatment. There has been much controversy surrounding the case and the Tavistock and Portman clinic (the only NHS provider of care to trans youth) has since been granted an appeal. This is due to take place in June 2021. We have compiled the following resource for anyone wishing to better understand the implications of the ruling. Sadly, there are many trans people of all ages who do not have the support of their parents or loved ones. For these individuals we take the same stance on consent as the NHS.

What is Dr Webberley’s role?

Dr Helen Webberley is the founder of GenderGP she continues to campaign tirelessly for improvements in trans healthcare, she is not currently practising as a GP. If you would like to read more about Dr Helen you can do so here.

Are puberty blockers safe?

Leading experts worldwide agree that: “[puberty suppression and subsequent gender affirming hormones] is the most widely accepted and preferred clinical approach in health services for transgender people around the world.”

Can I see your reviews / testimonials?

Absolutely. You can see our reviews on both Trustpilot and Google and the testimonials page of the GenderGP website.

Can I set up a SLA with you?

Yes you can. Please click on this link to view our template SLA.

Are the Medicines Licensed for This Use?

It is well known that many medications that are prescribed are unlicensed for use in trans healthcare. You can read GMC guidance about this here and GPhC advice here. All of our clinicians prescribe in line with The Endocrine Society Guidelines for the Care of Transgender Patients. Our prescribing protocol and a list of prescribed medications can be found here.

Are your doctors specialists?

Yes. All of our doctors have been carefully selected for their knowledge, skills and attitude in the field of gender-related healthcare and they follow strict International guidance for treatment protocols. Doctors working with GenderGP support thousands of patients in their capacity as gender specialists.

What Qualifications Are There in This Field of Medicine?

There is no recognised training or qualification in this field, so all learning is by personal professional development. GenderGP and its doctors follow the peer-reviewed, published International Guidance from the WPATH, The Endocrine Society, The University of California, San Francisco (UCSF) and Australia. Find out more here.

Is There Any Way I Can Show That We Are an LGBT+ Friendly Pharmacy?

Yes, there are plenty of things you can do including the provision of training to your pharmacy team to ensure their approach is inclusive visit: https://lgbt.foundation/prideinpractice to find out more. You can also sign up to our pharmacy network here.

Do I Need Special Training To Dispense to This Patient Group?

There is currently no specific training available which relates to this group of patients. The medication used and the monitoring required within this patient group, is no different to those who are being treated for menopause, endometriosis, prostate cancer, precocious puberty, constitutional delay in puberty.

Gender dysphoria is not a highly specialised field that involves dangerous medication requiring comprehensive monitoring. The benefits of having access to care far outweigh the risks associated with the denial of that care, particularly in light of NHS waiting times that are in breach of the NHS constitution.

In balancing the risks of providing essential pharmacy services to this patient cohort, there must also be an analysis of the risk of not providing services. Patients who struggle to get access to medical and pharmaceutical healthcare services often turn to the grey or black market.

Can I speak to someone on your team?

Yes. Please complete the following form and a member of the team will contact you.

Where are your doctors based?

GenderGP is a global organisation which provides health and wellbeing services to transgender people and those who care for them. Our organisation comprises medical and therapeutic gender specialists from all over the world who are regulated in each area of their specialism in the countries in which they are based.

Are you registered with the CQC?

As an international organisation we are not bound by English regulators. However, all of our specialists are individually regulated for each of the activities they carry out in the countries in which they are professionally registered.

What are your safeguarding procedures?

At GenderGP we take the safeguarding of all patients very seriously. Our safeguarding statement and policies can be accessed here.

How Do You Assess Capacity and Consent?

Capacity is obtained via written and verbal communication for all patients. Anyone who is over the age of 16 can be presumed to be able to have the capacity to consent to their own medical treatment unless concerns are raised. Anyone under the age of 16 can consent to their own treatment, as long as they are able to show that they can understand the implications of that treatment. Of course there will be people who are over 16 who will be unable to understand and make decisions, just as there will be people under 16 who are unable to consent. A full overview of our approach to consent can be found here.

What assessments do you do?

Our team of gender specialists carry out personal, physical, social, gender assessments according to need. We adopt a multidisciplinary approach. We do not believe in putting people through mandatory lengthy assessments in order to validate their gender. People who come to us understand their own experience better than anyone, our role is to help them to begin – or continue – their journey. We simply work with our service users to gather key information so that we understand more about them and their transition goals and our medical team can recommend the best course of action. You can read more about our approach to assessments here.

Sweden and Finland – The FAQs

What does GenderGP do?

GenderGP is a health and wellbeing service for trans and non-binary people. We offer medical and therapy services to help people who wish to transition. If people want to take hormones to masculinise or feminise their bodies so that their bodies more closely match their gender identity, then we offer that medical service. Our doctors are able to prescribe medication for you to help with that hormone transition.

How do prescriptions work?

Doctors evaluate the patient and with you they make the best choices on what medication is the safest and most effective option. The prescription is then taken to a pharmacy who will dispense the medication that has been prescribed. You will have to arrange to pay for the medication and the costs are set by the pharmacy.

How can I get the medication that GenderGP doctors prescribe?

There are several ways that we can help you get your medication from our prescription:

  1. We can send your prescription to one of our trusted pharmacy partners and they will send you the medication in the post.
  2. We can send you a paper prescription in the post to an address you specify, for you to take to the pharmacy of your choice and they will dispense the medication.
  3. We can send a treatment summary to your doctor, advising what medication they should prescribe for them to prescribe for you.
  4. If you are on Testosterone, we can prescribe you Nebido and you can arrange for that to be injected every 12 weeks at a clinic where they are supportive of trans rights.

What is the problem?

Each country has their own rules about handling prescription medication, and unfortunately the rules have changed making it difficult for people who live in Sweden and Finland to receive medication through the post.

What has changed?

According to the latest information from the Swedish Medical Products Agency, the prescribing and postage of medical products to Sweden is not possible from countries outside the EEA (European Economic Area). It is still possible from inside the EEA but crucially, not for products containing doping substances such as testosterone. Our latest information says that estrogen and blockers and anti-androgens are exempt from these restrictions, however, we have received reports that these medications are still being subjected to complications at the Swedish border.

This means that our Swedish patients can currently no longer have their medication sent via our European Pharmacy. Due to this change and the tightening of restrictions on the supply of HRT, Swedish pharmacies will now also only accept online prescriptions issued in Sweden.

Finland has adopted the same regulation as Sweden regarding the prescribing and posting of testosterone medication; however, Finnish pharmacies will still accept our paper prescriptions.

How can I get my prescription?

We are able to send your paper prescription to anywhere that you want us to. Some examples that people have asked us to do are the following:

  • Send the paper prescription to them at home and they have taken it to a pharmacy in their own country who is happy to dispense the medication.
  • Send the paper prescription to them at home and they have taken it to a pharmacy in a neighbouring country where the rules are not against gender-affirming care.
  • Have the medication sent to a collection address in a neighbouring country where the import rules allow prescription medication of any kind to be delivered.
  • Have the medication sent to a friend’s address in a country where the medication is allowed to be delivered.

Are there any restrictions on travelling with medication?

If you are wishing to collect your medication from outside of Sweden, the following restrictions apply:

  • You can travel to Sweden with 14 days supply of testosterone as long as you can show the medication is for your personal use.
  • You can travel to Sweden with a 3 month supply of other medications as long as you can show the medication is for your personal use.
  • We are able to provide you with a copy of your prescription (free) and a travelling with medication letter (£25) for these purposes.

What if I am on injections?

All of the medicines that we use can be given to you in different ways. For example testosterone injections can be swapped to testosterone gel, blocker injections can be given as a nasal spray. If you are finding it difficult to access your injection medication, then please ask the team to advise on what the other options are.

What are we doing to help?

We understand how important it is for you to be able to access gender-affirming care, and we also understand that there are sometimes people who want to make this difficult for you. At GenderGP, we are always working with authorities and leaders to give them the best and most unbiased information.

We are also expanding our network of pharmacies and other partners who will help us achieve our mission – for you to be able to live your life more easily.

As we find more solutions and hear of other ways that people have negotiated these difficult times, we will keep you updated.

Where is my medication?

The EU chemist uses DPD to deliver your medication. You will receive tracking information from DPD once your medication has been dispatched, and it can take up to 10 working days for your medication to be delivered. If it has been longer than 10 working days since you received your dispatch confirmation from DPD, please get in touch with Life Pharmacy directly via telephone on +353-61-415-195, or via email at hoganslimerick@lifepharmacy.ie

The medication on my prescription is wrong or needs to be changed

You can request a prescription via our Help Centre – just let us know the details on what needs to be changed and we can arrange this for you.

How long will I have to wait to receive my medication from your EU pharmacy?

It usually takes between 1-3 working days for us to process your request and for the chemist to dispense your medication after they receive our prescription. Once the EU chemist dispatches your medication, it can take up to 10 working days for your medication to be delivered. We strongly recommend that you submit your repeat prescription requests whenever you have four weeks’ supply remaining so that you don’t run out in between requests.

How long will I have to wait to receive my paper prescription?

It usually takes between 1-3 working days for us to process your request and up to 10 working days for delivery. We strongly recommend that you submit your repeat prescription requests whenever you have four weeks’ supply remaining so that you don’t run out in between requests.

How can I contact the chemist?

Our EU chemist, Life Pharmacy, can be contacted via telephone on +353-61-415-195, or via email at hoganslimerick@lifepharmacy.ie

Why can’t I order more than what is written on the prescription?

There are certain regulations that have to be followed for a prescription to be valid and for pharmacies to be able to dispense it. One of these regulations stipulates that some medications can only be prescribed and dispensed in certain quantities. Our EU chemist can only dispense a 1 month supply of testosterone at a time. If you require a 2 or 3 month supply on one prescription, we are able to provide you with a paper prescription in the post as an alternative.

Common questions being asked by patients this week:

Can I pause my prescription?

If you wish to remain under our care, then you need to be subscribed to our service. The subscription covers the advice, support, blood test analysis and the prescriptions as appropriate. If you wish to leave and return later that is fine, but we do not ‘pause’ as such.

Can you continue to offer care (e.g. blood test analysis and advice) if I source my medication from elsewhere?

Subscribed patients can access advice, blood test analysis and prescriptions. You are welcome to use any of these services if you are a subscriber. While we always recommend you get your medication from a regulated pharmacy, we are still happy to help our subscribers with blood tests and advice on dosages etc even if they do not get their prescriptions from us.

As oestrogen and/or blockers are not being restricted, can you send my medication anyway?

We can send your prescription to any pharmacy that you choose. The pharmacy can send you the medication that they are allowed to send, and that varies from country to country. If some of the medication we prescribe is allowed to be sent from the pharmacy to you then we can ask them to do that.

Can you send medication to a PO box?

We do not send medication, we send prescriptions. If the pharmacy that you choose for us to send your prescription to is happy to dispense your medication to a PO Box for you to collect then that is fine. We can check with the pharmacy that they are happy to do that if you can provide proof that you own that PO Box address.

Please get in touch with us via the Help Centre for details on how to contact our partner pharmacies.

Can you send paper prescriptions to a PO box?

Yes, of course, we can send a paper prescription to any address you authorise us to.

Can you send medication to a non-residential address, such as a hotel or business?

Yes, see above.

Can you send my prescription directly to a pharmacy of my choice?

If we have an agreement with the pharmacy, we can send your prescription to them electronically. If not then we can send them a paper prescription.

I want to switch my testosterone preparation - how can I do this?

Just ask the team and they will switch your testosterone to an equivalent dosage.

How do I request my patient file for my doctor to review?

We can prepare a summary for your doctor which would include your Appraisal Pathway Form, your Information Gathering Session report and a summary of your current medication and latest blood tests. We can give your doctor a Treatment Summary to show the treatment we recommend.

Will this affect other countries now that the UK is no longer in the EU?

Transphobia and misinformation seems to know no bounds, but many countries are much more accepting of trans people’s rights. The community needs to stand together and be strong and fight for equality and human rights.

Do you have any friendly pharmacy recommendations I can take my paper prescription to?

The best place to get recommendations is from Internet forums where people are sharing their experiences and solutions.

Where can I book Sustanon injection training?

You can book Sustanon training sessions with a nurse via our Help Centre.

Sustanon Training Sessions

Can I get a refund on my subscription fees?

We can refund you for services that you haven’t been able to receive, but if you have had services during the time of your subscription, then these will be used to pay for the wages of those who have assisted you.

I started my Appraisal Pathway with you but no longer want to continue, can I get a refund?

People who have not moved on to subscription can have their set-up fee refunded. If, however, prescriptions and blood tests and advice and IGS evaluation have all taken place then the set-up fee is non-refundable.

Blog – Pharmacy

Keep up to date with the latest pharmacy news at GenderGP.

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