[Name change](#namechange)                                        --
[Children (NHS care)](#children)                                  --
[Adults (NHS care)](#adults)                                      --
[Private care](#private)



## Name Change {#namechange}

*This is for UK \*citizens\* only.* If you're resident in the UK, but
not a citizen, you still have to go through your own government in the
countr\[y/ies\] in which you are a citizen of. See:
<https://www.gov.uk/browse/citizenship/citizenship>

Go to any decent solicitor and arrange to have your legal name changed
via *deed poll*. You can also use this to get your legal title changed
(E.g. Mr. to Ms., or Ms. to Mr., etc).

You don't have to get a lawyer to do it, you can do it yourself too.
This page has a guide for it: <http://bikkit.co.uk/deedpoll.html>

**If you do it correctly as per that guide (if you're doing it yourself
without a solicitor) and the deed poll gets rejected, note that this is
\*discrimination\* according to the Equality Act 2010. Your deed poll is
equally valid whether you write it yourself or get it from a
solicitor.**

It's cheap, and anyone (even cis people) can do it, with little or no
scrutiny. You then contact e.g. bank, utility providers, landlord /
mortgage provider, etc to get your name/gender changed in their records.

See: <https://www.gov.uk/change-name-deed-poll/overview>

### Getting a new passport (with gender marker changed)

The UK government has guidelines:
<https://www.gov.uk/government/publications/applying-for-a-passport-information-for-transgender-and-transsexual-customers>.

This can also be used to get a new passport, in your new name, with your
gender marker changed.

You should present as your desired gender, in your new passport photo;
basically, you should look in that photo like you think you're going to look
the next time you need your passport (e.g. verifying your ID when you register
a bank account, or go travelling, etc). So if you're a trans woman, present as
a woman in the new passport photo. If you're a trans man, present as a man in
the new passport photo. NOTE: non-binary people are not legally recognized in
the UK; passports are only issued with M or F gender markers on them. This is
a current issue in the UK, which ought to change (E.g. X gender marker on
passports).

You can find photo booths (for taking passports) in or around most supermarkets
or in shopping centres. These photo booths are often intended for the purpose
of passport photos, and photos for other official ID in the UK.

**You need doctors authorization to change your gender marker on your
passport.** This does not have to be at a gender clinic. You can just
ask your GP to write a letter for you, and give you the letter,
confirming that you are transitioning. NOTE (non-binary people): you can
only change your passport to say either Male or Female. The UK does not
legally recognise non-binary people at present, unfortunately.

Going through your GP is the fastest route, if you're on a waiting list
(private or NHS, since both usually have waiting lists) for trans care.

Get your doctor (e.g. GP) to write something like this (substitute
man/woman as necessary):

**The letter from the doctor should say your \*NEW\* name, not your old
one. So for instance, if you're a trans man and your new name is Gary
Metcalfe, then the letter should say Mr. Gary Metcalfe on it, when
referring to you. If you're a trans woman and you're new name is
Annika Greer, the letter should refer to you as Ms/Mrs Annika Greer.**
(non-binary people are not legally recognised in the UK, and passports
can only say male/female on them. This is something that we as a
community need to campaign to change)

*United Kingdom Passport Agency,\
London Passport Office,\
Globe House,\
89 Eccleston Square,\
London,\
SW1V 1PN\
\
Subject: Mr/Ms/Mrs \[Your First Name\] \[any middle names\] \[Your
Surname\]\
\
To whom it may concern,\
\
The above named is a trans man/woman (female-to-male/male-to-female) who
\[wishes to receive health services related to gender reassignment and
is making strides to do so / is receiving private gender reassignment
health services via \[clinic\] since \[date\]/ is receiving NHS gender
reassignment services since \[date\]\].\
\
I can confirm that Mr/Ms/Mrs \[Your Surname\] has made an official name
change via deed poll process and has been living successfully in the
male/female role.\
\
In my opinion the patient is stable and permanent in his/her chosen
gender role and I would be grateful if you would issue a male/female
passport to him/her in accordance with this.\
\
Yours sincerely,\
\[Doctors Name Goes Here\]*


### Gender recognition certificate

Deed poll only changes your legal name/gender *currently in use*, but it
does not alter your birth certificate. It also does not alter your death
certificate (if you die, your death will be recorded according to your
birth certificate). If you go to prison, quite often they will send you
to the *wrong prison*.

In 2004, the UK government started allowing transgender people to update
their birth certificate, by letting them acquire what's known as a
*gender recognition certificate*.

To get this, you must first complete the *deed poll* process, and you
need to live full-time in your desired gender for *at least 2 years*,
with proof that you have done so (name on mortgage/rent, utility bills,
etc, and/or testimony from others). You usually also need an approval
letter from your gender clinic, whether NHS or private.

See: <https://www.gov.uk/apply-gender-recognition-certificate/overview>.



## Children (NHS care) {#children}

**There is a private clinic in the UK which prescribes HRT quickly,
including to children. You can request blockers or full HRT, even at age
12. They have prescribed full HRT to children in the past! Go to the
[GenderGP](https://gendergp.co.uk/) clinic. You do not have to go to
them physically, you can do everything over the internet, and they are
licensed doctors. If you want \*prescribed\* HRT (or just blockers, if
that's what you want, but they also will prescribe full HRT if you want
it), then this is your best bet. The NHS, by comparison, will make you
wait, and by that time you're screwed because you have breasts. Or a
beard. Or a deep voice. Or periods. Don't delay! These people are here
to help you.**

_You need to self-medicate on puberty blockers, purchased on the internet_

_You will not get puberty blockers before your puberty damages you if using NHS. The only way to guarantee it is to self-medicate. The supplier that you use will ship the blockers to you quickly, usually within a week._

_Go to our [HRT self-medication](hrt-internet.md) page for information about how to get HRT on the internet (also includes some advice on dosages). (also see note about GenderGP above, if you don't want to self-medicate)_

If you are of puberty age, and you're trans, it's vital that you start
on puberty blockers immediately. Go on the NHS to get them, but be
warned: **you will be severely delayed in starting it, because of
underfunding and understaffing of transgender services on the NHS. You
can blame our right-wing government for that, for not having the
foresight to provide adequate additional funding for the NHS in the
UK.**

NHS guidelines say that children of puberty age should be given puberty
blockers until they are 16, at which point they can also take estradiol
or testosterone, depending on which way they're going.

### PARENTS: this is IMPORTANT!

You need to make sure that your child **DOES NOT** go through their
genetical puberty, the one that their body is programmed to go through.
It makes most trans people depressed, or worse, suicidal, especially as
they get older. If you love your child, you will let them take hormones,
including hormone blockers, as early as physically possible.

The NHS is *SLOW* and your child will likely go through most of their
puberty by the time they get blockers. You can purchase blockers on the
internet. Check out our [self-medication HRT page which shows how to
purchase hormone blockers on the internet](hrt-internet.md) - NOTE: most
private trans care providers won't see children, so you're stuck with
the NHS, and you're stuck with self-medication.

DO NOT DELAY. **You have a moral responsibility as a parent to ensure
the safety and happiness of your child as they grow up. If you allow
them to go through their genitical puberty, you could very well end up
with a dead child. Transgender people under the age of 25 are 5x more
likely to commit suicide than their non-transgender peers, according to
official statistics. This is directly related to trauma brought about by
their puberty (if they went through their self-mutilating genetical
puberty), and abuse that they might receive because of that, especially
if they start \*not passing as their desired gender\* as a result.**

**We are deadly serious about this. No child should ever be forced to
suffer body dysphoria.**

### Moving on\...

Most private clinics only see adult patients (17 or older, in some cases
21 or older). You will need to [come out](coming-out.md) to your parents,
because you typically need parental permission.

Book an appointment with your GP, and say that you are transgender and
wish to transition. Whether trans woman, trans man or non-binary, you
should then ask your GP to refer you to a Gender Identity Clinic.

### Some GPs are assholes. Please report them. Also report the awesome ones!

Even with private care, you'll still use your GP for a lot of things
probably, including blood tests and endocrinologist referrals, unless
you get those privately too. The following external website maintains a
register of good and bad GPs:\
<http://transfigurations.org.uk/trans-friendly-doctors/>

Get a blood test BEFORE endo, and take the results with you.

A trans person in the UK who had a bad bad GP spoke to their local
elected MP and got her to write to the government. [This letter from the
UK Government's Department of Health outlines GP requirements and states
that they are required by law to immediately refer you to a gender
clinic when you request gender transitioning
services](/common/gp_letter.pdf).

When you go to that GP, regardless of whether you think it will go well
(most GPs are OK), take a printout of that letter with you just in case.

Thanks go to Gina Denham of the
[Transpire](http://transpiresouthend.org/) support group for sharing
this letter.

### Going about the process

Here is a list of NHS gender identity clinics (for UK residents):
<http://www.nhs.uk/Livewell/Transhealth/Pages/local-gender-identity-clinics.aspx>
The clinic that you choose will send you some forms to fill in. Fill
them in ***and make sure to book the earliest appointment possible***.

Children are not currently given full HRT, in the UK or even most
countries. If you're a trans woman, you might be able to get
antiandrogens (puberty blockers) which block testosterone; this blocks
your genetic puberty (e.g. they block body/facial hair development,
block voice deepening, etc). For trans men, you might get prescribed
antiestrogens which block breast development, etc.

Teenage trans children are not typically given estrogen until they're
17. Teenage trans men are not typically given testosterone until
they're 17. Testosterone is also a controlled substance in most
countries, which make it more difficult to self-medicate on it.

For non-binary children, we're not sure. You should probably take
puberty blockers to block your natural puberty, and then decide what you
want to do later. Or you might not. It's always different because there
is a lot more variance with non-binary people.

Genital surgery is not typically provided for trans children. They must
first become adults.



## Adults (NHS care) {#adults}

Go to your GP and say that you are transgender. Some doctors are
ignorant, so you need to make sure to explain what this means, and that
you wish to transition your gender. Ask to be referred to a Gender
Identify Clinic. Here is a list:
<http://www.nhs.uk/Livewell/Transhealth/Pages/local-gender-identity-clinics.aspx>


### Some GPs are assholes. Report them if they are. And report the awesome ones.

Even with private care, you'll still use your GP for a lot of things
probably, including blood tests and endocrinologist referrals, unless
you get those privately too. The following external website maintains a
register of good and bad GPs:\
<http://transfigurations.org.uk/trans-friendly-doctors/>

You should get a blood test BEFORE seeing an endocrinologist, and take
your test results with you.

A trans person in the UK who had a bad bad GP spoke to their local
elected MP and got her to write to the government. [This letter from the
UK Government's Department of Health outlines GP requirements and states
that they are required by law to immediately refer you to a gender
clinic when you request gender transitioning
services](/common/gp_letter.pdf).

When you go to that GP, regardless of whether you think it will go well
(most GPs are OK), take a printout of that letter with you just in case.

Thanks go to Gina Denham of the
[Transpire](http://transpiresouthend.org/) support group for sharing
this letter.


### Going about the process

If you live in or near London, the Charing Cross clinic is very good.

Be warned that the waiting lists at most clinics is about 2 years on
average, for your first appointment. This is because attitudes have
shifted in positive ways towards trans people, so more people these days
are transitioning; this means that the NHS is under more strain. Funding
hasn't increased much, and the NHS isn't equipped to handle a 500%
increase in people transitioning over the last 5 years.

[Private transitioning services](private-care.md) should also be used
simultaneously, if you can afford it. You can pay for it with health
insurance, or you can self-fund it. You can use private care while on
the NHS waiting list, and then ditch the private care once you are being
treated by the NHS.

You will then later on receive a letter from that clinic. Give your
details to that clinic, and make sure to book an appointment with them.
Then wait for your appointment.

What to expect from UK NHS trans care:

-   HRT (hormone replacement therapy)
-   voice training
-   hair removal
-   surgery
-   therapy

There is gatekeeping on the NHS, but it's light. However, expect *long*
waiting times. You might be waiting 5 years from now, for surgery. And
about 2-3 years for hormones.

We recommend using private care while on the NHS waiting list. Private
services also have (lower) waiting lists, and you can DIY a lot of your
transition before then (or if you can't afford private care). For
instance, refer to our [HRT self-medication guide](hrt-internet.md).




## Private care {#private}

### You'll still be using the NHS

Even with private care, you'll still use your GP for a lot of things
probably, including blood tests and endocrinologist referrals, unless
you get those privately too. The following external website maintains a
register of good and bad GPs:\
<http://transfigurations.org.uk/trans-friendly-doctors/>

Get a blood test BEFORE seeing an endo, and take the results with you.

### You should still self-medicate

Private trans care providers still have waiting lists, and still make
you wait a while (not very long) for HRT after you first see them, in a
lot of cases.

If you wish to start HRT while waiting for services with one of these
providers, refer to our [HRT self-medication guide](hrt-internet.md)

### You should also get on the NHS waiting list

You should only use private care while on the NHS waiting list. [You
should get on the NHS waiting list as soon as possible.](adults.md)

### Use one of these providers

#### GenderGP (UK)

<https://gendergp.co.uk/>

Informed consent clinic in the UK. Provides services over the internet
(email, video call, etc) or in person. Prescribes HRT quickly.

**They treat children. They even prescribe HRT to children below the age
16; this includes full hormone treatment, not just blockers.**

They provide advice, and they can also refer you to surgery and can help
you get on NHS waiting list etc. Very good clinic, especially if you're
in an awkward area of the UK where transport links to traditional
clinics makes transitioning unrealistic and/or unaffordable through a
regular GIC.

This clinic has proven to be controversial, precisely because they are
providing decent care that patients want. [Channel 4 even covered
them](https://www.youtube.com/watch?v=cf_EGumQRxQ).

#### GenderCare (UK)

<http://gendercare.co.uk/>

This is very good and they don't gatekeep much. Their waiting lists are
relatively rather high (as of August 2017) due to high demand,
so it might be better to use GenderGP or wait on NHS referall.

Go to [gendercare.co.uk](http://gendercare.co.uk/) for details.

Book an appointment with Dr. Lorimer and Dr. Seal.

### \*\*BAD\*\* providers which you should \*\*AVOID LIKE THE PLAGUE\*\*

TransHealth Ltd, or any clinic run by Dr. Richard Curtis. His clinic is
heavy with gatekeeping, and refuses to prescribe injectable estrogen or
oral estrogen. They also regularly refuse to prescribe spironolactone.
They will only prescribe gels or patches for estrogen, and they will
refuse to authorise surgery if you tell them that you self-medicate or
use alternative sources for HRT (e.g. NHS GIC for injections. They
won't prescribe GnRH (injection to shut down hormonal system, to block
testosterone) or cyproterone acetate.

They regularly gatekeep people for several *psychotherapy* sessions
before prescribing HRT, and they are more likely than any other GIC to
actually *refuse* to prescribe HRT for gatekeeping reasons (e.g. they
might decide that you are *not trans*).

They are also heavily biased against non-binary people.

***DO NOT USE Dr. Curtis's services.***

