transition-uk.md 18 KB
Name change -- Children (NHS care) -- Adults (NHS care) -- Private care
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
- They have prescribed full HRT to children in the past! Go to the GenderGP 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 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 - 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 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.
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 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
- 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.
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 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 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.
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
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.
Use one of these providers
GenderGP (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.
GenderCare (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 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.