Guide to private healthcare services for Gender Identity Care

NHS Gender Identity Clinics (GIC) are specialist services which involve diagnosis and care from a number of clinicians, typically Psychiatry, Medicine, Psychology and Surgery. 

We are aware that the long NHS waits for GIC services, may result in patients looking at private options. This document is meant as a guide for patients when looking at private services, as a way of making objective judgements about the quality of care on offer. We do not endorse any specific private services for care. The document is by no means exhaustive and is meant as a guide only. It does not guarantee that SHS is able to engage with shared care monitoring or prescribing.

Your GP can refer you to any of the English Gender Identity Clinics for diagnosis, support, talking therapies, medication, and surgery, in order to support gender dysphoria or transition. It is also possible to self-refer to some of the English Gender Identity Clinics – see their websites for details. 

The clinics are based in London, Exeter, Sheffield, Leeds, Newcastle, Northampton, and Nottingham. There are plans for new clinics to open in Greater Manchester and Merseyside.

https://www.nhs.uk/live-well/healthy-body/how-to-find-an-nhs-gender-identity-clinic/

There are additional services for patients who are registered in Scotland, Wales and Northern Ireland.

Services will be happy to consult with you if you are looking for a greater understanding of your individual gender identity needs, if you are unsure re transition options or what treatments may be available to you, or if you are certain of your intention to transition. You may be aware that these NHS clinics have long waiting times at present; this can be upwards of 2-3 years for a first assessment. In the interim GP services and other support networks, may enable you to begin your process of social transition such as changing your name and pronouns. 

Private Gender Identity Clinics are accessible, often without the need for a referral letter from a GP. If a referral is needed, please discuss with SHS.

The provision of private services is less regulated than NHS services and there is a wide range of options available. The quality of these services can be difficult to assess and the following advice is a guide to support you when looking for a GIC.

Clinicians working in the Private Sector should all have individual Medical Indemnity Insurance policies in place to cover their clinical care in case of Medical Negligence, and patients can make enquiries to ensure that this is in place. This would have to be done via the Clinician directly, there is no central database to check this unfortunately.

Private GIC Services

A quality GIC service should be Care Quality Commission (CQC) registered. This can be checked on the CQC website https://www.cqc.org.uk/

Services should include:

Psychiatrist

• GMC (General Medical Council) registered on the specialist register – check online on the GMC website open to public https://www.gmc-uk.org/
• UK-based – you may have to ask this of the service directly
• Preferably also working in UK NHS GIC or Psychiatry services – there are more ‘checks’ re ongoing quality of care, appraisal, keeping up to date with new developments in care etc, if staff hold NHS clinical contracts

PLUS

Psychologist

• All practitioner psychologists must be registered with the Health and Care Professions Council (HCPC)
• Some may have an additional secondary accreditation often related to additional skills or experience, such as with the BABCP (British Association for Behavioural and Cognitive Psychotherapy (BABCP) for CBT, AFT (for family therapy) or British Psychological Society (BPS)
• If the therapist has been employed by the NHS, government organisations or institutions (e.g. University, armed forces etc) or if they are officially recognised by BUPA or another insurance provider they will have already met certain recognised standards, experience and requirements

MAY INCLUDE

Endocrinologist

• GMC registered on the specialist register – check online on the GMC website open to public https://www.gmc-uk.org/
• UK-based – you may have to ask this of the service directly
• Preferably also working in UK NHS GIC or Endocrine services – there are more ‘checks’ re ongoing quality of care, appraisal, keeping up to date with new developments in care etc, if staff hold NHS clinical contracts

Surgeon

Gender Affirming Surgical Services should all be Care Quality Commission (CQC) registered.

There are some NHS Surgical Services operating in this area though there are long waiting times and current gaps in service – particularly for Female to Male Surgical transition.

Private Surgery options are available – it can be difficult to judge the quality of these surgical services, but using similar criteria to the above mentioned, plus recommendations from previous patients would be a good place to begin. The Surgeons involved are normally Plastic Surgeons or Urology Specialists. Many of these clinics are based abroad, we cannot advise as to the quality or regulation of any service outside the UK.

Other Private Gender Clinics

Other healthcare providers have set up Gender Clinics. These should all be CQC registered if they are providing healthcare.

Staff working in these clinics include General Practitioners (GPs) who sometimes work as General Practitioners with an Extended Role (GPwER). The Royal College of General Practitioners describes GPwER as: 

A GP who undertakes, in addition to their core general practice, a role that is beyond the scope of GP training and the MRCGP (Member of the Royal College of General Practitioners exam), and requires further training. The extended role is typically undertaken within a contract or setting that distinguishes it from standard general practice. There is currently no formal accreditation programme in place for GPwER. 

As Gender Identity treatment is a specialist area of clinical practice, GPwER should be supervised by a Clinical Specialist in order to carry out this role. Ideally, this would be a Psychiatrist or Endocrinologist working at the level specified previously in this document. Annual appraisal for the GPwER should include a specific review of the work undertaken in this specialist area.

There are also Nurse Specialists working in Gender Clinics, they should be supervised by a Clinical Specialist in this field, either a Psychiatrist or Endocrinologist working at the level specified previously in this document.

This document provides a guide and framework to assess the quality of Private Services. It is by no means an exhaustive list and is designed to enable patients to make informed judgements about the care providers they are choosing. It does not guarantee that SHS is able to engage with shared care monitoring or prescribing.