Medical transition: an overview for healthcare professionals

Each person’s medical transition will be different, however it is useful for clinical staff to be aware of the most commonly accessed forms of transition related care. Please note that this section refers to the care that can be accessed by trans adults over the age of 18 and does not reflect what is available to children and young people.

This page is part of TransActual’s Trans Inclusive Hospital Care resource. If you’re trans or would like to read about medical transition in more depth, take a look at our medical transition pages.

Trans women and non-binary people assigned male at birth

Available on the NHS:

  • Oestradiol – used for the feminising effects, typically taken for life.
  • Finasteride – can be used prevent hair loss in trans people of all genders.
  • GnRH agonist – can be used to suppress testosterone, typically given as an injection. Not taken after surgeries involving orchidectomy.

Accessed outside the NHS:

  • Progesterone – taken by some in combination with Oestradiol for perceived additional effects.

Available on the NHS:

  • Vaginoplasty – creation of a vulva, clitoris and a vagina, using penoscrotal skin and/or small or large intestine segments. The intestinal technique is rarely used in NHS treatment, the penile inversion method is more common. The process involves an orchidectomy and is typically completed in one procedure. Read more about vaginoplasty in the GDNRSS booklet.
  • Vulvoplasty – creation of a vulva and clitoris using penoscrotal skin. Some people choose to have Vulvoplasty without vaginoplasty. Read more about vulvoplasty in the GDNRSS booklet.
  • Orchidectomy – removal of the testes, typically in combination with Vulvoplasty or vaginoplasty. However, some people will have orchidectomy as a stand alone procedure.

Sometimes accessed privately:

  • Phonosurgery
  • Breast enlargement
  • Facial feminisation surgery
  • Lipoplasty or body contouring
  • Hair transplant
  • Tracheal shave

Trans men and non-binary people assigned female at birth

Available on the NHS:

  • Testosterone – used for the masculinising effects, typically taken for life.
  • Medroxyprogesterone acetate – sometimes used to suppress menstruation whilst waiting for testosterone treatment to achieve the same effect.
  • GnRH agonist – sometimes used to suppress oestrogen, typically given as an injection. Not taken after hysterectomy with oophorectomy.

Available on the NHS:

  • Bilateral mastectomy
  • Hysterectomy
  • Phalloplasty – A procedure to create a penis and masculinise the genitals. Typically split into 3 or more procedures and can include hysterectomy, bilateral salpingo-oophorectomy, urethroplasty, vaginectomy, placement of penile prosthesis, scrotoplasty with placement of testicular prosthesis, and glans sculpting. Donor skin, nerves and blood vessels from the forearm, thigh, or abdomen are used to create the penis. Read the GDNRSS booklet about phalloplasty
  • Metoidioplasty – A procedure to create a penis and masculinise the genitals. Sometimes completed in one procedure, sometimes completed in multi-stage procedures. It can include hysterectomy, bilateral salpingo-oophorectomy, vaginectomy, and scrotoplasty with placement of testicular prosthesis. The penis is created using clitoral tissue. Techniques vary, but a graft may be taken from the mouth or the forearm for use in lengthening the urethra. Read the GDNRSS booklet about metoidioplasty.

Sometimes accessed privately:

  • Facial masculinization surgery
  • Lipoplasty or body contouring

Errors or omissions

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A disclaimer: TransActual do not provide medical, health, or legal advice. The content of this page is intended for information purposes only. It is not a substitute for medical advice, diagnosis or treatment from a medical professional. It is not a substitute for advice from a legal professional. We strongly suggest you consult a healthcare professional or legal professional for specific advice about your situation. TransActual do not advocate or recommend the purchase of any specific product and we do not endorse or guarantee the credentials or appropriateness of any health care provider, any product or any provider of insurance and legal services.

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