Choosing a gender service

To get gender-related medical treatment in the UK, you normally need to be seen by a specialist service, which is called a gender clinic.

One of the first things you’ll need to consider is which gender clinic you would like to work with.

You could be seen by an NHS gender clinic. For most people, this is free of cost (except for prescription costs in England). However, the waiting times for NHS gender clinics can be very long. At some clinics, patients have been waiting over eight years to be seen (as the current date in 2025).

You could be seen by a private gender clinic – this is one you pay for yourself (or sometimes is paid for by a medical insurance scheme).

Due to the long waiting times for NHS services, many people opt to be referred to both a private clinic and an NHS clinic. The private service will be able to see you and offer treatment while you are on the wait list for the NHS clinic. This can help you get access to treatment much more quickly – if you can afford to pay for it. You can’t use a private diagnosis to skip diagnosis by the NHS – the NHS gender clinics want to do their own diagnosis of you.

If you’re a young person, you can learn more about the services you can choose from on the National CYP Gender Referral Support Service website.

If you’re an adult, the clinics you can choose depend on where the GP you’re registered with is based.

In Cymru (Wales): Under NHS Wales, you do not have a choice of which clinic you are seen by. You will be seen by the Welsh Gender Service.
In England: On the NHS in England, you have a choice of multiple NHS gender clinics. You are free to choose which one you would like to see you. It’s important to think carefully about this choice as it may affect how long you wait to be seen, the time between appointments, and the exact details of the support that is available to you. You can find a list of the NHS gender clinics available in England on our NHS gender clinics page.
In Northern Ireland: Under HSC NI, you do not have a choice of which clinic you are seen by. You will be seen by the Brackenburn Clinic.
In Scotland: Under NHS Scotland, you do not have a choice of which clinic you are seen by. You will be seen at a local clinic based on which local Health Board your GP surgery is based in. You can find out which Health Board you live in on our Local Healthcare Organisations page.

If you’re moving temporarily to another place – for example, if you’re moving temporarily to be a student at university – you may have the option of remaining registered with your current GP and making a ‘temporary registration’ at a GP surgery near to where you are currently living. This can be useful if you want to stay able to be seen by a particular gender clinic of your choice, but want to access local GP services in another area.

If you do move from one UK nation to another while you are on the waiting list for an NHS gender service, this may affect how long you wait to be seen. You can read more about this on our Gender Clinics page.

If you are looking for a private gender clinic, look at our Private Care page to see what’s available.

Due to the long waiting times, Integrated Care Boards in England have started to fund bridging prescription clinics. These are clinics where GPs will, if it’s appropriate for you, prescribe you hormone therapy whilst you wait to be seen by an NHS gender clinic. For example, people in the London Borough of Southwark can access The Bridge.

These types of clinic are still rare – your local support group will be able to tell you if there’s one in your area.

If you’re choosing a gender service, you could research:

How long is the waiting list? Are you likely to be seen promptly by the service? Are they willing to provide information about how long you might have to wait? You can find information about wait times for NHS services on our NHS gender clinics page.
Will they confirm your referral? Will you get written confirmation you have been added to a waiting list?
What’s their reputation like? Do past patients recommend the service?
Do they perform regular blood monitoring and testing? Will they regularly monitor your health if you are prescribed hormones?
Will your GP work with them? If they ask your GP for blood tests or to prescribe, will your GP agree to this? You can ask your GP ahead of time about this question.
Do they provide support to your GP? If your GP has questions around your medical care, can they contact the gender clinic quickly and easily to get expert advice?

For a private gender clinic, you might want to check:

Are the prices reasonable? Do they have fees or subscriptions and are you tied into a contract for a specific amount of time? How do their pricing structures compare to other services? You can find out about fees and costs for private gender services on our private gender clinics page.
Are they offering a genuine service? Are they able to offer you actual medical treatment like hormones or surgery? Will they only offer counseling – or just conversion therapy (therapy intended to ‘fix’ you, which is ineffective)?
Are they based in the UK? Are they subject to UK regulations and registered with UK medical professional bodies?
What is the level of contact? Do they respond quickly to questions? How often will they check in with you?
Do surgeons take their referrals? If they write a letter recommending you for surgery, will surgeons accept it?

A well-run gender clinic will be happy to help you with questions on these subjects. You may also find useful information about other people’s experiences of gender clinics by searching online forums like /r/transgenderuk for information.

Some trans people would prefer not to publicly change their gender presentation before starting hormones. If that’s your preference, you might want to check if gender clinics you’re choosing between will be okay with you doing that. Some gender clinics will ask for evidence of public changes (such as a deed poll name change) before they will approve hormone therapy.

If you would like your GP to agree to shared care with a private gender service, they may be more likely to do this if the gender service is staffed by clinicians who also work for NHS gender services. Private gender services will normally list which staff they employ, and you can search their names to find out whether they are also employed by the NHS.

If you’re expecting you might want to get a Gender Recognition Certificate (GRC) later on, check whether the gender clinic has staff who are qualified to provide evidence you need as part of your GRC application (Medical Report A). You can check who is able to write this evidence on the GOV.UK website. If you’d like to learn more about Gender Recognition Certificates, take a look at our page on the Gender Recognition Act.

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This page is based on information originally posted on genderkit.org.uk with permission.

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Page last updated:

9 December 2025