Common healthcare issues (and what to do)

Here’s a quick guide to some of the common issues faced by trans people within the healthcare system, and what to do about them.

Some GP surgeries will not allow you to register with them. They’re allowed to do this, but only if they have a good reason. They are required to tell you what the reason is. Valid reasons include:

  • The surgery has been given permission to stop accepting any new patients – this is called having ‘closed registration’.
  • The surgery has chosen to only accept new patients living in a particular area – this is called a ‘catchment area’.

In England, Scotland, and Wales, a GP surgery is not supposed to require you to show ID documents, proof of your address, or proof of your immigration status to register you with the surgery. It’s not a valid reason to deny you registration. 

(Your GP surgery is expected to ask you for ID documents to register you for the NHS App and other digital services – but can’t require them for patient registration.)

If your GP surgery says that you must show them your ID documents, proof of address, or proof of immigration, show them one of these pages:

If you’ve tried showing the GP surgery these pages, and they continue to tell you to provide ID or evidence, you could make a complaint about them. If you’ve been told you can’t register because of your immigration status, you can also phone the Doctors of the World Advice Line for help and guidance. 


In Northern Ireland, you are normally required to show ID documents and/or proof of immigration status as part of registering with an NHS GP surgery. You can find full details of how to register with a GP and what evidence you will need to provide on the HSC NI BSO website.

Read our Seeking Support From Your GP resource for information on talking to your GP surgery.

Some NHS systems may require that you have updated your gender marker to be ‘M’ to use the title ‘Mr’, and others may required your gender marker to be ‘F’ to use the titles ‘Ms’, ‘Mrs’, or ‘Miss’.

Read our Seeking Support From Your GP resource for information on talking to your GP surgery about changing your gender marker.

First check to see if it is possible to refer yourself to the gender clinic. You can find this information on our gender clinics page.

If your GP is unsure what the next step should be, you can direct them to the advice for GPs published by the General Medical Council – it is their responsibility to read this information and to be familiar with it. If you’re still not able to get a referral, you may find contacting the service you want to be referred to can help.

Your GP should make a referral for you, regardless of:

  • your mental health diagnoses
  • a diagnosis of autism spectrum condition or ADHD you have
  • high BMI / obesity
  • your nationality or immigration status
  • chronic health conditions
  • disability
  • learning disorders or disabilities
  • whether you smoke or vape

You can show our page on Making a Referral to your GP, contact the NHS gender clinic to ask them to confirm that a referral is appropriate, or use our suggestions for Handling problems with a GP or a GP surgery below. 

If your GP says that they will not make a referral for you because of your nationality, immigration status, or residency in the UK, or require you to prove these things first, show them this clear guidance from the British Medical Association.

First speak to the person who monitors your hormone therapy – usually your GP.

If they are unsure how to help, you can suggest they get advice from one of these sources:

  • NHS prescribing policies for trans people
  • An endocrinologist who originally recommended your hormone therapy
  • The endocrinology team at an NHS gender clinic
  • A local NHS endocrinology team if there is one in your area with expertise working with trans patients

If you have problems with your gender surgery referral, the NHS Gender Dysphoria National Referral Support Services (GDNRSS) have a Single Point of Access support line that you can call for information and advice about your referral.

01522 857799 and agem.gdnrss@nhs.net (Monday to Friday, 9am to 5pm)

More information about GDNRSS

If you’re over 18, UK based and have a letter from an NHS gender clinic asking a GP to prescribe you HRT, we have a resource for you.

Go to: My GP is refusing to prescribe my HRT: What can I do?

GPs are free to decide not to offer bridging prescriptions for a number of reasons, such as if you do not meet the criteria listed in the GMC guidance, or because they do not feel comfortable doing so. Many requests for bridging prescriptions are unsuccessful.

You can read about potential next steps in our bridging prescriptions resource.

The following guides are also available:

In some local areas, there are restrictions on who GPs can make shared care agreements with, but normally your GP can choose whether to offer you shared care.

To help them make this decision, you can offer your GP information such as:

If your GP does not feel comfortable prescribing for you, you can ask your private endocrinologist to write prescriptions for you instead. Your NHS GP may still be willing to perform blood testing for you, but if not, you can find other blood testing services on our hormones and blood testing page.

If you think it might be helpful to know what has been written in your medical records, you have a legal right to ask for this information. You can find out how to get access to your medical records on these pages about the process in England, Northern Ireland, Scotland, and Wales.

If you’re having a problem with the care you’re receiving from a GP, start by talking to the reception staff of the GP surgery by email or phone call.

Read our Seeking Support From Your GP resource for more information on talking to your GP surgery.

Handling problems with a GP or a GP surgery

If a GP or the other staff at your GP surgery are unhelpful or supportive, you might want to consider using some of these ideas for next steps.

The practice manager is the head of the GP surgery. They aren’t normally a GP themselves, but they are responsible for managing the day-to-day running of the GP surgery, so have the knowledge and power to fix many problems.

You can speak to the practice manager at your GP surgery by:

  • Calling the surgery and asking to speak to the practice manager. This is often the quickest and easiest way to get a response if you’re experiencing problems. You might be asked to wait for a call back.
  • Going to your GP surgery, and asking to speak to the practice manager in person.
  • Emailing the GP surgery and asking that your email be read by the practice manager.
  • Posting a letter to the GP surgery (or delivering it to the reception desk in person).

In NHS England and NHS Scotland, you have the right to ask for an appointment with a different GP if you want to. You don’t have to give a reason for asking to see a different GP, and your GP surgery is expected to try to accommodate this request. If the reception staff at your GP surgery aren’t aware of your right to do this, you can show them these links:

In Wales and Northern Ireland, while this right isn’t guaranteed to you in the same way, you can still ask for an appointment with a different GP at your surgery, and you can expect that this will normally be done.

You don’t need to justify why you want to see a different GP, or don’t want an appointment with a particular GP, but you may not be able to see the GP of your choice if they are busy or on leave at the time.

If you’re having problems with the whole GP surgery, you can also switch to a different GP surgery, without having to get permission from your current GP surgery.

You have a right to do this – it’s specifically mentioned in:

To change your GP surgery, follow these instructions:

Some GP surgeries may tell you that you are not able to register with them. They might be correct – but they also might not be. You can read more about this in the A GP surgery won’t let me register with them section.

You do not need to tell your new GP surgery why you want to leave your old GP surgery.

Some trans community organisations have created lists of GPs that they have had positive experiences with in the past, which might be helpful when you’re choosing a new GP surgery, though this doesn’t guarantee that a GP will be helpful to you. Many of these lists are available on the Trans Healthcare Intel website.

Making a complaint

Trans people are entitled to the same quality of care as everyone else. If you experience discrimination when accessing healthcare, or are not given proper support, you can complain. 

Read TransActual’s Why should you complain about your GP? article.

The first step is to tell the healthcare service informally that you are having a problem. For example, if you’re having a problem with a GP surgery, you could speak to the practice manager.

It’s important to think about what would help you to feel comfortable and confident when explaining your problem. Would it help you if:

  • you had someone with you for emotional support?
  • you had someone else to speak on your behalf?
  • you wrote down a list of points to cover to ensure don’t you forget anything?
  • you spoke to the service through email or letter than in person?
  • you could discuss the problem in a private room where your privacy is protected?

If you aren’t able to get the problem resolved, or if you want it to be on record, you can use a formal complaint process.

Going through the process of making a complaint can be draining. It’s a good idea to get help at this stage, or to ask someone else to lodge the complaint on your behalf, particularly if you’ve not been through the process before. You can find information about services that can help you with your complaint further down this page.

It is important to consider making a complaint quickly as some nations have time limits after which your complaint will not be accepted.

You can complain directly to:

  • either, the healthcare provider – for example, the GP surgery or the hospital that provided the treatment.
  • or, to the NHS organisation responsible for the healthcare in your local area. If you’re not sure who this is, read our Local healthcare organisations page.

For example, if your complaint is about how you were treated at a GP surgery, you can complain either to the GP surgery you had a problem with, or to the ICB, Health Board, or Primary Care Network that provides all the GP services in your local area.

All NHS healthcare services have a system for handling official complaints. You can normally find information about how to make a complaint on their website – for example, the website of the GP surgery or hospital that treated you (or didn’t treat you) should have information about how to make a complaint. If you aren’t able to find this information on their website, ask staff at the service how to make a formal complaint.

Sending a complaint by email is often quicker, though sending a letter through the post may be seen as more official. If you send it by post, keep a copy of the complaint for your own records. 

In your complaint you should make it clear what the problem is and how it affects you, and what you want to be done about it (for example, prescription of hormones, and potentially a review of how trans patients are treated in the practice). You should make sure that you give them contact details, and discuss any ways in which you feel your GP, or other staff members at your GP practice, have been transphobic or otherwise discriminatory towards you. 

If you have complained to either the provider or the health board and are not happy with the outcome, you can escalate your complaint to the national Ombudsman. 

There is information about how to do this on the website of each national ombudsman: 

If your complaint is about a specific person who has behaved inappropriately you can complain to their professional body:

In all parts of the UK, you can also complain about data protection issues to the Information Commissioners Office. You might want to do this if private information about you or your health conditions has been shared with someone who should not have access to it.

In most of the UK, you can also give feedback about the care you’ve received (or not received) to the independent regulator of NHS healthcare services:

You can’t make an official complaint about a healthcare provider to these regulators, but the feedback you give will help the regulator in forming their judgements about the quality of care provided by a service.

Where can I get support with making a complaint?

You can get free support to make your complaint if you are trans:

There is also free support for making a complaint available to anyone in the UK:

If your complaint relates to mental health services you may be able to get support from your local branch of Mind.

To get information and ask questions about the complaints process you can also contact the Patients Association helpline.

Where can I learn more?

There is a detailed guide to making a complaint about UK healthcare on the Patients Association website.

You can read more about how the complaints process works in each UK nation in these resources for England, Northern Ireland, Scotland, and Wales.

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

Visit genderkit.org.uk

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 legal services.

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