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.

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 service. 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.

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 service
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

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:

the guidance on prescribing for trans people on the GMC website (which covers prescribing “unlicensed medications”)
the guidance to GPs on shared care agreements with private clinics published by NHS England
whether the clinicians that have diagnosed you are GMC registered and are a registered specialist in gender dysphoria

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.

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?

That didn’t help, what can I do?

If your GP surgery is unhelpful or unsupportive, you might want to consider:

Speaking to the practice manager – The practice manager is the head of the GP surgery. You can request to talk to the practice manager on the phone or in-person, and this is often the quickest way to get problems resolved if you’re experiencing issues with their staff.
Switching to a different GP at the surgery – You have the right to change to a different GP at your GP surgery without giving a reason why. If you are uncomfortable with a particular GP, you can also ask to be given appointments with any other GP.
Changing to another GP surgery – You can search for GP surgeries near to you that the trans community have found helpful on the Trans Healthcare Info GP map or the Trans Aid Cymru Welsh GP map. If you are part of a local trans group, you might find it useful to ask people for their recommendations.
Changing to an online GP service – Some online services specifically advertise support for LGBT+ and trans people, such as GP At Hand.

You can also get support to help you resolve your problem from these sources:

in London, people over 18 can access the Spectra Trans Health Advocacy Service
in Manchester and Greater Manchester, people over 16 can access the LGBT Foundation Trans Advocacy service

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 are having a problem with a GP surgery, this might mean speaking 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 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 the healthcare provider (for example, the GP surgery or the hospital) or to the board responsible for healthcare in your local area.

In England these are referred to as Integrated Care Boards, in Northern Ireland they are Health and Social Care Trusts, in Scotland and Wales they are called Health Boards.

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. If you aren’t able to find this information on their website, ask staff at the service how to make a formal complaint.

For example, if your complaint is about how you were treated at a GP surgery, your GP surgery should provide information on how to do this on their website. If this information is not available, contact the surgery and ask to speak to the practice manager.

Sending a complaint by email is often quicker, though using 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.

Escalate your complaint to the NHS. There are guides on how to do this on the websites of the national healthcare organisations for England, Northern Ireland, Scotland, and the Welsh Government website.

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 Ombudsman. There is information about how to do this on the website of each national ombudsman: in England the Parliamentary and Health Service Ombudsman, in NI the Northern Ireland Public Services Ombudsman, in Scotland the Scottish Public Services Ombudsman, and in Wales the Public Services Ombudsman for Wales.

If your complaint is about a specific person who has behaved inappropriately you can complain to the professional body for doctors and surgeons (the General Medical Council) or nurses (Nursing and Midwifery Council).

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.

You may wish to complain to the Care Quality Commission (CQC), the independent health and social care regulator.

Where can I get support with making a complaint?

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

in London, people over 18 can access the Spectra Trans Health Advocacy Service
in Manchester and Greater Manchester, people over 16 can access the LGBT Foundation Trans Advocacy service
in other areas local LGBT+ organisations may also provide support

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

in England find your local Healthwatch using their search tool. The website for your local Healthwatch will normally include information about where you can get support locally for making a complaint, which is often provided by an independent organisation like POhWER or VoiceAbility. You can also contact the Patient Advice and Liaison Service for help with making a complaint.
in Northern Ireland speak to the Patient and Client Council Complaints Support Service
in Scotland speak to the Patient Advice and Support Service
in Wales contact Llais

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.

Does something look familiar?

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.

Page last updated:

8 July 2024