Formal diagnosis

Formal diagnosis is getting official acknowledgement (diagnosis) that you are trans from a specialist medical professional.

Why might I want a diagnosis?

You need a diagnosis to get:

• gender-related surgery in the UK
• a Gender Recognition Certificate

With a diagnosis, it can be easier to get hormone therapy, though some people access hormones without a diagnosis.

You don’t need a diagnosis to be trans, but it can help you accept being trans, and help you explain your identity to other people.

You can get a diagnosis from a NHS gender clinic or a private gender clinic. It is normally quicker to be diagnosed privately. 

However, if you have a diagnosis from an NHS gender clinic, you can access some free NHS services:

• free hormone therapy provided by the NHS
• free surgery provided by the NHS
• a limited amount of free permanent facial hair removal provided by the NHS (except in Wales)
• in some parts of the UK, and if you meet the criteria, free fertility preservation provided by the NHS

You can’t use a private diagnosis to access these free NHS services. If you have a diagnosis from a private gender clinic, but want to access the free NHS services, you will need to be referred to an NHS gender clinic and have a new assessment and diagnosis from them.

Why might I not want a diagnosis?

Some people do not want to be diagnosed.

This might be because they feel it is pathologising (that a diagnosis feels like being told your identity is a “disease”), because they don’t agree with the way the medical system works, or just because they feel it is unnecessary to get a diagnosis.

You don’t need a diagnosis to:

• change your name
• change the gender marker on official records like your passport or driving licence
• update your NHS medical record
• have permanent hair removal
• have speech therapy
• access single-gender spaces
• be protected under the Gender Reassignment characteristic of the Equality Act (2010)

Remember: you don’t need a diagnosis to be trans. Your trans identity is valid whether you have been diagnosed or not.

Who can get a diagnosis?

The latest international standards describe how diagnosis can be made. You can read the criteria for a diagnosis on the ICD-11 website. The criteria are written for medical professionals, so they can be a bit confusing, but the important things to know are:

• People of any age can be given a diagnosis, but there is a slightly different diagnosis given to young people who have not started puberty yet – Gender incongruence of childhood.
• You don’t need to have “gender dysphoria” or a strong dislike of your body to get a diagnosis.

How do I get a diagnosis?

In the UK, diagnosis is normally made by a specialist GP, psychologist, or psychiatrist at a gender clinic.

To learn how to access a gender clinic in the UK read our Getting referred to a gender clinic page.

Once you have been assessed by the gender clinic, they will write to your GP to say that they have diagnosed that you have “gender incongruence”, or “gender dysphoria”, and you will normally also be sent a copy of the letter. Information about your diagnosis may also be added to your NHS medical records.

What diagnosis will I be given?

The exact diagnosis given in the UK varies, but common diagnoses include:

• gender incongruence
• gender dysphoria

In the past, people in the UK were also diagnosed with:

• transsexualism
• gender identity disorder

Any of these diagnoses is enough to access medical treatment. These all mean broadly the same thing from a medical perspective.

The current term used in international standards for diagnosis is “gender incongruence” – you can read more about this on the World Health Organization’s page on Gender Incongruence. 

Many people in the trans community would prefer the use of this term over other labels:

• A diagnosis of “gender dysphoria” could be seen as implying that only people who experience gender dysphoria are valid as trans people
• “gender identity disorder” is often disliked because it suggests there is something ‘disordered’ or ‘wrong’ with trans people
• “transsexualism” is often viewed as an outdated term and to exclude people who do not wish to have particular medical interventions

Errors or omissions

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