The questions and answers below have been collated because they are often directed at the NHS Boards. These will be reviewed regularly.
Gender Identity Clinics are there to assist people in making progress through their transition. They are there to inform you, explore options that are available, and support you to make a decision on the right treatment that will lead to meaningful improvements to your gender incongruence.
How can I be referred to a Gender Identity Clinic?
You can be referred to your Gender Identity Clinic by your local GP.
Sandyford Adult Service accepts service users from Greater Glasgow & Clyde, Ayrshire & Arran, Dumfries & Galloway, Western Isles, Forth Valley and Lanarkshire NHS Boards and from the Argyll & Bute area. For the Young People’s Service and the Sandyford adult service (both based in Glasgow) you can also self refer.
If you’re not registered with a GP, you can call your local clinic to discuss your circumstances.
How many people are referred to Gender Identity Clinics each year?
Click here for patients added to the waiting list per quarter, 2019-2021
For more detailed data, please see the data appendix to the 2020/21 Annual report here
What can I expect from my first appointment at the clinic?
Your first appointment is an opportunity to talk to your clinician about your needs and expectations and to find out more about the service. These discussions cover many areas including your gender identity and general health, and how the service might be able to help you.
Do I have to present in a certain way at my appointments?
No, please turn up at your appointment wearing whatever you feel most comfortable in on that day.
Will I be able to go on hormones straight away?
In most cases, there will need to be some blood tests and other measurements taken, so that your clinician can have a conversation with you about your general health which will inform your decision about hormones.
How long will I have to wait between appointments?
Everyone is treated on an individual basis so this varies.
Will I have time to consider my options and not have to make a decision on my treatment straightaway?
Yes, you can take as long as you need to decide what is best for you.
I’m hoping to have gender affirming surgery – what could delay this?
Some of the factors that might cause delays to surgery include:
Giving up smoking – Some surgical providers will not operate on people who are active smokers. Smokers are significantly more at risk of serious complications from undergoing surgery, and smoking can affect the healing process and cause tissue death where skin has been grafted. Talk to your GP about giving up smoking or contact your local Stop Smoking service, available from all NHS Boards in Scotland. NHS Inform has more details here: https://www.nhsinform.scot/healthy-living/stopping-smoking
Getting to a healthy weight – There are a number of risks associated with procedures that require a general anaesthetic. Each surgical team will have its own guidelines about weight (under or over weight), as this will affect a person’s risk of surgical complications.
Getting fit for surgery – It is always good to be as fit as you can for surgery. There is a useful resource published by NHS Lothian that can guide you on preparing for pre and post-operative surgery: https://services.nhslothian.scot/preparingforsurgery/RIE/Pages/Gettingfitforsurgery.aspx
What support is available to me while I am waiting?
Additional resources can be found on our website:
https://www.ngicns.scot.nhs.uk/support-information/
What support is my GP practice able to provide?
The role of your GP practice is to work with you to manage your general healthcare needs. Day to day, they remain the first point of contact with NHS medical services for the majority of individuals in Scotland.
Although they may not be the experts in the specific needs of those undergoing transition they are expert generalists who can support you. Where they feel they are not best placed to meet your specific needs they are able to signpost or refer you to those specialist teams that can. They have a good understanding of the services available locally or regionally and how they can be accessed.
For the majority of individuals, on the recommendation of your specialist they will be able to provide your repeat prescriptions and offer longer term monitoring as would be the case for any other ongoing treatment.
More generally though the team in Primary Care are also there to support you and for specific enquires regarding medicines your local pharmacist will often be happy to help. Some practices have counsellors or wellbeing practitioners too who might help with support with things like smoking cession or weight loss for those who require support in preparation for surgery.
Will all my appointments be face to face?
You may be able to access your clinic virtually or in person. Some people may find an in person discussion more helpful, but this will be a personal choice. Some services may only be available online or by telephone at a particular time due to Covid-19 restrictions.
What services are offered by NHS Scotland?
Within NHS Scotland you will be able to access treatment for prescription and management of hormones, fertility preservation, voice work, hair removal, wigs, and gender affirming surgeries, as well as access to clinical input to help you explore gender identity issues, if this is required.
How long will I have to wait for my first appointment?
Current waiting times to access NHS gender identity services are long. NHS Scotland is working with the Scottish Government to reduce waiting times to access services. Clinics in Edinburgh and Glasgow publish their estimated waiting times on their websites.
Links to the waiting times data can be accessed here:
https://www.lothiansexualhealth.scot/gender-identity-clinic/gic-waiting-times/
How many appointments with there be?
There is no set number of appointments and it can vary from person to person. Your gender clinician will make sure to work with you to provide the care you need.
Will I have to see another clinician?
In some cases where there are lots of factors to consider, we may ask that you see another clinician in our team, this is purely so we can make sure we are offering you the best support and service we can and we will make sure to keep you informed.
How old do I have to be to access NHS gender identity services in Scotland?
Adult services usually accept referrals for people aged 18 years or older. Chalmers GIC will accept referrals at 17 years old. See our Gender Identity Clinics page for more details:
https://www.ngicns.scot.nhs.uk/gender-identity-clinics/
Is gender reassignment surgery provided in Scotland?
No – all surgery providers are currently located in England. A four nations contract is in place in conjunction with NHS England to allow people to access surgery. Support with travel and subsistence costs can maybe be obtained via your local NHS Board. More information is available here:
https://www.ngicns.scot.nhs.uk/nhsservices/adults/surgery/surgery-providers/
Your GIC will refer you to the Gender Dysphoria National Referral Support Service (GDNRSS) You can contact them to make an appointment to discuss your choice of surgical provider.
After accessing the gender identity clinic where can I access other services, like hair removal?
Your GIC will support you to access other services.
Do I need to access a gender identity clinic to receive hormones on the NHS?
In most cases, yes. An assessment is required to access hormone treatment, based upon assessment by health professionals for the appropriate and safe prescription of this medication. In most cases treatment will be recommended by GIC. This may not apply in some situations such as moving to Scotland on an existing established prescription from your GP. If you have an existing prescription please discuss this with your GP.
The Young People’s Service
I am a young person, or primary caregiver/parent/guardian of a young person, accessing the Young Person’s Gender Service at Sandyford in Glasgow. What can I expect?
For individuals up to 17 years old, the Young Person’s Service offered by NHS Greater Glasgow and Clyde at Sandyford accepts referrals from all of Scotland. More information can be found on their website:
https://www.sandyford.scot/sexual-health-services/gender-identity-service/
At present, there is a lot of interest in services for young people. The following questions have been included to assist with some of the queries we receive.
How many young people are prescribed ‘Puberty Blocker’ medication each year?
The Sandyford Young People’s Service reported that in the period 2011 to 2021 inclusive, a total of 93 young people were referred for an appointment with Endocrinology (hormone specialist), an average of eight young people per year.
Of those young people, over the period 2011 to 2021 inclusive, 82 young people were prescribed hormones, an average of 7 per year.
Are people under 16 ever referred for gender reassignment surgery in Scotland?
No.
How many people detransition in Scotland?
This information is not held by NHS National Services.
Last updated July 2022