If you have a child with gender variance, there are two routes for accessing professional support in the UK – NHS or privately. NHS services are provided via the Tavistock and Portman NHS Foundation Trust, and the Sandyford clinic in Scotland. Self-funded care is provided by recognised private specialist practitioners, such as GenderGP who can work with your GP to share care and minimise costs. It is worth noting that taking the privately funded route does not preclude patients from re-entering the NHS for further progression, including shared care and hormone therapy at a later date.

If you decide to go down the NHS route, the first step is to discuss your concerns with your GP who may well refer your child to the Tavistock and Portman clinic. You do NOT have to be referred to CAMHS first. If your GP doesn’t want to refer your child, see another GP in the practice or register with a new GP surgery. Once your child is referred, a specialist care team will work with you to develop a treatment plan that is right for your child. Mermaids Charity can also refer your child to NHS services and can advise on the best way to navigate the system.

The specialist team will assess each child on a case-by-case basis to determine what support is needed. Support generally includes some or all of the following:

  • Family therapy
  • Individual child psychotherapy
  • Parental support or counselling
  • Group work for young people and their parents
  • Regular reviews to monitor gender identity development
  • Medication to suppress puberty
  • Gender affirming (cross sex) hormones

Most treatments offered at the initial stages of referral via the NHS are psychological, rather than medical or surgical. This is due to strict NHS protocols which are in place to ensure those being treated are genuinely affected by gender variance, as opposed to there being another, underlying condition.

In cases where gender variance is diagnosed and the onset of puberty is causing the child to suffer considerable distress, puberty blockers can be prescribed. This medication is considered to be fully reversible.

Once your child reaches the age of 17, they can be referred to an adult gender clinic and they are entitled to consent to their own treatment and follow the standard adult protocols. Treatments at this stage may be more extensive and include provision of gender affirming hormones and surgery. It is worth noting that the law states that providing a young patient has shown competence according to the ‘Fraser Guidelines’ (Gillick Competency) they can inform their own medical treatment, whatever their age.

Patient numbers on the NHS are high, and increasing, and as such waiting times for an appointment at the Tavistock and Portman can be lengthy. If this adversely affects your child, be sure to raise it with your GP or at the Clinic. As with any medical appointment, it is very important to attend the slots offered to you. If you miss more than one appointment without giving notice, you may be discharged.

Teenagers who are using the NHS system currently need to be on puberty blockers for a year before progressing to cross-sex hormones. Many find this hard as they wish to progress through puberty at the same time as their peers, and long waiting times and assessment periods can cause delays in the system.

Many people use private services to bridge the gap and avoid progression of puberty while waiting for an appointment to access NHS services. To find out more get in touch: doctor@gendergp.co.uk

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