Gender dysphoria services: a guide for general practitioners and other healthcare staff

Abstract

This guide reflects current practice of National Health Service (NHS) gender clinic services in the United Kingdom (UK). The NHS offers healthcare free at the point of access. The guide describes how and when people with gender dysphoria should be referred; and what people with gender dysphoria can expect in terms of assessment, treatment, care and support from gender clinic services. This guide has been written by clinicians of the four largest gender clinic services in England. An early draft of this guide was shared with all UK gender clinic services for their input, following which trans people and other relevant stakeholders were consulted and given an extensive opportunity to comment on the draft guide. This guide is intended to inform primary care physicians, known in the UK as general practitioners, as well as all other relevant gender-related healthcare and psychotherapy service providers, both NHS and privately, commissioning bodies, and people with gender dysphoria.

Individuals with gender dysphoria and autism: barriers to good clinical practice

“…There is a growing recognition that primary care and mental health services for people with ASC and gender dysphoria are patchy, at best (Ahmad et al . ). While their communication and social interaction needs require careful consideration during therapeutic engagements, there is a paucity of specialist knowledge in relation to how therapeutic interventions may be developed for such individuals.…”

Gender Dysphoria and Autism Spectrum Disorder: A Systematic Review of the Literature

“…For instance, the number of referrals being received by gender identity clinic services in North America and Europe has increased substantially over the years [71,72]. The increase in prevalence over the years is likely to be due to several factors: the increased visibility of trans people in the media, which likely contributes to at least a partial de-stigmatisation of being trans [71]; the wide availability of information on the internet about trans people, which also likely contributes to de-stigmatisation [71]; the increased awareness of the availability of biomedical treatment [2,3,4]; and the development of societal tolerance towards trans individuals [73]. Perhaps trans individuals, with ASD, have less reservation to seek referral to gender identity clinic services, as explained above, and therefore constitute a relative overrepresentation within clinical samples.…”

“…Sometimes this gender incongruence is sufficiently intense that people undergo a transition to the opposite gender (usually from male to female or from female to male). This typically involves changes in social role and presentation, and may require prescription of cross-sex hormones and/or having gender related surgeries [2,3,4].…”

Systematic Review and Meta-Analysis of Prevalence Studies in Transsexualism

“…When this distress is sufficiently intense, individuals wish to transition from one point on a notional gender scale to another -most commonly from a man to a woman (people known as trans women) or from a woman to a man (people known as trans men) [1,64]. The diagnosis of transsexualism according to the ICD-10 [63] is currently under revision.…”