Transgender Healthcare and Shared Care Prescribing

At Ladybarn Group Practice, we are committed to providing respectful, open, and sensitive care to all our transgender and non-binary patients. We believe every individual has the right to access healthcare with dignity and to have their identity respected.

We understand the significant challenges faced by the transgender community, particularly regarding the current waiting times for specialist NHS services. This page outlines our practice policy on "Shared Care Agreements" for hormone therapy and monitoring.

Our Policy on Shared Care

A Shared Care Agreement (SCA) is a formal arrangement where a specialist and a GP share the responsibility for your treatment.

NHS Specialist Clinics

We accept shared care agreements for patients who have been started on treatment by an NHS Gender Identity Clinic (GIC).

  • NHS clinics are multi-disciplinary, providing access to doctors, nurses, psychologists, and surgeons.

  • These agreements are voluntary and must be agreed upon by all parties to ensure safe monitoring and appropriate funding.

Private (Non-NHS) Providers

As a practice, we do not accept shared care requests from private or non-NHS providers to prescribe or monitor medications for gender dysphoria.

  • This applies to all private transgender clinics, including online providers.

  • While we understand many patients seek private care due to long NHS wait times, we believe it is not clinically safe for our team to take on this work from private providers.

Why we cannot support Private Shared Care

We have carefully considered this position based on the following clinical and safety reasons:

  • Clinical Competence: Hormone treatment for gender dysphoria is highly specialized and is currently outside the standard GP training curriculum and scope of practice.

  • Governance and Quality: It is challenging for us to be assured of the long-term quality, accreditation, and governance of various private clinics.

  • Continuity of Care: Specialist medications require enduring specialist oversight. There is often no guarantee of this long-term specialist availability within the private sector.

  • Resource Constraints: General practice does not currently have the capacity or the NHS funding to meet the additional clinical and administrative demands of private sector shared care.

Care for Children and Young People (Under 18s)

The safety of our younger patients is a primary concern. Following national NHS guidance and government legislation:

  • Puberty Blockers: There is an indefinite ban on the sale and supply of puberty-suppressing hormones for treating gender dysphoria in under-18s, except for those already established on treatment within the NHS.

  • Unregulated Providers: GPs must refuse to support private prescribing or monitoring from unregulated providers for children and young people.

  • NHS Numbers: In response to identified safeguarding risks, the process for issuing new NHS numbers for gender reassignment in patients under 18 has been stopped. We can, however, still update your name and title on your existing record.

How We Can Support You

While we may not be able to prescribe medications recommended by private clinics, we remain your partner in health:

  1. NHS Referrals: We can refer new patients to NHS Gender Identity Clinics or re-refer those who have been discharged.

  2. Medical Records: You have the right to change your name and gender marker on your medical record at any time without needing a Gender Recognition Certificate.

  3. Screening: We will work with you to ensure you remain invited for relevant NHS screenings (such as cervical or breast screening) based on your specific clinical needs.

  4. Mental Health: If you are struggling while waiting for treatment, please book an appointment to discuss support for your mental health.

External Support

For additional help and information while waiting for treatment, you may wish to contact Gendered Intelligence, a charity supporting transgender patients.