Trans and non-binary healthcare

We want every trans and non-binary patient to get respectful care and have their identity respected. This page explains which gender-affirming medicines we can prescribe, and how we can help you while you wait for specialist care.

What shared care means

Hormone treatment for gender incongruence or gender dysphoria is started by a specialist gender service. Once it is settled, the specialist can ask your GP to take over the prescriptions and some of the blood tests. This is called a shared care agreement. The specialist stays responsible for your treatment plan.

A shared care agreement is voluntary. You, the specialist and the GP must all agree to it, so that your monitoring is safe and properly funded.

If an NHS gender service started your treatment

We accept shared care agreements from NHS gender dysphoria clinics and from NHS-commissioned services such as Indigo Gender Service in Greater Manchester. The service must send us a completed shared care agreement, and our pharmacy team must approve it before we take over prescribing.

If a private or online provider started your treatment

We do not take on prescribing or monitoring of gender-affirming hormones for private or non-NHS providers. This includes online providers. It applies whatever your age.

We know many people go private because NHS waiting times are very long. We have thought carefully about this, and decided it is not safe for us to do this work because:

• hormone treatment for gender dysphoria is a specialist area, outside GP training and the work GPs normally do
• we cannot check the quality, regulation and oversight of every private clinic
• these medicines need a specialist for as long as you take them, and a private provider may not be there in the long term
• GP surgeries are not funded or staffed to take on extra specialist work from private providers

You can still see us about anything else, including your general health and any side effects you are worried about.

How we can help

• Referral: we can refer you to an NHS gender dysphoria clinic, or refer you again if you have been discharged.
• Your name and title: you can change these on your record at any age.
• Your gender on your record: if you are 18 or over, you can change the gender recorded on your NHS record at any time. You do not need a Gender Recognition Certificate. We will explain your options first, including whether you keep your NHS number, and what changes for screening invitations and hospital waiting lists.
• Screening: we will make sure you are invited for the NHS screening you need, such as cervical or breast screening, based on your body rather than the gender on your record.
• Mental health: if you are struggling while you wait, book an appointment to talk about support. You can also see our mental health page.

To change your name, title or gender on your record, contact us.

Children and young people under 18

National rules for under-18s are stricter.

• Puberty blockers: since January 2025 it has been illegal to supply puberty blockers to under-18s for gender dysphoria on a private prescription, or on any prescription from a prescriber in Europe or Switzerland. The NHS now only prescribes them for this within a research trial called PATHWAYS. Young people can only join it through the NHS Children and Young People's Gender Service. A court allowed the trial to go ahead in July 2026. Young people already on NHS treatment can continue. The government will review the ban in 2027.
• Hormones (oestrogen or testosterone): since March 2026, the NHS has paused new treatment with these hormones for gender dysphoria in 16 and 17 year olds. NHS England consulted until June 2026 on stopping this treatment for all under-18s, and the pause continues while it decides. Young people already on NHS treatment can continue if they, a parent or guardian, and their NHS gender service agree.
• Private providers: we cannot support private prescribing or monitoring of these medicines for anyone under 18.
• Your record: under-18s can change their name and title on their record, but not the gender recorded on it. The NHS has stopped issuing new NHS numbers to under-18s for this reason.

We can still refer young people to the NHS Children and Young People's Gender Service, and support their mental health. See mental health support for children and young people.

Support while you wait

• LGBT Foundation (opens the LGBT Foundation website): a Manchester charity offering advice, support groups and counselling for LGBTQ+ people.
• Gendered Intelligence (opens the Gendered Intelligence website): a charity supporting trans people.
• Gender dysphoria (opens the NHS website): NHS information on treatment and getting a referral.

If you are unhappy with our decision

Talk to us first. If we cannot sort it out, you can make a complaint.