West of England specialist gender identity clinic

  • A centre of excellence, providing advice and treatment for gender dysphoria.

  • How we can help

    How we can help

    We work with people who have a wide variety of needs related to their gender identity.

    Your journey with us will be built around your unique needs. We will start with an assessment to fully understand your circumstances and establish a diagnosis and agree a treatment plan with you.

    Everyone has a named professional for advice and support throughout their time with our service. 
  • How to get help

    How to get help

    Your GP can refer you to our service for an initial assessment. You will need to be aged 17 or over and registered with a GP.

    If you want to transfer from another NHS gender identity clinic, please ask them to make a referral for a transfer of care and to inform your GP.

    If your referral is successful you will be sent a letter with information about your appointment and what to expect.

    For GPs and professionals - please contact us for information about how to refer to our service and to request a referral form.

Waiting times

We're currently experiencing high demand and long waiting times. We understand how difficult this can be and sincerely apologise for the delays.

We see people in the order of their referral date, with a few exceptions:

  • Those returning after discharge with an understanding they can resume treatment if referred again
  • Transfers from the gender identity development service (GIDS) or other gender identity clinics already receiving essential clinical treatment
  • Referrals from GIDS who have not received a diagnosis or started critically important treatment will join the waiting list with the date of their referral to GIDS.

Increased demand

Our service was designed for a limited number of people per year. Demand has grown significantly, and although referrals are now decreasing, the backlog remains. COVID-19 also impacted access to gender-confirming surgeries.

What we are doing

  • Focusing resources on those already in treatment or post-first appointment.
  • Continuing care for critical transfers from other clinics.
  • Working with commissioners to expand capacity and reduce wait times.
  • Exploring ways to support people while they wait.
  • Please don't contact the clinic about wait times as we are unable to provide more detail than what's shared here.
  • If your referral has been accepted, you remain on the waiting list.
Current waiting times as of June 2025
Topic Number
People waiting for first appointment 4,962
Referrals received last month 66
People currently in treatment 558
Most recent initial assessments Referred in April 2017
Discharges last month 30

 

While you wait

  • Gendered intelligence a free, confidential and independent telephone and information service.
  • For those waiting for surgery contact the NHS gender dysphoria national referral support service (GDNRSS) on  01522 857 799

Other organisations that may be able to help

Here are some external organisations, helpful links and apps that might help to support you. Although they may be helpful, by listing them we do not endorse them and we are not responsible for the services or information they provide.

Apps

  • MoodTools - if you are feeling sad or depressed
  • SAM: self-help for anxiety management
  • Mindshift to help teens and young adults cope with anxiety
  • Virtual Hope Box - a mobile app that includes simple tools to aid coping, relaxation, distraction and positive thinking.
  • Headspace - a mobile app that involves a course of guided meditation.
  • Relaxing Melodies - a relaxation and sleep app that allows you to select sounds and melodies that you like and combine them to create a mix.
  • Daylio - a journal, diary and mood tracker
  • What's Up? - daily tools to help  you cope with depression, anxiety, anger, stress and more

Your assessment

This will now happen as part of a two-step process.

You will be invited to meet with a clinical gender specialist who will complete the first part of your assessment, gathering the necessary information and clarifying your treatment goals.

Next, you will have the second part of your diagnostic gender assessment with one of our lead clinicians - either a medical gender specialist or a specialist clinical psychologist, depending on your specific needs. At this stage, a treatment plan will be created, which may include hormone therapy or surgery referrals, if appropriate.

You will be allocated a named professional who will be your continuing point of contact and support within our service.

Unable to attend your assessment?

If you are unable to attend your assessment, please let us know, so we can offer your appointment to someone else who is on our waiting list.

Help with travel costs

You may be able to claim a refund of reasonable travel costs under the Healthcare Travel Costs Scheme. 

Your care and treatment

We will work with you to create an individual care and treatment plan to support and advise you about living in your preferred gender role. 

This may include:

  • Hormone therapy
  • Psychotherapeutic interventions
  • Occupational therapy
  • Speech and language therapy referal
  • Hair removal treatments referral and funding
  • Medication advice and monitoring
  • Referral for surgery

For some people, support and advice from the clinic is all that you will need to make you feel comfortable in your gender identity. You will have plenty of time to discuss your own personal care pathway with your assigned professional at The Laurels, and plan your future.

For family, friends and carers

Carers, family and friends often play a large part in supporting a person with gender identity issues.

Unfortunately, we are not currently running any family support groups. This is under review and this page will be updated as and when changes occur.

In the interim, please refer to the links below for information which you might find helpful:

Information for families

Older trans people

Age UK information and advice on your rights 

  • Carers' assessments, care support needs and financial assessments

Visit Carers UK for advice, information and support, or call on 0808 808 7777.

Referring to our service - for GPs and professionals

The West of England specialist gender identity service accepts referrals from any GP in England for people aged 17 and above with gender dysphoria.

If your patient is under 17 years of age, please follow the advice on the NHS Arden and Greater East Midlands website.

Please complete the West of England specialist gender identity clinic GP referral form August 2023 [docx] 63KB* and return attaching a current medical summary and any relevant diagnostic reports, for example - mental health, ASC, substance misuse, etc. This will help us to process your referral efficiently, without having to request further information from you.

*We are aware that the referral form is not fully accessible. Some elements, such as tables or other content may not be fully compatible with screen readers or other assistive technologies. Please contact us if you require it in another format.

Transfers of care

Our service also welcomes transfers of care directly from other NHS gender identity clinics, correspondence should come directly from the transferring clinic.

To process transfers effectively and efficiently we require the following information:

  • Correspondence detailing the reason for the transfer of care and any recommendations for further assessment and/or treatment where applicable
  • Reports relating to the assessment and treatment of your patient's gender concerns to date.

Risk management

  • A number of studies suggest that people who identify as transgender are at higher risk of depression, self-harm, substance misuse, suicidal thoughts and ideation
  • We would advise our patients to approach their GP should their physical or mental health deteriorate
  • We advise GPs to monitor physical and mental health, and make local referrals as appropriate
  • We will offer advice at the GP's request on any health problem related to our patients' gender concerns
  • Our service does not provide urgent or emergency advice to patients. Should patients require urgent or emergency advice, they are advised to contact local primary care or emergency services
  • We will endeavour to respond to requests for advice from health professional colleagues regarding specialist gender identity-related matter.

Prescribing

GPs may find it helpful to refer to our gender dysphoria prescribing guideline.

What to expect during transition

Transition involves a profound change in your life; this may seem daunting but we are here to help. There are a range of challenges to be addressed during your transition, so we've prepared a checklist to help you prepare.

This list is not exhaustive. Transition involves much, much more than the obvious medical interventions of hormone therapy and surgery. You will also need to consider its social and legal implications, from formally changing your name through to dealing with the emotional aspects of informing family and friends.

Helpful hints for transition

  • You will be provided with a great deal of new information about gender identity issues by the clinic. We recommend that you keep this and all correspondence relating to your treatment in a file, to support your Gender Recognition Certificate application in the future, should this be required.
  • Living life in your new social role may be very different to your current life and you are likely to have many new experiences; be ready for change and for some challenging situations. Ask your named professional for help if you feel overwhelmed by everything; difficult challenges can be overcome with help.
  • Medication and hormone treatment may be offered. We strongly discourage self-medication with irregularly sourced drug treatments. Internet-sourced hormone therapies can be dangerous and are sometimes contaminated. Their use is likely to affect blood test results and, if our medical team are unaware of your self-medication, they may inadvertently offer inappropriate advice or recommend unnecessary investigation. Please, be honest with us. 
  • Gender reassignment surgery (GRS) cannot be provided until you have lived in a social role appropriate to your gender identity for at least twelve months.
  • At some point, you will want to tell other people about your transition. We can advise you on how to carefully and sensitively inform all those who need to know about your transition, from family members to employers. Employers have legal responsibilities to protect you and Unite has further information on their website.
  • You may be eligible for NHS-funded treatment to reduce your facial hair (epilation).  There is a limit to the amount of treatment funded by the NHS and there is no guarantee that this will reduce your facial hair to your complete satisfaction. If you want additional or future epilation treatment, you will have to pay for this yourself. We can advise you about this.
  • Your pension and any benefits arrangements might be affected if you're a transgender. Seek advice from your private provider and/or the Department of Works and Pensions. 
  • Appropriate use of pronouns may become an issue. Politely advise people of your preferred pronoun.
  • Transphobic hate incidents may happen and can take many forms including verbal and physical abuse through to threatening behaviour and online abuse.  Transphobic hate crime is a criminal offence.
  • As you prepare for your new life you may require assistance with clothing, footwear, wigs, and cosmetics. You may also need guidance with this, your named professional will be able to provide advice on all these matters.
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