Transgender healthcare for GPs

Demand for specialist gender identity services has risen dramatically in the past five years, and since the publication of the Levy report, the only route to referral for adults will be via GPs. For children, referral to paediatrics or child and adult mental health services (CAMHS) is required first. Completing the course will give you confidence in your role in referral, including what to discuss with the patient, knowing what information to include, and the importance of optimising physical and mental health from the point of referral. The course outlines the clinical aspects of providing care related to gender identity - both in specialist centres and in the community, delineating the roles and responsibilities of various services, and how commissioning needs to evolve. The concept of 'active waiting', or 'waiting well' is explored, building on the discussions between the GP and the patient around the time of referral. In recognition of the fact that access times are considerable, various resources are highlighted to support patients whilst they wait for their appointment.

The course looks at the clinical aspects of trans health, such as prescribing, gender dysphoria, screening and co-existing conditions to consider and manage alongside gender care. Prescribing is looked at in some detail, considering the options available, benefits and risks, and elements of monitoring, although it is recognised that this may not always take place in a usual general practice setting. Understanding the key characteristics of the drugs is useful for all GPs, in the context of providing general practice services to this cohort. Non-clinical aspects of trans healthcare are also considered, such as sensitive medical record keeping and legal aspects of gender care, and links to the RCGP position statement and GMC guidance. Two case studies are used to illustrate how the key learning points fit into day to day practice. They also explore some of the ethical and medicolegal challenges around prescribing and monitoring medications, for example when the patient is not under the care of NHS gender services.

This course is for RCGP members only.

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