Medical transition options

Every trans / non-binary person is different and there is no ‘fixed path’. Below are some of the different ways a trans person may choose to transition.

Hormone Blockers:

Under 18s: Please note the GIDS service is undergoing a period of significant change which significantly impacts their procedures for prescribing blockers. Please click here to read their Service Specifications.

These suppress the body’s natural sex hormones:

For trans women (people with a female gender identity who were assigned male at birth) blockers will suppress the testosterone that their body would normally produce.

For trans men (people with a male gender identity who were assigned female at birth), blockers will suppress the oestrogen that their body would normally produce.

Non-binary individuals may also choose medical transition options. Hormones will impact the person as detailed above depending on their assigned birth sex.

If blockers are started after puberty has taken place, they cannot ‘reverse’ all of the body’s changes. For example, once a voice has broken it cannot be restored.

N.B The NHS states that although GIDS advises this is a physically reversible treatment if stopped, it is not known what the psychological effects may be. For full details on hormone therapy and the impact of blockers / hormones click this link to access the NHS guide to Hormone Therapy.

Hormones:

Cross-sex hormones are prescribed to individuals where appropriate to enable their body to develop in line with their gender identity.

The GP and Gender Identity Clinic will work very closely with the individual to ensure it is the correct path. Hormone levels are also monitored regularly to ensure the treatment is effective.

It is essential that individuals taking cross-sex hormones are carefully monitored and supported by a GP.

In trans women and non-binary people assigned male at birth, oestrogen may cause the following effects:

Fat may be distributed on the hips
The size of the penis and testicles may be slightly reduced
Some trans women find that erections and orgasm are harder to achieve

In trans men and non-binary people assigned female at birth, testosterone may cause the following effects:

It promotes beard and body hair growth
Male pattern baldness may develop
The clitoris increases slightly in size
Libido may be heightened
Muscle bulk increases
The voice deepens, but not usually to the pitch of other men.
Periods will stop, although there may be some breakthrough bleeding requiring adjustment of dosage
Some individuals develop acne

Cross-sex hormones can be stopped at any time, though some changes to the body will remain. For example, trans men have successfully become pregnant by pausing their hormone treatment and allowing their (female) biological body to function. However, changes such as a deeper voice, facial and body hair will remain.

For full details on hormone therapy and the impact of blockers / hormones see our useful websites page which includes the NHS guide to Hormone Therapy.

Surgery Options:

Some of the key surgery options for trans men or non-binary people assigned female at birth:

*Breast removal
*Hysterectomy
*Penis construction

Other plastic surgery options can be considered as with any individual wishing to alter their appearance, such as muscle enhancers.

Some of the key surgery options for trans women or non-binary people assigned male at birth:

*Breast enhancement – though often trans women find that breasts develop naturally as a result of hormone treatment
*Vagina construction

Other plastic surgery options can be considered as with any individual wishing to alter their appearance, such as Adam’s apple reduction and facial feminisation.

There is a common misconception that all trans people will undergo ALL relevant surgery, but this is not the case.

Each person is different and unique and many trans / non-binary people are comfortable with making a social transition (name change, appearance etc). Every surgery carries potential risks and so it is a big decision to make. For example, we have worked with many trans men who have chosen to have breast removal surgery, but they choose not to proceed with a hysterectomy (as the hormone treatment already prevents monthly periods) and many choose not to proceed with penis construction surgery.

Private Options:

If your child is under 18s: Please click here to read their GIDS NHS Interim Service Specification released June 2023 – it includes information regarding accessing private health care.

How to pick a private doctor?

If you’ve got the money to go private, here are some things to consider regarding assessment, prescriptions or gender affirming surgery.

Get quotes from different transgender clinics, check out their websites, call and talk to them and get a feel for how they operate. Have a checklist of questions to ask when making enquiries by email or by phone. Get clear quotes from the clinics – what will the total cost be?

Be prepared

This is going to be a big leap from NHS healthcare and is a much higher price for prescriptions. Before having any trans healthcare your child will need to first have a psychological assessment to discuss their experience and be diagnosed with gender dysphoria. There will be multiple consultation appointments with the prescribing doctor and/or surgeon. Each will be individually costed. You should always be able to get a clear estimate on what the cost range will be depending on your child’s needs.

Ask others

Reach out to other parents who have supported their child through private healthcare. It can help to ask people who’ve had the same procedures or have taken hormones from a private prescription. Would they recommend their doctor?

Compare

Check clinic reviews, be aware of fake reviews and look beyond the clinics own site for reviews. The site trustpilot is a good place to check – some clinics also do other services that may not be relevant to gender affirmation, so scroll through and find specific reviews of people who have had gender affirming support or procedures. Put together a short list of clinics available.

Get support

Sit with a trusted friend or family member and write up the pros and cons of the different clinics you’ve found. Write down the prices and service offered. You may find the clinic you felt most comfortable with might not be the cheapest. Talk through with your trusted friend or family member for support in making the best decision.

It may also be helpful to discuss plans with your child’s NHS GP. Sometimes the GP may be asked to liaise with the private practice.

🚩 Red flags 🚩

– Clinic offers much cheaper quotes than others

– Requiring large sums up front – you should only be paying for upcoming appointments

– Sending hormones without a prescription, there should be a prescribing doctor and you then collect the prescription from a pharmacy

– Can’t find them on any independent review sites

– Language used such as ‘breast reduction’ instead of breast removal

Please be assured, whatever you are feeling right now is ok and there is plenty of support available to help you through this journey.

Please do get in touch for information, advice and guidance: [email protected]

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