We asked readers to get in touch and tell us what GP care was like for trans men and women. While some told us of good relationships, many others raised serious concerns.

Being outed by healthcare professionals

Francis, a 23-year-old trans man, was outed to other medics by his GP. “I needed a referral to a neurologist and I ended up having a brain scan – and the referral to the neurologist mentioned that I was trans,” he says. “I admit there are times when you might have to mention it otherwise it’ll be confusing, but I don’t think a brain scan is one of those times.”

Win Wyatt, an 18-year-old trans man, was told he needed to come out as trans to his parents before receiving any further help. Getting hold of prescriptions, he said, could be difficult: one situation at a pharmacy involved having to disclose he was trans in front of a queue of people.

“It was the pill,” he said. “I was stood at the counter for an hour and a half because they were very confused as to why they were giving me this medication because obviously my biological gender marker or whatever was not marked on my prescription and my name was Winston Wyatt. And they were like, ‘this is not for you’ and I was like, ‘it is, it is for me actually’.”

Hostility and a lack of education on gender issues

Ali Brumfitt, 45, who identifies as gender queer,went to the doctor to talk about difficulties relating to the menopause. But the GP insisted that Brumfitt explain whether they were “a man or a woman now”. “I was like, ‘well, I was assigned female at birth and I am not taking hormones … and I do have a womb’,” said Brumfitt.

But that was not enough for the doctor. “‘Look, I am just trying to get my head around it’, is what he said to me. ‘Are you a man or a woman? And were you born a man or a woman and what are you now?’,” Brumfitt recalls. “He just was really angry with me, he was very patronising. And I was in tears and shaking by this point.”

Jack Doyle, 26, a graduate student who acts as a healthcare advocate for trans people, said having to be an expert in their own healthcare puts a huge strain on trans men and women.

“It essentially makes a really life-saving kind of care dependant on your ability to be resilient, and to be prepared to go through something that I think a lot of patients don’t ever have to go through in terms of being vulnerable and being willing to have basic dignity and selfhood challenged,” he said.

“And a lot of people can’t do that, a lot of people just can’t do it. They don’t go to the doctors any more, they stop going on care, they self-medicate, or they self-harm, or they they experience suicidal ideation and that is often where we as advocates actually have to step in and unfortunately not enough people know that advocacy is an option.”

Trans patients in England face 'soul destroying' wait for treatment Read more

Problems with referrals to gender identity clinics (GICs)

Charlie Knowles, a 19-year-old trans man, said he was left distraught after it emerged his referral to a gender identity clinic had been lost – something he only discovered after waiting almost two years for an appointment.

“I remember sitting on the bus on the way home and just crying because I knew I was then looking at another two-year waiting list,” he said, adding that his life was now on hold. “I was going to uni in September 2018 but I didn’t end up going… I really badly wanted to have started at least some sort of hormone therapy or something before I made that big sort of change in my life. I wanted to go into uni as myself rather than, like, I look like a prepubescent teenage boy.”

Kimberley, a 31-year-old trans woman, was initially, and wrongly, sent to mental health services after talking to her GP in 2016. Six months later she was referred to a GIC – but has yet to have an appointment. She said the lack of contact after the initial acknowledgement left her feeling very alone. “Unless you keep pushing you don’t hear anything. I have received nothing from the clinics themselves since I was referred,” she said.

The idea of surgery was a distant thought, given that that was only considered by doctors after an individual had been seen at a GIC, and been on hormones for a certain time, Kimberley said. “It doesn’t feel like it is ever going to happen because it is just this constant thing of waiting, and because I have not heard anything, because nobody gets in contact, if I am having any problems I am here on my own,” she said. “I have nobody who understands that can talk through it with me.”

Edward Smith, a 23-year-old trans man, also experienced problems with communication after his referral. “I have just not heard anything at all from the gender identity clinic. I have not had a letter, I have not had any receipt of confirmation,” he said.

The prospect of a lengthy wait left him feeling down and drove him to seek private healthcare in the interim. “I am going to a clinic in London and it was a big decision for me because it is a lot of my savings I am spending on these appointments but that is the only thing that has really given me some hope that things are going to get better in a relatively less-bad time frame,” Smith said.

Access to healthcare, he added, was a key concern for trans men and women. “I see a lot of articles that are … sensationalising things or trying to create some controversy over things like what toilets we use and things like that. But actually I think this is the biggest thing that affects transgender people’s lives and this is what we struggle with, getting the healthcare we need. We just want to get on with our lives and just live normal lives really.”

Feeling like trust in the doctor has been eroded

“I do feel nervous about going [to the GP], particularly anything where I am going to have to mention anything about gender and/or surgery, because I feel they then go off on a complete tangent,” said Brumfitt. “A bit like if you are obese, they just think everything that is wrong with you is because you are fat.”

Eric, a 36-year-old trans man, expressed similar concerns. “ I have never been a massive fan of going to the doctor for every little thing anyway, but I will avoid it probably longer than I should,” he said. “I know I should be going to see the GP at the moment for something completely unrelated to gender identity, hormones or anything else and I have been putting it off for quite some time,” he said. The presence of gender dysphoria and contact with mental health professionals on his records meant such topics were invariably raised, regardless of why he was visiting the GP, he said.

Problems with GP records

Annabelle, 38, a trans woman, tried to find out what updating her gender marker to female on her records would mean for her medical care after her practice manager asked if she would like it to be changed.

“I was like I don’t know actually because what are the implications for managing my health provision moving forwards?,” she said, adding that, for example, in the case of an accident it would be important for doctors to know she would not be expected to be pregnant. The upshot was a phone call that lasted around two hours. “I was trying to ask them what the medical implications were of them changing my gender marker on my notes and they were trying to do the politically correct thing of saying well it is what you want, it is not about what we want.”

In the end Annabelle had her gender marker updated. A week later she received a letter inviting her for cervical screening – despite not having such anatomy.

Lack of information on health issues

Some have complained about a lack of information on how health matters common to cis men and women might affect those who are gender queer or who transition to a different gender.

“It is bad enough trying to find info on menopause but trying to find something on how it affects someone like me has been really, really difficult,” said Brumfitt.

Difficulties accessing ‘bridging hormones’

Kimberley was told by her GP that he would only take over prescribing hormone therapy if she was self-medicating. So that’s what she did – but no help was given. “I have had to do it all on my own, which of course is incredibly risky,” she said, although she said the medication has been very beneficial to her.

What’s more, after disclosing the source of her hormones, Kimberley found the website was soon shut down. “I went into withdrawal and within six weeks I had spent a night in hospital because I had tried to kill myself,” she said. “There were a couple of additional factors, things that were going on outside of that process, but it was the testosterone coming back into my system that really made me paranoid and quite aggressive and I just couldn’t cope. The main part of it was that I couldn’t get what I needed.”

Some names have been changed