If you are not currently registered with WellBN you can register through our website ( Register With Our Practice (wellbn.co.uk) ) and also access downloadable PDFs to register by pen and paper. If it is easier, this will need to be posted or dropped into a WellBN clinic.
Yes, WellBN has been working for years to improve the experience of and access to health care within the TNBI community.
The clinicians who run the hormone clinic - GP, Dr Samuel Hall and Advanced Nurse Practitioner, Jacqui Liddle - are experienced with trans care as well as the specific needs of non-binary patients.
Our in-house pharmacy team is trained in hormone care and can provide regular medication reviews.
We work closely with the local trans-led charity, The Clare Project to provide psychosocial support in the community.
Care coordination was added to our services with the specific aim to improve this cohort’s experience of primary care by providing ongoing, individualised support.
We also have an in-house physiotherapist and mental health practitioner, both of whom are trans-affirming and trained on trans inclusion.
In January 2022 a care coordinator was recruited at WellBN with the aim to improve the TNBI (trans, non-binary and intersex) patient cohort’s access to general and affirming health care.
The care coordinator provides a friendly and affirming point of contact for patients who have been historically discriminated against in health care settings. This is done by building ongoing, individualised relationships and easing access to services, referrals, appointments and more.
The TNBI care coordinator at WellBN is Lili, you can check out their short bio here: https://www.wellbn.co.uk/lili_hornyai/nhs-services/doctors?go You can access the care coordinator by emailing them at lili.hornyai@nhs.net. They will be happy to answer any health care related queries including, but not limited to gender/trans-related things.
Please note that this is a highly sought-after service, so response time can be up to 10-15 working days. Emails are triaged so if your query is urgent, you will get a response sooner, but please bear with us while we process more routine requests.
In order to access a bridging prescription for HRT at WellBN you need to meet the following three criteria:
You need to be on the GIC (Gender Identity Clinic) waiting list. If you have not been referred yet, we can sort this out for you after a video call appointment with our care coordinator.
You will need to read and sign our informed consent form. Please download the appropriate form (masculinising if you’d like to access testosterone or feminising if you’d like to go on oestrogen) and read through it carefully. Please make note of any questions that you may have about the contents.
You will need to get a baseline blood test done at one of our clinics. You can book these through our online booking system or by contacting the care coordinator. PLEASE NOTE, the blood test must be an HRT baseline blood work as a set up blood test for your initial appointment.
Once the above are in place, a clinician will be able to prescribe to you at a hormone clinic appointment.
Email your completed consent form and any questions that you may have to the care coordinator, Lili, at lili.hornyai@nhs.net. They will be able to arrange a Trans Health & Wellbeing Advice Clinic and/or a Hormone Clinic appointment for you.
A bridging prescription is issued to tie you over until you are seen by a specialist at the Gender Identity Clinic.
It is not a lower dose than what would normally be prescribed to you by the GIC.
There is no time limitation on this, you can be on a bridging prescription as long as you need it (e.g. when your prescription is overtaken by the GIC endocrinology team).
This is supported by the General Medical Council as a harm reduction method due to long waiting times (hence you need to be on the waiting list to become eligible).
Your first hormone clinic appointment will involve a simple chat with a clinician about your background, your gender journey so far and your aims with gender affirming care. They may ask you about your dysphoria and what you hope to achieve with HRT. You will also be prompted to consider whether you want to have biological children in the future. You will also be able to discuss your blood test results.
The appointment will not be invasive, intimidating and it is not for the purpose of gatekeeping, but rather to make sure you are starting treatment with the proper support around you and to ensure that you are making a truly informed decision.
The appointment will be 15 to 30 minutes long and take place face-to-face or via phone.
If you have not had your height or weight measured recently, the clinician may take this during your initial appointment. If this is something that causes any issues or distress for you then please let us know ahead of your appointment.
At this appointment you will be prescribed hormones as long as there are no major health concerns that could arise from commencing HRT. Please feel free to ask all your questions about the risks of HRT, the clinician will be more than happy to answer them.
You will be able to collect your prescription from your dedicated pharmacy within 24-48 hours.
The current cost of prescriptions on the NHS are £9.35 per item.
Prescription Prepayment Certificate or PPC can also be purchased if you are in need of multiple prescriptions throughout the year. A 3 month and 12 month certificate can be used at the cost of £30.25 for the 3 months and £108.10 for the 12 months.
You can order your repeat prescriptions via the NHS app - it is highly recommended you set this up as you will also be able to access your blood test results, appointments and referrals through this service.
You can also order prescriptions online through the WellBN website. You will need a SystemOnline login to access this platform. For this option follow this link Prescriptions (wellbn.co.uk).
You can also call WellBN to order your repeat prescriptions. This service is open Monday to Friday, 8am to 4pm through the number 08081647678. For all WellBN centres choose either option 1 or 2.
To make sure that your hormone levels are within the safe and appropriate ranges we ask that in your first year you have a blood test every three months. After this we will monitor your blood every six months in your second and third years and then commencing yearly in your fourth year and onwards.
Your blood test results will be checked by a hormone specialist clinician and you will have regular follow-up appointments to discuss your levels and HRT regime, in general.
You can either book in your blood tests yourself via the online platform (make sure to mention that it is to monitor HRT) or by contacting your care coordinator.
It’s important that you don’t apply your gel (testosterone or oestrogen) on the day of your blood test until after the test is done. If you usually use your gel in the morning and your appointment is in the afternoon, then make sure that you apply the gel on the opposite arm from the one where the blood will be taken from.
This advice clinic is run by the TNBI care coordinator via video calls.
Appointments are 30 minutes long and consist of a casual chat about your health care, general physical and mental wellbeing. You can discuss appointments, assessments, referrals, prescriptions or anything else that is related to your health care.
The calls are done on an integrated system so you will receive a link at the time of the appointment. The link opens a browser tab with the video chat window so you won’t need any specific software to access the call. You can book an appointment by emailing Lili at lili.hornyai@nhs.net .
If you haven’t been referred to the GIC yet, we will be able to sort this out for you after a video chat appointment with our care coordinator.
Once referral is made, you will receive a welcome pack from the GIC within a couple of months. Please keep an eye on your inbox (including your spam folder) as you will need to return a form to them to finalise your place on the list.
The current official waiting time for a first appointment with the GIC is 5-7 years. During this time the service doesn’t tend to communicate with patients, so it is not uncommon that you don’t hear from them for years.
Please note that your first appointment will not involve a discussion of HRT or surgery referral - it is an initial assessment where you will be asked about your background, history and physical and mental health.
Any kind of treatment or referral is usually discussed at a second or third appointment that might only happen another year down the line.
You will also be asked to have regular blood tests to monitor your progress and ensure your hormone levels are within the safe ranges - similar to how we monitor your blood work at WellBN in between hormone appointments and HRT reviews.
You can also self-refer to a specific, regional GIC of your choice (please see list below). Please note that your GPs involvement will still be required in providing the GIC with your medical assessment and throughout the whole treatment so it is advisable that you have a GP who will support you through this pathway.
Here is the list of NHS GICs and where they are based:
The Tavistock and Portman NHS Foundation Trust: Gender Dysphoria Clinic for Adults, London, NW3 5HR.
Sheffield Health and Social Care NHS Foundation Trust Gender Dysphoria Service, Sheffiled, S11 9BF.
Leeds and York Partnership NHS Foundation Trust Gender Dysphoria Service. Leeds, LS14 6WB.
Cumbria, Nrothumberland, Tyne and Wear NHS Foundation Trust Northern Region Gender Dysphoria Service, Newcastle, NE6 4PF.
Nottinghamshire Health NHS Foundation Trust the Nottingham Care for Transgender Health, Nottingham, NG1 3AL.
Devon Partnership NHS Trust West of England Specialist Gender Dysphoria Clinic, Exeter, EX1 1QA.
It is important to note as well that you do not need to be assessed by a mental health service first and your GP does not need any prior approval for your referral from any integrated care boards responsible for public health.
If you have a diagnosis of gender incongruence/dysphoria and are due to start hormone therapy as part of your affirming care, you are eligible for fertility preservation on the NHS.
Under our current, local Sussex pathway, you can get the diagnosis from Dr Samuel Hall at WellBN, so you won’t have to pay for a formal psychiatric assessment. Please note though that Dr Hall’s appointments are booked up quite far ahead and so you may need to wait a couple of months to be able to start the fertility preservation process and you cannot start HRT before that process is complete.
You also mustn’t smoke or have any living biological or adopted children (including your partner’s children).
For egg preservation, patients have to be between the ages of 16 and 40, and BMI between 19 and 30.
For sperm storage, patients have to be under the age of 55.
Once you are referred to the local fertility clinic (Agora), you will be contacted by them for an initial consultation. You will also need to get a blood test done to screen you for STIs.
Storage is funded for up to 10 years, as long as your circumstances don’t change in regards to the criteria, as stated above.
Please note that fertility procedures related to your stored gametes may not be funded.
Funding under NHS England varies by local area which is based on rules that are set out by your local clinical commissioning group (CCG) and many of these CCGs are now funding treatments.
Funding under NHS Wales allows for people to get funded treatment for 10 years.
Other options may include the storage of embryos or reproductive tissues. However, these are relatively new and especially for storage of reproductive tissues is currently experimental.
You may want to consider treatments abroad, though make sure to do thorough research on the clinics available, costs of these and their pregnancy and twin/triple rates as they can bring complications and risks to pregnancies and the carrier of the child.
Legislation is set up within the EU to protect you if you were to seek treatment abroad. It sets standards for quality and safety, however not all EU countries have implemented this legislation and clinics in those countries are not necessarily accredited by a national body.
If you are interested in Speech and Language Therapy (SALT) we can refer you to a local specialist. Please register your interest by emailing TNBI care coordinator, Lili at lili.hornyai@nhs.net and they will arrange the referral for you.
We work with local specialist consultants who have extensive experience working with trans and non-binary patients. They offer appointments across Sussex, though waiting times vary widely from clinic to clinic.
Therapy in most cases will be offered on a 1-to-1 basis, pairs or in small groups depending on individual needs and prior agreement with the consultant at your initial appointment.
In some cases, you may be required to be seen by the clinic’s ENT (Ear, Nose and Throat) department before starting SALT to look at laryngeal health and movements; this can help inform the therapy team.
People over the age of 25 who have an intact cervix are invited to do a cervical smear test every 3 years to screen for cervical cancer.
You can easily book a smear test through our online booking system, follow the link Online Booking & Services (wellbn.co.uk). You will need a SystemOnline login for this. Alternatively, you can email the care coordinator to arrange this.
You can bring a friend/partner with you for emotional support and you are also entitled to have a chaperone present, if you wish so.
Please feel free to bring headphones, fidget toys or anything else you may find useful to distract you during the procedure.
It can be useful to use vaginal oestrogen in the week prior to your smear test, so if you are concerned about dryness, please let us know and we can arrange a prescription for you for this.
Similarly, if you feel very anxious about your appointment, you can get a one-off diazepam prescription to take the edge off. Alternatively, you can call the surgery a day before your test to check if there’s any available in-house to save you the prescription fee.
Smear tests are done by Nurse Rhoda and Nurse Abi at WellBN. They are both trained and experienced in dealing with TNB patients and are especially careful, considerate and welcoming during these appointments.
If you have changed your name by deed poll then we can change your name immediately on our system - please send a digital copy to the care coordinator and it will be added to your record.
We are also able to put your pronouns on your file so that clinicians who you will be in contact with will know how to address you correctly.
If you have not legally changed your name yet, we can add the name you use to your record as a ‘preferred name’. This should still be noted by clinicians, but the system is not foolproof and, unfortunately, the text reminder system automatically pulls in your legal name, too. These are under continuous review and development so we are hoping to improve this system eventually.
If you need help completing a deed poll to change your name please see How can I change my name via deed poll? FAQ on this page.
Changing your gender marker can be a lengthy process and currently there are only two options to pick from, these being M for male and F for female. There is no possibility at the moment to get legal recognition for non-binary people and this includes their gender markers on their medical records.
Changing gender markers can also hinder your access to essential healthcare services. You can only get a new gender marker with a completely new NHS number. This means that your old record associated with your NHS number that was assigned to you at birth will be destroyed and you will be registered as a new patient altogether. During this process, your old record is rendered invalid and your access to repeat prescriptions becomes limited. This can take several months to sort out, during which time you will need to collect printed prescriptions from the surgery to be able to access your medication.
This process is done at a central NHS system, not at the GP surgery and so we have very little control over it. We are hoping to influence change around this topic with NHS primary care support services in the future.
Nevertheless, if you’d like to change your gender marker, we can initiate this for you, but please bear in mind the potential administrative issues as laid out above.
You will first need to decide if you want to have an enrolled or unenrolled deed poll.
An unenrolled deed poll is a simple formal legal statement that you have changed your name. You can make this yourself - you do not need a solicitor.
An enrolled deed poll is a deed poll which has been officially registered at the Royal Courts of Justice. These are specific to births registered in England and Wales; there are separate procedures for Scotland and Northern Ireland.
An enrolled deed poll costs £42.44, but most organisations are likely to accept a free, unenrolled deed poll, too, including for the purposes of changing your passport.
In order to change your name via deed poll you will need to be 16 years old or older and need to have two people witness the signature of the deed poll who are known to you but are not family/related to you.
To create a deed poll document you can follow templates such as on the government website, we have also created a template example of what a deed poll should look like for the correct legal wording, find an example of a deed poll template in our resources and links page.
To be eligible to apply for a gender recognition certificate you must be 18 years of age or over, have a formal diagnosis, you must have lived as your gender identity for 24 continuous months and intend to continue to for the rest of your life.
If you are married or in a civil partnership, you may need to check what obtaining a GRC means in regards to your marriage/partnership. For more information visit UK Trans Info's useful guide, see page 28 for the relevant section.
It costs £5 to apply. You might be able to get help with this payment if you get benefits or are on a low income.
If you have an expired passport, you can apply online and ask to update your name and/or gender marker. You do not need a GRC to be able to do this.
You will need to submit an original copy of your deed poll, a GP letter and some form of evidence of you using your name (eg payslip, household bill). Alternatively, if you have a GRC already, you can just submit that on its own along with your application.
The cost is £75.50 if applying online and £85 if applying by post.
To obtain the GP letter in support of your passport application, please get in touch with care coordinator Lili at lili.hornyai@nhs.net.
You should be aware that any current visas you hold will not be transferred to your new passport, so please bear this in mind when travelling. Some countries require you to have the visa transferred to your new passport but others may require you to purchase a new one entirely. For more information, visit https://genderkit.org.uk/article/getting-a-new-passport/
The Trans Health Hub is an outreach clinic to provide information and advice to TNBI patients who are NOT registered at WellBN. It was established with the aim to improve access to affirming healthcare wherever patients are located.
The Trans Health Hub is run by Dr Samuell Hall, a GP at WellBN. Appointments are 30 minutes long and are designed to give a safe space for patients to discuss their health care aims and current situation with their GPs. Dr Hall can write an advisory letter to your GP guiding them on how to prescribe a bridging prescription and how to monitor your hormone levels. Please note that the Trans Health Hub does not prescribe and cannot prescribe any medications it is an advisory service only.
Appointments can be via phone call, video call or in person at the Dorset Gardens Methodist Church, when emailing for an appointment please specify what method of contact you would prefer for your appointment to make the process quicker.
WellBN supports the use of the Trans Health Hub to enable patients to further understand their rights regarding equal access to health care.
The Trans Health Hub is run in partnership with The Clare Project to improve your experience of and access to healthcare. The clinic is run via pre-booked appointments, please email sxicb-bh.transhealthhub@nhs.net to set up a meeting.
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