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Trans Health Hub – FAQs

How do I register to be a patient at WellBN?
  • 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.
Does the practice have any experience with TNBI patients?
  • Yes, WellBN has been working for years to improve the experience of and access to health care within the TNBI community.
  • Trans health care are delivered at WellBN by a team of clinicians who 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 and regular blood monitoring is done by an HRT specialist pharmacist.
  • 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 in-house mental health practitioners who are trans-affirming and trained on trans inclusion.
How does the informed consent model work for HRT at WellBN?
If a patient expresses a need to discuss accessing HRT for gender affirming purposes, contact is made by a member of the triage team or the TNBI care coordinator to assess needs and the patient’s journey with gender so far.
They are then given an informed consent form that sets out the risks, potential side effects and reversible and irreversible intended effects of hormone therapy – this includes the topic of fertility preservation.
If they need additional support with the consent form, a further appointment can be arranged. If a referral to the local Gender Identity Clinic service is requested by the patient, this is arranged. They are then booked in for a baseline blood test that checks their pre-HRT hormone levels as well as a series of other base health indicators.
Once everything is in place, they are scheduled a 40-minute appointment with a clinician – this is a holistic health review covering physical, mental and sexual health. It also provides an opportunity to discuss questions or concerns related to the consent form with a clinician. If the patient then wishes to start hormones, a prescription for HRT is issued.
Patients on HRT are monitored regularly – every 3 months in the first year – including a blood test and a review with a clinician who can adjust the hormone regime, if needed. They also have ongoing access to care coordination and the support of the TNBI team via the Trans Health Hub.
How can I access a prescription for HRT at WellBN?
  • We work with an informed consent model for HRT at WellBN. This means that you need to meet the following three criteria:
  • You need to be on a GIC (Gender Identity Clinic) waiting list. If you have not been referred yet, we can sort this out for you.
  • 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 Trans Health Hub. PLEASE NOTE, the blood test must be an HRT baseline blood work as a set up for your initial appointment.
  • Once the above are in place, a clinician will be able to prescribe to you at a holistic health review appointment.
  • Email any questions that you may have to the Trans Health Hub email address, sxicb-bh.transhealthhub@nhs.net or fill out a Klinik form via the HRT/Hormones pathway.
What will happen at my holistic TNBI health review appointment with WellBN?
  • TNBI patients are entitled to a comprehensive annual health review. The purpose of this is to determine ways that the GP surgery can support your wellbeing.
  • Health review appointments are 40-45 minutes long.
  • During your annual holistic health review, a clinician will go through a template with you that will prompt them to ask questions about your gender identity and the affirming care you had/in need of. They will also ask you about your physical, sexual and mental health (including neurodivergence) to give you the opportunity to bring up any concerns.
  • You might find it helpful to write down and bring a list of your questions with you, so you can discuss them with the clinician.
  • You can find more information about your health review appointment here: Your-annual-holistic-health-review-appointment.pdf
How much will my prescription cost?
  • The current cost of prescriptions on the NHS are £9.65 per item (as of April 2024).
  • 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.
  • Some people are eligible for free prescriptions, please check the criteria here: https://www.nhs.uk/nhs-services/prescriptions-and-pharmacies/who-can-get-free-prescriptions/
  • 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.
How will my hormone levels be monitored?
  • 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 the Trans Health Hub at sxicb-bh.transhealthhub@nhs.net or filling out a KIinik form via the HRT/Hormones pathway.
  • 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.
  • You can find more information about monitoring your HRT here: Your-HRT-prescription-and-monitoring-feminising.pdf and Your-HRT-prescription-and-monitoring-masculinising.pdf
What is the Trans Health & Wellbeing Advice Clinic and how can I access it?
  • 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.
  • You can also request a call to discuss any concerns you may have in regards to the informed consent form or HRT in general.
  • It’s a good idea to prepare for the appointment with a list of questions and/or topics to discuss so you can make the best use of the time.
  • To schedule a video call, email the Trans Health Hub at sxicb-bh.transhealthhub@nhs.net or filling out a KIinik form via the HRT/Hormones pathway.
What should I know about the Gender Identity Clinic (GIC) referral process?
  • If you haven’t been referred to the GIC yet, we will be able to sort this out for you. Please email the Trans Health Hub at sxicb-bh.transhealthhub@nhs.net or fill out a KIinik form via the HRT/Hormones pathway.
  • Unless otherwise requested, we will refer you to the Tavistock clinic in London.
  • You will receive confirmation once your referral has been submitted. You will also receive a welcome pack from the GIC within a couple of months.
  • You can find information about current waiting times for an initial appointment here: https://genderkit.org.uk/resources/wait-times/
  • It’s important that you keep the GIC updated with your contact details. If you change your name, NHS number, postal address, phone number, email address or GP, you need to let them know by emailing their admin team.
  • You can find more information about this process and what the GIC can and can’t offer here: Your-referral-to-the-Gender-Identity-Clinic.pdf
How can I get referral for fertility preservation on the NHS?
  • If you are due to start HRT as part of your affirming care, you are eligible for fertility preservation on the NHS (conditions apply).
  • Please email the Trans Health Hub at sxicb-bh.transhealthhub@nhs.net or fill out a KIinik form via the HRT/Hormones pathway to query about a referral.
  • Please note that if you haven’t started HRT yet and want to go ahead with fertility preservation, you will only be able to start HRT once the process is complete.
  • If you are already on HRT, you will need to stop for 3 months before we can refer you.
  • From referral, the whole process usually takes 2-4 months.
  • Storage is funded for up to 10 years (conditions apply).
  • For further information on the referral criteria and the preservation process itself, please read our information sheets here: Your-options-for-fertility-preservation-eggs.pdf and Your-options-for-fertility-preservation-sperm.pdf
How can I access Speech and Language Therapy (SALT) on the NHS?
  • If you are interested in Speech and Language Therapy (SALT) we can refer you to the Combined Voice clinic. Please email the Trans Health Hub at sxicb-bh.transhealthhub@nhs.net or fill out a KIinik form via the HRT/Hormones pathway to query about a referral.
  • You will need to have a laryngoscopic examination of your vocal chords at the ENT clinic first – this is to inform the voice therapist’s work with you.
  • After your ENT appointment, you will be added to the waiting list for SALT
  • The combined waiting time is likely to be 12-18 months.
Can I get a smear test done at WellBN and what support do you provide for this?
  • 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 Trans Health Hub at sxicb-bh.transhealthhub@nhs.net or fill out a KIinik form via the HRT/Hormones pathway.
  • 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.
  • You can also ask the clinician to let you insert the speculum yourself.
  • 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.
  • 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.
  • You can find more information about smears and why they are important here:
    https://www.wellbn.co.uk/article/wellbn/cervical-screening-for-lgbt-patients/ and here: https://www.wellbn.co.uk/article/wellbn/cervical-screening-smear-test/
How can I change my name at WellBN?
  • If you have changed your name by deed poll then we can change your name immediately on our system – please send a digital copy by email to the Trans Health Hub at sxicb-bh.transhealthhub@nhs.net.
  • 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 admin and clinical staff at WellBN, but the system is not fool proof.
  • 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.
How can I change my gender marker at WellBN?
  • Changing your gender marker can be a lengthy process and currently there are only two options – M for male or F for female.
  • 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.
  • You can find more information about the pros and cons of changing gender markers here: Updating-your-NHS-gender-marker-and-changing-NHS-numbers.pdf
  • If you would like to proceed with requesting a new NHS number and gender marker, please email the Trans Health Hub at sxicb-bh.transhealthhub@nhs.net or fill out a KIinik form via the HRT/Hormones pathway.
How do I change my name via Deed Poll?
  • 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 use our template from the Resources and Links page here: https://www.wellbn.co.uk/trans-health-hub/trans-health-hub-resources-and-links/
  • You can find more information about updating your documents here: Updating-your-documents.pdf
What are the requirements for a Gender Recognition Certificate (GRC)?
  • 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.
  • 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.
  • You can find more information about the process and the necessary documents for application on the government’s website here: https://www.gov.uk/apply-gender-recognition-certificate
  • You can also read our guide on how to update your documents here: Updating-your-documents.pdf
What do I need in order to change my gender marker on my passport?
  • 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.
  • To obtain the GP letter in support of your passport application, please get in touch with the Trans Health Hub at sxicb-bh.transhealthhub@nhs.net or fill out a KIinik form via the HRT/Hormones pathway.
  • You can also read our guide on how to update your documents here:  Updating-your-documents.pdf