Transgender Hormone Therapy London
Hormone replacement therapy for transgender or gender variant individuals, also sometimes called cross-sex hormone therapy, is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender, or gender variant individuals, for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. These hormones vary based on whether the aim of treatment is feminisation or masculinisation.
- Feminisation therapy for transgender women – oestrogens and anti-androgens
- Masculinising hormone therapy for transgender men – androgen, occasionally anti-oestrogens
Our aim at The London Transgender Clinic is to support our patients in a compassionate, caring and effective manner adhering to The World Professional Association for Transgender Health (WPATH) guidelines and standards of care version 7. We work with a number of Consultant Psychologist and Psychiatrist Gender Specialists who offer psychological assessments and follow-up sessions, including reviews for endorsement of hormone therapy with our Nurse Prescriber, Mary Burke RN and specialist transgender surgery with world renowned plastic surgeon Mr Christopher Inglefield BSc FRCS (Plast)
Cross-sex hormone therapy has been shown unquestionably to have a positive physical and psychological effect on the transitioning individual. Transgender individuals experience discord between their self identified gender and their biological sex. The World Professional Association for Transgender Health (WPATH) has created transgender specific guidelines to help service a framework for providers caring for transgender or gender variant individuals. These guidelines are mostly based on clinical experience from experts in the field. Guidelines for hormone therapy in transgender men are mostly extrapolations from recommendations that currently exist for the treatment of hypogonadal natal men and oestrogen therapy for transgender women is based on treatments used for postmenopausal women.
Hormone therapy must be prescribed on an individualised basis depending on a patient’s goals, the risk/benefit ratio of medication, consideration of other medical conditions and social and economic issues. Hormone therapy can provide significant comfort to patients who do not wish to make a social gender role transition or undergo surgery or who are unable to do so.
Frequently Asked Questions
When can I start hormone therapy?Hormone therapy can be initiated once a psychological assessment has been completed by a Consultant Psychologist or Psychiatrist Gender Specialist and the patient has been determined to be an appropriate candidate for hormone therapy. Informed consent reviewing the risks and benefits of starting therapy must also be obtained.
How much for my initial consultation?Your initial consultation will cost £300. This includes an assessment with our experienced Specialist Nurse Prescriber, Mary Burke, who will record a full medical and social history, blood pressure, inBody analysis, weight, height, nicotine test and/or pregnancy test if appropriate. You will also be seen by Mr Christopher Inglefield, Specialist Transgender Surgeon, for a physical examination. If there are no contraindications following your consultation with Mary you will usually be prescribed hormone therapy at this appointment.
Will I require a follow-up consultation?At The London Transgender Clinic we aim to review your care every 6 months for the first two years and then annually until your care has been taken over by endocrinology services at a NHS gender identity clinic. This is our responsibility as part of the Shared Care agreement with your GP. We understand that general practitioners are not specialists in this area and neither are they expected to be, this is why we share care to support both you and your GP. Follow up consultations will cost £100 each.
Will I require blood tests before my appointment?Yes, these can be arranged prior to your appointment with your GP.
How will my GP know what hormones to prescribe?Following your initial consultation with Mary Burke, a letter will be sent to your GP including all the necessary information about your hormone therapy and a Shared Care Agreement, which will include all the information your GP will require to continue your care.
What happens if I require further blood tests?In your Shared Care Agreement it clearly states which blood tests you will require and the recommended timing for these. It also outlines any further investigations, procedures or ultrasounds that may be recommended.
Am I required to be living in my preferred gender role prior to hormone therapy ?
No, guidelines do not require this step and instead it is recommended that patients transition socially with hormone therapy at the same time, however, your assessing and referring Consultant Psychologist or Psychiatrist will be able to discuss this in greater detail.
In the past the guidelines recommended patients undergo “real-life experience” prior to starting medical therapy. This test required patients to live full-time in their self affirmed gender for a predetermined period of time, approximately one year, before starting cross sex hormones. The recommendation was intended to help patients transition socially, however, this step is unreasonable for many patients. Social transition can be very challenging if there is incongruence between the individual’s self affirmed gender and their physical appearance.
Do I need to change my name by deed poll prior to commencing hormone therapy?No, this is not a requirement, however it may be recommended by your referring Consultant Psychologist or Psychiatrist to move forward with your transition, prior to commencing hormone therapy.