Letter from the Department of Health
[Local MP] contacted the Department of Health on your behalf about support for transgender people.
Under the provisions of the Data Protections Act, during this pre-election period the Department is not able to share information or respond to enquiries on behalf of third parties without their express consent. We have therefore written to [Local MP] to explain that we would reply to you direct.
NHS England has informed gender identity services of their obligation under the NHS Constitution to commence first definitive treatment within 18 weeks of the date of the referral. However, despite increased financial investment by NHS England in gender identity services, the long waiting times cannot be managed through additional money alone. The main limiting factor is the shortage of trained professionals with the necessary specialist skills and experience. This is being addressed by collaborative work between the NHS, Health Education England, regulators and the professional associations to develop a national workforce and training plan.
The Women and Equalities Committee highlighted that GPs in particular often lack an understanding of transgender identities , of referral pathways into gender identity services and of their own role in prescribing hormone treatments. The Committee concluded that in some cases these problems in general practice lead to appropriate care not being provided.
The General Medical Council (GMC) has acted on the Committee’s recommendations by publishing new guidance on the responsibilities of GPs in treating transgender people. The guidance provides doctors with advice on issues such as confidentiality and respect. It also advises that an individual who requests treatment for gender dysphoria should be referred to a specialist gender identity clinic without delay.
The GMC’s guidance also confirms the role of GPs in prescribing and monitoring hormone treatments for transgender people, and confirms that it is safe and appropriate for them to do so. GPs who fail to follow this guidance are at risk of being referred to the GMC, which regulates medical practitioners.
Since the Committee’s report, NHS England has also published new guidance for GPs that reiterates the GMC’s position on the prescribing and monitoring of hormone treatments for transgender people in primary care. NHS England has been developing new service specifications for gender identity services for the purpose of public consultation. The draft service specifications would confirm that GPs should refer individuals who request treatment to a specialist gender identity clinic without delay, and the specifications will provide clarity on referral pathways into gender identity services.
In order to address cultural awareness issues in the NHS, Health Education England has recently publicised a planned programme of work that would make recommendations for the training and development of the future workforce in the field of gender identity. This would focus on new core competencies for staff working in gender identity services, professional standards for continuing professional development, establishing new trainee placements within gender identity services and recommendations for general awareness-raising amongst NHS staff. This work would include engagement with patient groups and people who use gender identity services.
The Gender Recognition Certificate (GRC) is a matter for the HM Courts and Tribunals Service, which is sponsored by the Ministry of Justice. You may therefore wish to address your concerns about the GRC, after the General Election, to:
Now that Parliament has been dissolved before the General Election, the Department cannot comment further on this matter. Any decisions on further work on these issues will be a matter for the incoming Government.
I hope this reply is helpful.
Ministerial Correspondence and Public Enquiries
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