Intended for healthcare professionals

Feature LGBT+care

The struggle for GPs to get the right care for patients with gender dysphoria

BMJ 2020; 368 doi: (Published 22 January 2020) Cite this as: BMJ 2020;368:m215
  1. Sally Howard, freelance journalist
  1. London
  1. sal{at}

Family doctors lack training and feel under pressure to prescribe, finds Sally Howard

Gender dysphoria can be difficult terrain for primary care doctors. Gender identity and gender dysphoria are not part of the GP curriculum.1 Patients face an average 18 month wait for specialist referral.2 And the NHS’s frontline doctors may bear the brunt of some patients’ distrust of a system that can’t cope with the current demand for services.

Specialist gender identity clinics (GICs) have seen referrals at least double over the five years to 2018, said James Palmer, medical director for specialised services at NHS England.3 As of 2019, about 7839 adults were waiting for a first appointment.2 Some 4000 young people are waiting for a specialist appointment.4

Chris Preece, a GP in North Yorkshire, told The BMJ that the two year wait for patients to be seen by his local gender identity clinic puts pressure …

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