Interventions such as hormone blockers or gender affirming hormones require initial psychological assessment from gender specialist services before being referred to a paediatric endocrinologist, or endocrinologist. In certain circumstances, GPs have undertaken these treatments, without these requirements, due to the exceptionally long waiting times for NHS treatment. Whilst many parents and carers we spoke to preferred for their child’s trans healthcare to take place within the NHS, the waiting times at the gender identity services for both children and adults, meant that some opted to pay for it privately. For example, E and D were able to pay privately for their adult son’s appointments with a gender identity specialist and endocrinologist. This allowed their son to avoid waiting a long time to be seen on the NHS and get hormones prescribed, which as E observed ‘did seem to help a lot’ with how he felt about himself.
E and D talked about their son seeing a gender identity specialist and an endocrinologist privately but ongoing treatment was carried out in primary care under the NHS.
This section is mostly about seeing the endocrinologist on the NHS. Below, you can find out more about the parents’ and carers’ experiences of going to the specialist hormone (endocrine) clinic with their child, to get their child assessed for hormones, hormone blockers or to get their stage of puberty assessed.
Within the NHS, the referral to the specialist endocrinologist is always done by the Gender Identity Development Service (GIDS) after the young person has been assessed by the therapists within the service. Some parents also spoke about getting a local endocrinologist involved in their child’s care via their local GP practice or getting more ‘joined up’ or ‘collaborative’ care where appointments would be attended by professionals from both GIDS and the endocrinologist. Being referred could involve several visits and include blood tests, scans and filling out consent forms.
Adele spoke about getting her son approved for hormone blockers, seeing and endocrinologist and the time it took.
Leigh said there were many, many conversations’ in the family and with her foster son’s therapist and social worker about what would be involved in taking hormone blockers.
For parents, whose children are waiting to start hormone blockers, seeing an endocrinologist and other specialists who can explain aspects of medical transition can be informative and reassuring. This was the case for Richard, who felt the visits to the specialist clinic ‘were excellent.’ He particularly appreciated the tactful manner of one of the specialists and his ability to make him and his daughter ‘feel really comfortable’ discussing potentially embarrassing issues.
Richard felt talking to the specialists at the hospital about hormone blockers and future medical interventions was a very positive experience.
Lisa’s son was on hormone blockers prescribed by a private provider. In order to be able to access hormone blockers on the NHS he was required to stop taking the privately prescribed blockers and have his pubertal development assessed by an NHS endocrinologist. Lisa then requested joined up appointments between the Gender Identity Development Services and the NHS endocrinology team. She said: ‘we’ve started now to have joint meetings with endocrinology and the [Gender Identity Development Service]. They have been more helpful, because we can agree a process and then everybody knows.’ Lisa emphasised that such ‘multidisciplinary team meetings are really useful in circumstances where there are different types of support that are needed, especially for a child.’
Lisa described her experience of getting the endocrinology team and the Gender Identity Development Services to work more closely together to support her son.
Getting an endocrinologist involved in her daughter’s care was something that Jan saw as a very positive outcome of her efforts to ensure that her daughter’s specific healthcare needs were met locally. She felt it was ‘great to have somebody in our local practice, we feel like [her], her trans care is a part of her overall medical care.’