What blood tests do I need?

Starting treatment
Blood tests are an important part of treatment to make sure you are healthy and to keep you healthy for the future. They are essential if you are over 60,  if you have any other medical problems or if you are certain medications.

If you have had some blood tests within the last year, either at your doctor's or at a hospital, and have been told that they were within the accepted ranges, then we do not need to repeat them at this stage.

There is no need to have any routine blood tests before starting gender-affirming hormone therapy with the following exceptions:

  1. If you are going to take spironolactone we need a Kidney Function Test (U&E's including potassium test) and a blood pressure reading. 
  2. If you are going to take cyproterone acetate or bicalutamide we need a full health check (Full Blood Count (FBC); Kidney Function Test (U&E); Liver Function Test (LFT); Diabetes (HbA1C); Cholesterol (Lipids); and blood pressure reading).
  3. If you are going to take testosterone it may be useful to have a baseline test for haematology (how many red blood cells you have in the blood) prior to starting. This may help if your haematocrit comes back high after starting testosterone, but is not essential. Haematocrit is higher when you have testosterone than when you have oestrogen, so we expect it to increase on testosterone treatment. (This test is optional and the patient can choose whether or not to have it done).

However, it is really important that regardless of gender-affirming care that you keep healthy and we recommend that everyone has a routine health check with their doctor when needed, but this does not affect your ability to start gender-affirming hormones.


Our recommendation is that everyone who is aged 40 to 74 who does not have any of the pre-existing conditions listed below should have a health check every 5 years.

If you do suffer from any of the conditions listed below you should already be having regular check-ups.

Your own doctor will be able to give you more information about this.

  • heart failure
  • heart disease
  • atrial fibrillation
  • previous checks have found that you have a 20% or higher risk of getting cardiovascular disease over the next 10 years
  • deep vein thrombosis
  • high blood pressure (hypertension)
  • stroke
  • transient ischaemic attack
  • chronic kidney disease
  • diabetes
  • peripheral arterial disease
  • inherited high cholesterol (familial hypercholesterolemia)
  • currently being prescribed statins to lower cholesterol

If you are going to ask someone else to do your blood tests for you then please ask them for 'Full blood count, kidney function, liver test, lipids, diabetic check'. If you are already taking hormones then please also ask for 'oestrogen and testosterone'.

Continuing Treatment


Yearly - Full Health Check:

  • Full Blood Count (FBC)
  • Kidneys (U&Es)
  • Liver (LFTs)
  • Lipids
  • Diabetes (HbA1C)
  • Testosterone
  • Oestrogen

Every three months:

  • Oestrogen
  • Testosterone

If your prescription contains Spironolactone, please check U&Es (including potassium) every three months, as well as blood pressure.

If your prescription contains Cyproterone Acetate or Bicalutamide, please check LFTs every three months.

If your prescription contains Testosterone, please check FBC every six months.

If your prescription contains *only* blockers (with no hormones), we only need to see yearly Full Health Checks as outlined above.

More information about blood tests and how to obtain them can be found on our website here.

You can upload your blood test results here.