Should GPs collaborate with gender specialists if they lack knowledge in this area?

The NHS constitution gives patients the right to access certain services delivered through the NHS within maximum waiting times, or for the NHS to take all reasonable steps to offer a range of suitable alternative providers if this is not possible.

The Specialised Services Circular 1620 states: ‘Guidance for GPs, other clinicians and health professionals on the care of gender variant people’ states that, ‘GPs are usually at the centre of treatment for trans people, often in a shared care arrangement with other clinicians. GPs may prescribe hormones and make referrals to other clinicians or services, depending on the needs of the particular service user. Sometimes a GP has, or may develop, a special interest in gender treatment and may be able to initiate treatment, making such local referrals as necessary. Otherwise referrals may be made to a specialist Gender Identity Clinic (GIC) where there are multidisciplinary teams of professionals. Private treatment with a gender specialist may be preferred by the service user.’