Medication

What are the ideal hormone levels for medical transition?

Hormone therapies work by starting with small doses and gradually building them up until a target range is reached. There is a difference between the target range (which is acceptable) and the ideal level. Everyone's body is different, and some people will respond better or worse to different hormone levels. We will work with you to ensure you get the treatment that best fits you. In general, the desired hormone levels in over 16s are follows. For feminising hormones: - Testosterone < ...

How quickly can patients start treatment?

People who are clear about their gender identity and are eligible for treatment can start treatment when needed. In straightforward cases, this can be as quickly as 4-6 weeks. We have no waiting lists and to subject patients to long waiting lists or unnecessary delays only causes harm. To start your journey with us visit our Appraisal Pathway (http://gendergp.com/full-pathway).

Is there any guidance for unlicensed medication use?

Yes, the GMC and GPhC both offer guidance for the use of unlicensed medication in the UK. At GenderGP we prescribe in line with the Endocrine Society Guidelines for the Care of Transgender Patients, which offers guidance for the off-label use of medications specifically in the field of trans healthcare, these include puberty blockers and gender-affirming hormone therapy. Our prescribing protocol and a list of prescribed medications can be found here (https://www.gendergp.com/prescribing-proto...

Is off-label prescribing legal?

The GMC guidelines state that, ‘You should usually prescribe licensed medicines in accordance with the terms of their licence. However, you may prescribe unlicensed medicines where, on the basis of an assessment of the individual patient, you conclude, for medical reasons, that it is necessary to do so to meet the specific needs of the patient.’ Because the legal responsibility lies with the clinician who signs the prescription, it is important for GPs and other prescribers to ensure that the...

Is unlicensed medication safe?

Yes, when it is used in accordance with best medical practice. Unlicensed, off-licence and off-label refer only to the use of the medication beyond the terms of its licence, and do not refer to improper, illegal, unsafe or experimental use, as noted by the American Academy of Pediatrics.

Who is responsible for licensing medication?

Different organisations are responsible for licensing medication in different countries. In the UK it is the role of the Medicine and Healthcare product Regulatory Agency (MHRA) and the European Medicines Agency (EMA). Full information about licensing medication can be found on our website (https://www.gendergp.com/is-unlicensed-medication-safe/).

Who uses unlicensed medication?

Unlicensed medication is used by a wide variety of people. It is particularly common in paediatric and geriatric care, as some drug manufacturers do not want to pay to license their medications for younger and older users. This is because there tends to be less overall use of most medications in younger and older people, and so drug manufacturers make less money by licensing them for these groups. The same thing happens in transgender healthcare - because transgender people are a minority, it is...

What is unlicensed medication?

Unlicensed medication, also referred to as off-label or off-licence, is medication that is prescribed for a use other than the use listed in the terms of its licence, within the country of use. The licence says what conditions the medication can be used for, what age patients it can be given to, how much can be given and how to give it. However, there are many medications that are used either outside of the terms of their licences or without a licence at all, when it is in the patient’s best ...

Are the medicines used in treating trans patients similar to those used for Hormone Replacement Therapy?

Yes. Gender-affirming hormones are the sex hormones that your body needs. If your own body can’t produce them (because you have gone through the menopause for example, or if you are transgender) then they can be given as medicines.

Are gender-affirming hormones reversible?

No. Gender affirming hormones are classed as being partially reversible. These hormones have long-lasting and irreversible implications, although the changes do not occur overnight. No doctor would ever choose to actively prescribe such medication unless it was in the best interests of the patient.

I want to stop self-medicating, what should I do?

If you are obtaining your medication in this way, GenderGP can swap you onto safe prescription medication and arrange to have your bloods monitored to check your hormone levels are safe. You can start today with our Appraisal Pathway (http://gendergp.com/full-pathway).

Why do people self-medicate?

Many trans and non-binary people have been forced to start treatment on their own due to long waiting times and a struggle to access the right healthcare regime for them. If you are self-medicating and want to stop, you can talk to your GP about bridging hormones or start treatment with us via our Appraisal Pathway (http://gendergp.com/full-pathway).

What is self-medding/self-medicating?

Self-medding or self-medicating is the term used to describe the process whereby a trans individual carries out their own research via trans forums and support groups to try to understand what levels of hormones might be right for their needs. The individual then obtains the “medication” (often without a prescription) and begins to follow a treatment regime. This approach is often unmonitored and the legitimacy of the medication questionable, which can carry worrying health implications. If you...

Can taking HRT lead to the development of new allergies?

Allergies develop when our immune system identifies non harmful substances as threats to our bodies. As individuals, we are all unique in the way in which we interact with our environment, and so there are no specific guarantees in terms of how our bodies may react when hormone therapy, or another unrelated substance, is introduced. Allergies involve a complex interaction between immunity, infection, inflammation, and hormones. For instance, it is known that there is a tendency for allergic or a...

Has GenderGP prescribed hormones to patients as young as 12?

Yes. There may occasionally be compelling reasons as to why a young trans person, who is completely aligned with their gender identity, might benefit from allowing the right puberty to continue at an age as young as 12.

Does GenderGP provide ‘easy access’ to medicines to under 16s?

If a young trans person fulfils the criteria for medical intervention, then we provide appropriate blockers and hormones when clinically indicated. GenderGP operates according to a gender-affirming model of care. Transgender patients of all ages who come to our service can be assured of receiving belief, support, and compassionate access to medical care. We will do all we can to support them and to ease any dysphoria which may be causing distress. We provide Health and Wellbeing Services to tran...