We offer initial assessment over two appointments which are generally two to four months apart. If you want a family member or significant other to be part of your assessment, please ask at your first appointment. You are not required to bring someone with you to an assessment.
At the end of the assessment you may be discharged if we cannot assist you; you may offered further assessment; or you may be offered some form of assistance or treatment. Assistance may include psychotherapy, sex and relationship therapy, speech and language therapy, as well as recommendations for hormonal therapy, facial hair removal, or surgeries.
Many people attending our service have problems with anxiety, social phobia, depression, and self-harm. In general local services are best placed to help with these things and your GP can refer direct. Dealing with these issues will help make any transition easier.
A small minority of people have difficulties which require specialist psychotherapy with one of our psychotherapists. Some people we see have difficulties with sexual relationships and sex and so we also offer sex and relationship therapy.
Speech and language therapy
We offer speech and language therapy for trans men, trans women, and non-binary people here at the center. Find out more about speech and language therapy [pdf] 85KB.
However some areas of the country also have local expertise, and your GP may be able to refer you for this directly.
Not all trans and non-binary people wish to have hormone therapy and many live very comfortable lives without them. Nonetheless there are a significant number of trans and non-binary people who do wish to take hormones in order to make physical changes to their bodies so they are more in line with their felt sense of themselves. We generally recommend hormones after a person has made a formal and established gender role change.
Expectations of hormones are discussed when you are assessed. As hormone therapy causes infertility, it is really important to consider storing gametes (eggs or sperm) before taking hormones.
Facial hair removal
We provide recommendations for facial hair removal therapy which is carried out by private providers and funded by the NHS.
Some trans and non-binary people live very comfortable lives without surgery of any kind. Some trans people only wish to have chest or other surgery. It is important that you decide if surgery is right for you.
If you do opt for surgery, and it is considered appropriate by your gender specialist clinicians, then it will be undertaken by surgeons within NHS Trusts who are not part of The Nottingham Centre for Transgender Health; or by private providers who are contracted to carry out NHS work.
We work closely with the staff at these surgical centers, however please bear in mind that we don't directly influence their policies and procedures. We can't control which clinicians the surgical centers will accept referrals from, any special requirements they may have, their waiting lists, or which centers will be funded to perform your surgery.
Surgeries for people assigned female at birth
Removal of breasts or chest reconstructive surgery (‘top surgery') is generally carried out by the following surgeons: Mr Kneeshaw at Castle Hill Hospital, Hull; Miss Dabritz at North Manchester General Hospital; Mr Ross, Mr Andrew Mellington and Mr Charles Nduka at Nuffield Health Brighton Hospital; Mr Fitton and Mr Morris at Nuffield Health Plymouth Hospital; Miss Milroy at St George’s University Hospitals NHS Foundation Trust; Mr Caddy at Hallamshire Hospital; and Miss Rose at St Thomas’ Hospital. Other providers may also be available however, we are sorry that we are no longer able to refer to Mr Yelland.
Genital surgery (‘bottom surgery') for trans men generally includes hysterectomy and oophorectomy, as well as phalloplasty or metoidioplasty. The hysterectomy and oophorectomy are sometimes carried out separately from the phalloplasty or metoidioplasty. Phalloplasty or metoidioplasty is generally carried out at St Peter's Andrology Centre London.
Surgeries for people assigned male at birth
Genital surgeries such as penectomy, orchidectomy, vaginoplasty or cosmesis, and clitoroplasty are usually carried out through Imperial College Healthcare NHS Trust London, Nuffield Health Brighton Hospital, and Parkside Hospital London.
Breast augmentation (after a minimum of two years on hormones), thyroid chondroplasty and cricothyroid approximation, and facial feminization surgery are generally not funded on the NHS.
We provide letters to support the people we see to change their gender on their passport. Please ensure that you have sent us a copy of your change of name document and other updated ID, and please make the request at your appointment or by email at firstname.lastname@example.org.
Gender Recognition Certificate reports
We provide reports for people we have seen for applications for a Gender Recognition Certificate (GRC). Please allow up to three months for the completion of a report. Please make the request at your appointment or by email at email@example.com.