GPs will be paid for trans hormone prescriptions
Kat Lay
Health Editor
Saturday April 02 2022, 12.01am BST, The Times
Trans rights campaigners have welcomed the programme
ISAAC ESQUIVEL/EPA
Family doctors are to be paid for prescribing hormones to transgender patients, in the first scheme of its kind in the UK.
Under the programme, which was launched yesterday, GPs in Sussex will get £178 a year for every adult to whom they prescribe “cross sex hormone therapy”. They will also be able to claim an extra £91 a year for providing an annual health check to a transgender, non-binary or intersex (TNBI) patient.
The scheme, which also requires staff to take training in transgender healthcare, is aimed at reducing the high rates of long-term physical and mental health problems in TNBI patients and improve their low levels of satisfaction with NHS care. Trans rights campaigners welcomed the programme. Patients referred to gender identity clinics (GICs) face waits of years, after referrals soared 240 per cent in five years.
The Tavistock and Portman NHS Trust in northwest London is offering first appointments to people who were referred in December 2017.
Concerns were raised, however, that medicines could be provided without appropriate psychological support for patients and add to pressure on GPs.
A document, seen by
The Times, says that the Sussex scheme is “not designed to promote the initiation of hormonal treatment in general practice”.
It says that it aims to provide “interim support” to patients on the gender clinic waiting list and “improve access” to hormone therapy.
Trans men may be given hormones, such as testosterone, to help with masculinisation while trans women get hormones such as oestrogen to help with feminisation.
The document adds that any decision to start hormone therapy is “at the discretion of the individual GP”.
Debbie Hayton, a transgender advocate who transitioned in 2012, said that the scheme would lead to more patients starting on GP-prescribed cross sex hormones “even if it’s not the intended outcome”. She described the new scheme as “desperate measures for desperate times”.
Hayton questioned the level of psychological support in the scheme. “When I transitioned I had an hour with a therapist every week for months,” she said. “That’s what I needed to understand myself. An annual review is a pale shadow of that.” Doctors will also have to monitor patients and carry out blood tests to ensure they are taking treatments safely.
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To receive payments, participating surgeries are required to compile a register of anyone considered to be TNBI.
The scheme will initially run for three years across Brighton and Hove, East Sussex and West Sussex. Participating GPs must undertake two and a half hours of online training.
Sasha Misra, an associate director at Stonewall, said: “With enough capacity and training, schemes like this could ensure trans people can access the specialist care they need in their local community and without the lengthy wait.”
Zara Aziz, a Bristol GP, said she was concerned that the scheme would add to doctors’ workload, with capacity already “strained”. She said: “It feels like . . . this is being handed over to GPs with a training package and off you go.”
Professor Martin Marshall, chairman of the Royal College of GPs, said that family doctors had an important role in delivering care to trans patients.
Setting out its reasons for launching the scheme, Sussex Clinical Commissioning Groups said that research showed “the most frequently suggested action for improving healthcare for trans people was an increase in awareness training within primary care”.
A spokeswoman for Sussex Commissioners said: “Transgender, non-binary and intersex (TNBI) people experience significant health inequalities — something we are committed to tackling.”
![LinkinParkxNaruto[AMV]](http://uploads.kiwifarms.st/data/avatars/l/61/61177.jpg?1699571951){kind=avatar}
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