Do you need both parents’ consent for my young person to join Anne Health and start a medical pathway?

We only require one parent to consent to start treatment, and if the young person is Gillick Competent, they must also consent.

Please refer to the below resource for further information:

https://www.nhs.uk/conditions/consent-to-treatment/children/ 

Do you require social transition before prescribing HRT?

Social transition is not a prerequisite for being supported with gender-affirming hormone therapy as we work on an informed consent model. Each individual person’s circumstances are always a consideration, and we strive to help all our patients manage their unique transition and exploration of gender.

Could you provide a referral for surgery?

It depends on the type of surgery and the surgeon whether they will accept our referral. Once you have researched your surgeon and chosen who you wish to go to, contact them to ask if they will accept our referral. We are also happy to contact them directly to discuss our services and the process we follow. 

Is the service able to recommend a professional who can undertake a gender dysphoria diagnosis, or is this something Anne Health can do?

It depends on the purpose of the diagnosis. It would be best to have a conversation with the team to determine whether we can provide this or whether you need a more comprehensive assessment. For example, a diagnosis by Anne cannot be used to apply for a GRC, but we have partners that we can refer you to if that is what you need.

What surgeons can you refer me to for transmasculine top surgery?

While we cannot endorse or guarantee specific results, the following surgeons have accepted our referral letters in the past:

• Dr Ioannis Ntanos: Works between the UK and Greece, with a base in Manchester.

• Mr Miles Berry: Associated with Cosmetic Surgery Partners in London.

• Dr El Gammal: Also associated with Cosmetic Surgery Partners in London.

• Miss Chloe Wright: Associated with Pall Mall Medical Group.

• Dr Kate Williams: Associated with Pall Mall Medical Group.

• Mr Robert Morris: Based in Plymouth (specific affiliation not confirmed).

If you are seeking surgery with a surgeon not listed above, contact them to ask if they will accept our referral. We are also happy to contact them directly to discuss our services and the process we follow. Please be aware that individual surgeons may have varying protocols. For example, depending on factors like age or gender identity, one or two referral letters may be required.

Only two surgeons will not accept Anne Health's surgery referral letters: Mr Kneeshaw in Hull and the Nuffield Clinic in Brighton.

Do you have experience with GPs who have agreed to share care with you?

We have GPs who share care, most with adults 18 and older. We have detailed documentation to assist patients in asking their GPs for support, including a breakdown of the care pathway, recommended treatment, and the credentials of our clinical team. If you would like us to help you facilitate shared care with your GP, we are happy to do so.

How does the prescribing process work? And if I have difficulty redeeming a prescription, does Anne have any connections with pharmacies that can assist?

As part of the prescribing process, the qualified clinician working with you will issue an electronic token prescription for you to take to your local pharmacy. If you are over 18, we have pharmacy partners in the UK who can deliver medications to your door. 

For young people accessing blocker medication through our legal route, we will support you with the details of how to order, purchase, collect, and arrange the medication's administration with a qualified medical professional in an EU country.

Are all your appointments online?

Anne operates as a telehealth service, which ensures maximum accessibility for all. Therefore, almost all our appointments are online. We do, however, in some cases, offer in-person appointments. This is based upon individual circumstances and is not usual practice.

Where are your clinicians based?

We facilitate access to EU prescribers for patients under 18, and EU and UK prescribers for those over 18. 

Do you advise about the medical pathway, or is it up to us to request what pathway we want and for you to assess if this is appropriate?

We facilitate access to qualified and experienced clinicians who will support you in making the best decisions for you/your child whilst also adhering to international best practices. The clinician overseeing your care will advise on the medical pathway. Their knowledge is invaluable in ensuring that you follow a medical path that is both best for you/your child and clinically appropriate. The clinicians will not prescribe 'to order'; however, they will listen and consider your aims, hopes and concerns.

We already paid a subscription to another provider, and my child has been assessed as Gillick competent for a medical pathway - would we have to go through this process again?

Our intake process is mandatory for everyone to satisfy our need to establish competency and understanding of the risks and benefits, regardless of their previous pathway. However, we try to minimise this for people transferring from another provider. For those under 18, it is usually a minimum of 3 appointments with a therapist before the referral to the doctor. However, for young people transferring, a minimum of 2 should be all that is needed, barring any concerns. 

We then do regular follow-ups with a member of the therapeutic team. This is not talking therapy; it is more of a check-in. 

Do you share the details of my/my child’s medical care with the GP?

With permission, we can share the notes and recommendations, including prescriptions, with the GP. Our system also allows us to email them as part of the process if requested. 

If my child has been on hormone blockers only for 2 years and over, are there concerns about the lack of hormones for their physical well-being?

As part of the membership, we facilitate appointments with an endocrinologist with experience in this field for young people under 18. You can discuss your concerns at the appointment, and they will then advise on ongoing treatment options. We cannot guarantee the outcome of these appointments; however, all our clinicians follow the WPATH Standards of Care and Endocrine Society's guidance, which recommends a stage-not-age approach to access gender-affirming hormones alongside ensuring that a young person does not remain without hormones for too long which has been identified as a potential risk for bone health.

What mental health support do you offer?

Details of our counselling and therapy support are detailed on the website here.

I can’t afford membership. Can you help me?

Anne is a not-for-profit organisation, and we plan to offer a means-tested membership as soon as we can.

Please sign up for our newsletter and follow our social media for updates on when this will become available. 

Despite the puberty blocker ban, I understand that Anne Health can support families who need to access blockers for under-18s. Can you provide more details?

We have secured a legal route via EU countries. After completing our intake process, we will facilitate access to a qualified and experienced clinician. If appropriate, the clinician will prescribe blocking medication. We will then support you with details of where you can travel to in the EU to purchase and collect the medication and then have it administered by a medical professional. 

The provision of gender-affirming hormones is not banned, and neither is access to blood tests and other aspects of gender-affirming healthcare for transgender people under 18.

How are blood tests arranged? For example, how do I arrange a blood test, and where are the clinic locations?

If you’re on a Standard membership or Youth membership, all the blood tests you need are included for the entire length of your membership. This applies whether you’re just starting or are years into your transition.

Blood tests aren't included in your plan if you’re on the Transfer 12, Transfer 24, or Lite membership. However, we’ve arranged competitive rates with our partner clinic, making booking tests through Anne Health easy and affordable. The cost depends on the specific blood test you require and the levels being monitored.

Here’s how it works when your clinician requests blood tests:

• We’ll send your details and the required tests to our partner clinic.

• You’ll receive an email with information on scheduling your appointment, including how to find your nearest clinic if you are 18+.

• A phlebotomist will collect your blood, either in a clinic or, if the patient is under 18, at your home, and the sample will be sent to the lab for analysis.

• Once the results are ready, you’ll be alerted to book a follow-up meeting with the doctor or nurse who ordered the tests.

Your healthcare professional will review the results via an online appointment or email—whichever works best for you—and discuss any adjustments to your medication and healthcare plan.

Can you outline the intake process with Anne, from first contact to receiving treatment, and the approximate time scales for each step?

We have designed the Anne intake process to be as accessible and user-friendly as possible. Each of the steps is outlined below. 

• Pay the Membership Application fee

• Complete the medical intake form and upload any supporting documents

• Our team reviews the intake form

• Receive an email confirming membership details

• Set up a monthly subscription on our website

• Book counselling intake session/s and arrange your blood tests

• Our clinical team reviews blood tests

• Receive an email with details of how to book a medical intake session

• Book and attend medical intake session

• Prescription arranged if appropriate

We aim to complete the intake process in 10-12 weeks; however, this will vary depending on your circumstances, such as the number of intake sessions required, your availability for sessions, how your blood tests are arranged, and how you will receive your medication.

What happens if I don’t pay my monthly subscription?

Anne's payment processor will automatically try to retake it if a payment fails. If this fails, our team will email you. 

If you are having financial difficulties or a payment has failed due to an issue with your card, please contact us as soon as possible. Our email address is hello@anne.health. However, if you default and do not respond to any communications, we must take action. Our Terms and Conditions of Service detail your obligations when you join Anne. If you break that commitment, we will initiate our rights as set out in the terms of service to recover any part of the subscription that is contracted but not paid.

How long is the membership contract for?

You can read the full terms and conditions for all membership types here - https://www.anne.health/terms 

Standard, Youth, and Transfer Memberships are 12-month contracts. If you change your mind after the 14-day cooling-off period, you will still be liable to pay the monthly subscription until your 12-month contract ends. We will refund you if you change your mind within 14 days of paying the £200 Joining Fee and have not accessed our services. 

The Lite Membership is a rolling one-month contract, so you can quickly transfer to another membership type or cancel.