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This toolkit offers helpful information and resources on adult (18+) trans+ care pathways in England, reviewed by Russell-Cooke LLP.
It is intended for general information only and should not be relied upon as legal or medical advice.
Content last reviewed: 20 October 2025
Changing GP practices is your right, and you don’t need to give a reason. This includes changing to a new GP (or refusing to be seen by a specific GP) within the same practice or moving to a completely new one. This information pertains to the latter: you have decided to change your GP surgery completely.
If you’re receiving gender-affirming care through an NHS GP and then move to a new practice, here’s what you can expect and what your rights are.
If your previous GP was prescribing hormone replacement therapy (HRT) under a shared-care agreement (for more information, see Shared Care Agreements) with a specialist Gender Dysphoria Clinic (GDC) or private provider, the new practice should be able to establish a similar arrangement without requiring you to start the process all over again.
The GMC’s guidance emphasises that new GPs should seek to re-establish shared care rather than re-refer you to a GDC as though you are a new patient.
Your new GP must ensure continuity of care by transferring relevant medical records, including any necessary adjustments or communication preferences. This includes:
Contact your new GP practice before your move to check whether they will continue your shared-care arrangement. Experiences vary – GPs are not obligated to continue shared care, especially from private clinics. You may need to advocate for yourself if they do not have experience supporting trans+ patients before.
Provide your repeat prescription slips or a summary care record from your old surgery alongside any GDC and/or specialist letters that support the prescription. This may help demonstrate that the medication was prescribed for a valid, ongoing condition.
You have both rights and options to ensure your care continues as needed. Under the Equality Act 2010, you are protected from discrimination based on ‘gender reassignment’ from the moment you begin social transition, even before any medical or legal transition. GPs do have a professional discretion, but this must be applied lawfully. They must justify their decision based on rational clinical reasons. You are entitled to understand their clinical reasons.
If you disagree with the reasons, you can, in the first instance, seek a second opinion and escalate if necessary. This is typically done by first complaining to the GP surgery and then to your local Integrated Care Board.
Following that, if the practice does not remedy the situation to your satisfaction, you may refer a complaint to the Parliamentary and Health Service Ombudsman. The steps for following this process are detailed below.
Some people have reported missing important medical history after transferring, including vaccination records or monitoring data.
In both local records and the NHS system, and understand how this affects preventative screening invitations.
Keep records of conversations, letters, and care arrangements.
If you speak to the GP on the phone or in person, consider recording the conversation, as there will be a lot to remember. You may also have a friend accompany you to take notes.
You can inform your GP that you will be recording the call/visit if you want, for your records. They cannot use this as a justification to stop the call/visit or discharge you from their service.
You do not, however, need their permission to record. As noted by the Medical Defence Union, it’s your personal information, so GDPR doesn’t apply. Recordings (even if made secretly) can generally be used as evidence when dealing with these kinds of issues, either to show wrongdoing or to support your case.
Unfortunately, this situation happens more often than people expect when moving to a new GP surgery.
A new GP is not legally obliged to continue any prescription just because your previous GP issued it, but you do have rights and straightforward steps you can take if you disagree with their decision. Here’s how you can challenge it.
Sometimes it’s due to clinical judgement, safety concerns, interactions, or monitoring requirements. At other times, it’s about practice policy; certain medications are only prescribed under a specialist’s care, or the practice may have a global refusal to support trans healthcare.
Ask the GP to explain their reasons clearly, in writing, with reference to any policy, guidance, rule or standard they seek to rely on.
You can also request a copy of your medical record, which should detail the GP’s reasoning.
You are entitled to request a second opinion from another GP within the practice. Some surgeries allow you to book directly with a different GP if you’re unhappy with the first decision.
You should be clear why you disagree with the first decision. Remember, the second GP will be able to access your medical history and records.
If a GDC clinician initially recommended the medication, refer to this, along with copies of any correspondence you may have. You can ask your GP to liaise directly with the clinician to discuss your case.
Specialist input often carries significant weight and may override a GP’s hesitation. Any further decision made should be documented in writing, and you can request a copy.
Things to know:
If you are unsatisfied with the response to your formal complaint, you can contact the Parliamentary and Health Service Ombudsman (PHSO). The PHSO is an independent complaint-handling service for complaints that the NHS has not resolved in England. Note: the PHSO does not deal with complaints involving the private sector.
For help and support in making a complaint, you can contact the Patients Association Helpline, which covers all of health and social care.
Many law firms have regulatory, equality law, and medical experts who can consider your set of facts and determine whether you could successfully challenge the decision.
Remember that there are deadlines you must meet if you wish to challenge a decision via a formal, legal route. You should therefore not delay seeking an initial steer on whether there is merit in pursuing a legal challenge promptly to protect yourself on a ‘limitation’ front.
You can request that your GP provide a bridging prescription while the matter is reviewed, to avoid abrupt withdrawal.
Alternatively, you could check whether a private prescription is possible temporarily (you’d have to pay, but it ensures continuity).
Some GPs are more knowledgeable and supportive of trans healthcare. This resource from Trans Healthcare Intelligence lists trans-friendly GPs based on real patient experiences.
If you’re in a rural area with fewer local options, consider an LGBTQ-inclusive online UK GMC-registered GP service.
If you’ve completed all these steps without success, please get in touch with us at community@anne.health.
These sample letter templates have been reviewed by solicitors at Russell-Cooke LLP prior to publication. Notes on using these templates:
Subject: Transfer of care: Gender-affirming treatment
(Your Name)
(Your Address)
(Date)
To: (GP / Practice Manager’s Name)
(Practice Name)
Dear (Practice Name / Practice Manager),
I am registering as a new patient with your practice and would like to ensure there is continuity of care regarding my gender-affirming treatment.
I am currently prescribed [hormone(s) and dose if you want to include] under a shared-care arrangement with [name of Gender Identity Clinic or private provider, if applicable].
My previous GP practice [INSERT DETAILS] has been prescribing and monitoring my treatment in line with this agreement since [DATE].
In line with GMC guidance on continuity of care, I would like to confirm:
If any additional information or documentation is required from my previous GP or my specialist provider, please let me know, and I will be happy to assist in arranging this.
Thank you for your support. Please confirm the next steps and who at the practice I should contact regarding ongoing prescribing and monitoring.
[Please note I consider myself to be protected by the protected characteristic of ‘gender reassignment’ under the Equality Act 2010. All my rights are reserved in this regard.]
Kind regards,
(Your Name)
(NHS Number, if you want to include it)
If you have updated your name/gender marker, you can add:
“I would also like my records to reflect my correct name and gender marker. I understand this may affect automated screening invitations, and I would like advice on how best to ensure I still receive relevant screening.”
If you are on a bridging prescription (temporary prescription while awaiting a GDC), specify that too, since some practices handle it differently.
Subject: Request for review of decision to discontinue prescribed medication
(Your Name)
(Your Address)
(Date)
To: (GP / Practice Manager’s Name)
(Practice Name)
Dear (Practice Name / Practice Manager),
I am writing to formally request a review of the recent decision to discontinue my prescription for [medication name, dose].
My former GP of [previous surgery name] previously prescribed this medication at and has been part of my ongoing treatment for gender dysphoria since [DATE].
I fully appreciate that each GP must exercise their own clinical judgement when prescribing. However, I am concerned that this decision will unfairly and unnecessarily impact on my health and wellbeing. If my treatment is stopped abruptly [explain the expected impact, in your own words].
If you do not change your position, please provide me with written reasons clearly and in writing, together with copies of any policy, guidance, rule or Standard you seek to rely on.
[To support my request, I can provide:
I respectfully ask that this decision be reconsidered, and if necessary, that I be offered:
If the practice is unable to meet this request, please provide your reasons in writing, along with details of the NHS complaints process and instructions on how I can escalate my concerns further.
Please note I consider myself to be protected by the protected characteristic of ‘gender reassignment’ under the Equality Act 2010. All my rights are reserved in this regard.
I appreciate your attention to this matter and look forward to your response.
Yours sincerely,
(Your full name)
(Date of birth / NHS number, if you wish to include)
(Contact details)
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