About our service

We work with children and young people up until their 18th birthday, to provide specialist assessment, consultation and care including psychological support and physical treatments, to help with the distressing feelings of incongruence between a young person’s assigned gender and their gender identity. Whilst language surrounding gender identity is evolving, this mismatch and associated distress is currently referred to as Gender Dysphoria (GD).

Our service accepts referrals for children and young people with features of Gender Dysphoria as described in the “Gender identity development service for children and adolescent service specification

We also support:

  • The family or carers of children and young people
  • The children of transgender parents

We are unable to accept self-referrals. Children and young people wishing to access our services should do so via their GP or CAMHS team.

Where people are seen

Families from Yorkshire and the Humber, North East England, North West England and Scotland are usually offered appointments in Leeds. Families from Devon and Cornwall are usually offered appointments in Exeter. Families from the West Midlands and some parts of the Midlands are usually offered appointments in Birmingham. Families from most other places are offered appointments in London.

If the young person or family wishes to be seen at a different base (e.g. Leeds instead of London), this needs to be clearly stated in the referral.

Advice for referrers

We are currently experiencing a high demand for our service, and – as a result – long waiting times for an assessment are common. Please carefully consider the appropriateness of a referral using the guidance below and on the form before making a referral. If you are unsure, please contact us.

Our preferred route of referral is through a local Child and Adolescent Mental Health Service (CAMHS), who will have completed their own holistic assessment.  However, we also accept referrals from other health, social care, and education professionals, including directly from GPs. We are unable to accept self-referrals from young people or their families.

Referring professionals must discuss the referral with the family/ carer of the child/young person in order to provide detailed referral information and seek their agreement.

Not everyone who identifies with a gender other than the one they were assigned at birth, or whose gender expression is different from what others might expect of them, will need to be seen by a specialist Gender Identity Development Service.

If you feel that the child or young person requires support, but may not need our specialist Gender Identity Development Service, you may find it helpful to initially direct them to resources on our website: https://gids.nhs.uk/young-people#finding-a-community

A child or young person is unlikely to be accepted into our specialist Gender Identity Development Serviceif they do not currently have a strong desire to be another gender or insist that they are another gender to the one they were assigned at birth. To meet our service threshold, they would have to feel this way and have done so for at least 6 months. For more information on this, please see our service specification.

 

Risk and safety

Young people experiencing gender dysphoria are a vulnerable group and may experience a higher incidence of co-occurring mental health issues or self-harm.  It is important to be aware that at present our waiting times are lengthy, and young people may require additional support with gender distress and other issues during the wait.  We strongly recommend that plans are drawn up by the referrer and local professional network to ensure the needs of the young person are being met in the interim and clearly communicated to GIDS on the referral form.   Please note that we will not be acting directly on the information until a person is seen for assessment and until that point clinical responsibility remains with the referrer and the local professional network.  For useful information and resources for professionals, young people, parents and carers, please explore our website.

Referral Form

Our referral form requests details about different aspects of the child or young person's life. We aspire to get the best possible information from referrers, at the earliest opportunity, to help us rapidly establish the most helpful sources of support. Therefore, we ask that referrers provide all the information we request; doing so will also save referrers’ time by reducing the need for further information requests. We are currently redesigning our referral form to help referrers provide the information we need. The most common reasons for requesting further information are:

  • Clarifying what the young person/family is seeking from GIDs
  • Understanding detailed gender history: when incongruence was first noticed, how it has been responded to, any social transition (e.g. changes in pronouns, name, appearance), length of time living in role, etc.
  • Ensuring appropriate family/carer/guardian consent
  • Identifying which other services, and who from those services are also involved
  • Clarifying family and developmental history
  • Understanding who will be providing input with this young person and family while they wait to be seen by GIDS (e.g. care plan)
  • Risk has been identified without a care plan
  • Risk is unclear

To help us deal efficiently and effectively with referrals, we are unable to accept:

  • Hand-written referrals
  • Referrals made without use of our referral form
  • Referrals for under 16s where parental consent is not present (please contact us for advice)
  • Referrals where it has been indicated the young person is the only person to be contacted, but the contact provided is the parents/carers postal address.
  • Self-referrals from young people or families

Referrers may find the referral form a useful resource, when considering how to approach your conversations with young people and children about their gender identity. Completed referral forms should be returned to our Intake and Discharge Administrator by emailing it to tpn-tr.gidstransfer@nhs.net. For further information or advice on completing our referral form, please visit our contact us page.

 

Electronic Referral Service

Please be aware that GP practices are now able to refer to a Referral Assessment Service (RAS) via the Electronic Referral Service.

To locate the GIDS service on eRS, enter the following in the search fields:

Service Name: GENDER IDENTITY DEVELOPMENT SERVICE - TAVISTOCK & PORTMAN NHSFT
Specialty : Mental Health - Child and Adolescent
Clinic Type: Not Otherwise Specified
Priority: Routine
Organisation or Site Name: Tavistock and Portman NHS Foundation Trust

 

What happens next?

Once a referral has been accepted, we write to both the referrer and the young person / the family to confirm this.

We will write again in due course with details of the first appointment. Read more about our current waiting times.

Options for 17 year olds

As a child and adolescent service, we are commissioned to see young people until their 18th birthday. Adult services are commissioned to see those who are 18 years of age and above. 

Options for 17 year olds are therefore slightly different from those for people who are either younger or older.

If you are considering referring a 17 year old to a gender identity service, there are broadly speaking two options available:

 

Referral to an adult service

Some young people prefer to be referred directly to adult services where possible. There are several different adult gender identity clinics in England.

The Tavistock and Portman NHS Foundation Trust is the interim provider of the Gender Identity Clinic. The Gender Identity Clinic is the largest and oldest gender clinic in the UK, dating back to 1966. They accept referrals from all over the UK for adults (over 17 years and nine months) with issues related to gender. Visit the Gender Identity Clinic website

As adult services are nationally-funded, patients living in England can be referred to any of the adult gender services across the country.

There are separate adult services in Scotland and Northern Ireland.

We are aware that some adult gender services accept referrals for 17 year olds. Their waiting times vary, as do their policies about when they will offer a first appointment. Adult services do not usually meet with the whole family.

We recommend you contact adult services directly to enquire about their current policies and waiting times.

If - following assessment - hormonal intervention is felt to be appropriate, adult services do not routinely require all patients to start with 12 months of hormone blocking treatment. Indeed, adult services have and do commence people on cross-sex hormones without having first taken hormone blockers.

 

Referral to our child and adolescent service

We differ from adult services in that we often meet and work with the whole family.  Our process of assessment usually involves between three and six meetings over a period of between three and six months, after which we write a report with recommendations.  Recommendations might include further therapeutic support, which would usually be provided through local services.

Sometimes we would recommend a referral to one of our endocrinology clinics for consideration of a physical intervention.  As a child and adolescent service we take a staged approach to physical intervention meaning that young people must currently be on hormone blocking treatment for 12 months in our service before they can be considered for cross-sex hormones.

We would not usually accept a referral for someone who is shortly due to turn 18. If this is the case, we would generally recommend referring to an adult service instead.

Funding arrangements

England

If your referral comes from England it will be funded via our national contract with NHS England and there is no need to seek local funding approval.

 

Northern Ireland and Scotland

There are local services available in Northern Ireland (for under 18s) and Scotland. You may wish to consider these options as an alternative to our service. 

However, our national contract also covers referrals from Scotland and Northern Ireland. As with referrals from England, no local funding approval is required.

 

Wales and other countries or territories

If your referral comes from Wales, or from any other country or territory not mentioned above (including overseas), we will need to establish funding confirmation before we can offer an appointment.

We are usually not able to make applications for funding ourselves. These requests normally have to come from the referring clinician. We strongly recommend that you apply for funding as soon as possible. This helps to avoid delays in the young person accessing our service.

If our contracts team let us know there is no funding in place, we will get in touch to let you know this.