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In July 2022, NHS England announced its plans to move to a regional model of care for children and young people (CYP) experiencing gender incongruence and gender dysphoria including bringing the current provision at The Tavistock and Portman NHS Foundation Trust to a managed close. The new services will open from Spring 2023.

Given the current waiting times for this service, it is highly unlikely that anyone referred now would be seen by GIDS at The Tavistock and Portman NHS Foundation Trust.

To help facilitate a smooth transition to the new services, NHS Arden and Greater East Midlands will now manage all referrals to Children and Young People’s Gender Dysphoria Service (CYP-GD Service) via their Referral Management Service (RMS) – on behalf of the new providers.

Who to refer?

Referrals will continue to be accepted for CYP with features of Gender Dysphoria as described in the “Gender identity development service for children and adolescent service specification

How to refer

The RMS will not be able to accept self-referrals in any circumstances.

Referrals can be made via:

  • GP
  • Children and Young People’s Mental Health Services
  • Specialist Paediatric Services
  • Schools
  • Social Care
  • Relevant voluntary sector organisations

Download and complete the referral and risk assessment forms below and send them to a CYP-GD Service at  agem.cyp-gd@nhs.net.

New referrals sent directly to The Tavistock and Portman NHS Foundation Trust will be returned. Please forward these to agem.cyp-gd@nhs.net.

Referrals from Wales will only be accepted from Child and Adolescent Mental Health Teams.

Advice for referrers

Please carefully consider the appropriateness of a referral using the guidance below and on the form before making a referral. Not everyone who identifies with a gender other than their natal sex, or whose gender expression is different from what others might expect of them, will need to be seen by a gender specialist.

There is a high demand for these specialist services and long waiting times for a first appointment.

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

If you feel that the child or young person requires support,  you may find it helpful to initially direct them to resources here.

Clinical responsibility remains with the referrer and the local professional network until the patient is seen by a CYP-GD Service.

Advice on completing the form

The referral form requests details about different aspects of the child or young person’s life. Referrers should provide as much information as possible at the earliest opportunity. The most common reasons for requesting further information from the referrer are:

  • Clarifying what the young person/family is seeking from CYP-GD services
  • 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 CYP-GD services (e.g. care plan)
  • Risk has been identified without a care plan
  • Risk is unclear

To help us deal efficiently and effectively with referrals, the following referrals will not be accepted:

  • Hand-written referrals
  • Referrals made without use of the referral form
  • Referrals for under 16s where parental consent is not present (please contact agem.cyp-gd@nhs.net 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
  • Referrals for young people aged 17 years as they are unlikely to be seen by the time of their 18th birthday which is the cut off point for CYP services – You may consider a referral to an adult Gender Dysphoria Clinic from 17 years of age should you consider that the young person is likely to meet the acceptance criteria

Referrers may find the referral form itself a useful resource, when considering how to approach your conversations with children and young about their gender.

For useful information and resources for professionals, young people, parents and carers, please explore the website (www.gids.nhs.uk).

Backdating of referrals

Please note that unless a clear admin error has been made by the RMS referrals are unable to be backdated. This is to ensure equity for all young people referred to CYP-GD services, including those already on the waiting list.

Risk and safety

Children and young people experiencing gender dysphoria are a vulnerable group and may experience a higher incidence of co-occurring mental health issues or high-risk behaviours.  It is important to be aware that at present the waiting times for CYP-GD services are lengthy, and young people may require additional support with gender distress and other issues during the wait.  It is strongly recommended 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 on the referral form. 

Please note that clinical responsibility remains with the referrer and the local professional network until the patient is seen by CYP-GD services. For useful information and resources for professionals, young people, parents and carers, please explore the website (www.gids.nhs.uk).

Download the referral form and risk assessment form

The referral form is in XLSX format. Please save a local copy of the referral form before completing.

You can save this form and come back to it later to complete if you need to gather further information.

Once complete, the tab ‘final print’ should be saved as a PDF. This PDF should be emailed.

Please only send completed PDF files, and not the unfinished Excel file.

For all referrals, please also complete the separate risk assessment form and send both to the above email address.

Download the referral form (XLSX format, 600Kb)

Download the risk assessment form (DOCX format, 100Kb)

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