A new report by Healthwatch UK has found that trans and non-binary patients across Britain are facing severe challenges when accessing healthcare, particularly gender-affirming care through GPs.
Published on 25 July, the survey paints a concerning picture of NHS service gaps, miscommunication, and systemic failings. Fewer than a third of trans and non-binary respondents (32%) rated the gender-affirming care provided by their GP as “good” or “very good.”
Disruptions and Discrimination
The findings highlight several key areas of concern:
- 28% of respondents who had changed their gender marker lost access to their previous NHS records.
- 16% experienced prescription disruptions.
- 18% were misgendered in NHS written communications.
- 21% were denied sex-specific medical procedures—such as cervical screenings—based on their gender marker change.
One participant, Nick, 31, revealed that changing his gender marker resulted in two NHS numbers, causing confusion during emergency visits. Despite a family history of uterine cancer, he is no longer invited for cervical screenings.
“They may risk being outed or made to feel uncomfortable when they book, check in for, or are called in for appointments,” the report noted, adding that nearly 25% of trans and non-binary respondents felt disrespected by GP receptionists.
Hormone Therapy Disruptions
The report also found widespread disruptions in hormone replacement therapy (HRT), with only 30% of HRT users reporting uninterrupted access. Gaps in HRT access can lead to distressing physical effects, including menopause symptoms in trans women or the return of menstruation in trans men.
This follows a March 2025 report revealing that some UK GPs have stopped prescribing HRT altogether, citing a lack of support and clinical knowledge. Under NHS policy, Gender Identity Clinics (GICs) often rely on shared care agreements where GPs must issue prescriptions based on specialist advice. If GPs refuse, patients are left with no NHS pathway.
Samathy, a 29-year-old trans woman, told PinkNews that losing access to care would be mentally devastating.
“I’d much rather enjoy being treated for my NHS-diagnosed medical condition by an NHS doctor. Removing people’s access to healthcare does not remove the need for it.”
A Call for National Strategy
Healthwatch CEO Louise Ansari called the findings “profound,” and urged the government to deliver a national LGBT+ health strategy.
“It’s now time for the government to develop a holistic strategy that clarifies primary care’s role in gender-affirming care—especially during long waits for specialists,” Ansari said.
The strategy, she added, should also confirm the future role of adult gender dysphoria clinics, currently under national review.
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