Information for Transgender, non-binary, intersex and gender diverse service users.

Our Promise

All of our services are free, confidential and non-judgemental. We promise to treat everyone with kindness and respect. Your health, wellbeing and safety is our priority. We are here to help you.

  • You can attend our clinics with any gender expression or identity which best describes you
  • You can register and be addressed by any name.
  • You can be addressed by the pronouns that fit best for you

We want to ensure that you are happy and comfortable at all times when accessing our services. Looking after your sexual health is an important part of your wellbeing, and we want to reassure you that our services will be able to support you.

A person can register with our Sexual Health service under any name.  This name can also be changed at any time.

When you register with our service, you will be asked to provide your gender identity and your sex assigned at birth. This information is important for us to provide you with the most appropriate care for you. We will always address you with the name and pronouns you ask us to. More information is in the section below ‘What happens in clinic’.

  • Gender Identity: At present someone can be recognised as male (including transman) and female (including transwoman) and non-binary.
  • Sex assigned at birth: At present national NHS systems can only record someone’s sex as male or female. There is currently no option to record someone as Intersex. We understand these are limitations which are unfortunately part of the constraints of national requirements. As soon as we can make changes to this, we will. However, we will still always be able to see you to provide care. Your feedback is always welcomed. (details below)

We will do our best to address you by any names and pronouns you tell us. Please let us know if we use the wrong name or pronouns for you.

If you are in a waiting room and would like to be addressed by a different name when called in for your consultation, please let us know.

If you would like to change how you are addressed, you can request this at any time and ask for your records to be updated for our service.

Our records are separate and not linked to any other NHS or healthcare system. Therefore:

  • We don’t import any information held about you from elsewhere
  • Other health services will not be able to access any information we hold about you
  • We are not aware of your gender history from previous records.

All information we hold about you is strictly private and confidential. It can sometimes be useful and beneficial to your health to share your records with your GP but we will not do this without your permission to do so. There are certain situations where we, as a service, may need to share your confidential information. We would always discuss this with you first and this will only happen if we are concerned that you or someone else are at serious risk of harm. Please see our page on confidentiality for further information.

If you have any questions about confidentiality, you can discuss this when you speak with our clinicians.

When you see one of our clinicians, they will discuss with you your need for attending the clinic.

Each consultation is personal and tailored to you. We will ask rather than assume your sexual orientation, sexual practices and behaviours, hormone use or history of any surgery. This is information we will ask you so you can answer. Information you share is up to you, but we can help you best if we have all the information we need. We will ask you each time you see us in case anything has changed.

In order to provide you with the most appropriate care, we need to ask you questions about the type(s) of sex you are having. Remember, our service is confidential and non-judgemental. Please answer any questions honestly so we can provide you with the best care and support.

Our registration forms ask about a person’s sex assigned at birth as well as gender identity. The reason why we require information about your anatomy is to ensure the health information, advice and consultation we provide does not make assumptions. We want to hear from you about the language you would like us to use to describe your body, genitals and anatomy. The clinician will use language and terminology which you find most appropriate. You can use the descriptions you feel most comfortable using when talking about your anatomy and that of partner/s.

If you have had genital reconstructive surgery performed (‘lower’ or ‘bottom’ surgery) please let the clinician know the type of surgery you have had, and which tissue was used in the reconstruction. This helps the clinician understand how to best help you in relation to the type of sex you are having and when undertaking investigations or examinations. Any concerns, questions or worries you have will be dealt with sensitively and professionally.

We will ask you about any medication you are presently taking. If you are taking any hormonal medication or Gonadotropin Releasing Hormone (GnRH), please let the clinician know when they ask you about medication. It is important we know about any medication you are taking in case you need any treatment which may be affected by your existing medication. It is important you let us know about all prescribed and non-prescribed medication, if this applies.

 

Examinations

If you have no symptoms, we do not need to look at your genitals.

If you have symptoms, we may need to perform an examination. This will be tailored to you in order to provide you with the care you need.

  • You will be offered a chaperone during the examination, if available. This is another member of sexual health staff.
  • The examination process will be explained to you in full.
  • You will be asked for consent to undertake the examination. You can ask to stop at any time.
  • The examination will be tailored to you based on your anatomy, the type of sex you are having, and the need to provide you with appropriate care.
  • If you have any questions about the examination, you can ask the clinician you are seeing.
  • Samples may be taken during your examination. The clinician will explain what these samples are for, how they will be taken, and how they are processed. Some samples can be self-taken.

You will be given time and privacy to remove any items which may relate to your transition or gender history such as binders, breast forms, gaffs or packers or STP devices (if necessary) to undertake your consultation. You will be provided with privacy to do this.

 

Testing

If you are being tested for Sexually Transmitted Infections (STIs) the clinician will discuss the testing options with you. All the different sampling options will be explained to you, how they are taken, and what they test for. Some sampling options provide more accurate results than others based on your anatomy. From this information, you can choose which is most suitable for you based on the type of sex you are having. As a guide for standard STI testing in a Sexual Health clinic the following sample collection methods are available:

  • Vaginal (frontal) swab. If you were assigned female at birth, this will test for Chlamydia & Gonorrhoea. This can be taken by yourself or the clinician, depending on symptoms, if you have any. If you take the sample yourself the clinician will explain how to do this.
    • If your vagina has been constructed, a urine sample (see below) will give a more accurate result.
  • Urine sample. This will test for Chlamydia & Gonorrhoea. You take this sample yourself. The clinician will explain how you take your sample. This is for people with a penis or constructed vagina.
    • People assigned female at birth with a vagina can provide a urine sample but a swab (see above) provides more accurate results.
  • Rectal (anal) swab. This will test for Chlamydia & Gonorrhoea. This can be taken by yourself or the clinician, depending on symptoms, if you have any. If you take the sample yourself the clinician will explain how to do this.
  • Throat swab. This will test for Chlamydia & Gonorrhoea. The clinician will take this sample for you.
  • Blood sample (usually from your arm). This will test for HIV & Syphilis. The clinician will take this sample for you.

If any other samples or tests are required, these will be explained to you.

 

Contraception

If there is a risk you could become pregnant from the type of sex you have, you can get free contraception from us. The clinician will explain all the different options available to you. They are all implemented and work in different ways. You will be given all the information in order to make the choice which is best for you. The clinician will answer any questions you have.

If you are taking any hormones, please let the clinician know when they ask you about any medication you take. This is so the clinician can advise you on which options are most suitable.

Discussions around contraception are very individual as no two people are the same. The consultation will be tailored to you in order to give you the best care.

If you are looking to lessen or stop your periods as part of your transition, our service can offer hormonal contraception for this purpose.

 

Treatment

Similar to examinations detailed above, if you require any treatment this will be explained to you in full beforehand. You will be told what the treatment will involve, and you can ask any questions you may have. All sexual health treatment is free, but if you prefer to take a prescription to a Pharmacy you may be charged.

If you are taking any hormones, please let the clinician know when they ask you about any medication you take. It is important for a clinician to understand medications you are taking when considering treatment options to ensure this is most effective.

 

Vaccinations

Based on the type of sex you are having, we may be able to offer you vaccinations for Hepatitis A & B, and Human Papilloma Virus (HPV). The clinician will discuss your risk and eligibility with you in your consultation.

 

PrEP

PrEP is a pill you can take which protects you from HIV. PrEP may not be right for you, but if you feel it is something you would like to discuss, we are here to help you. If eligible, PrEP is available for free from the NHS.

There are different ways to take PrEP, and this depends on a number of individual factors. Similarly to attending for a sexual health screening, when you speak to us about PrEP we will talk to you about the type of sex you are having, and your level of risk.

PrEP is very safe with hormone treatment. Your clinician will discuss any medication or treatment you are taking before you start taking PrEP.

We provide continued follow up care through your journey with taking PrEP.

In your consultation we will discuss the different way to take PrEP, side effects, and interactions with other medicines. More information on PrEP is available on our PrEP page.

To find out if PrEP is right for you, you can use the PrEP Tool.

 

 

You can order postal STI testing kits via our new Personal Health Record.

We asked for your thoughts on postal STI kits. Following this feedback from trans, non-binary, intersex and gender diverse people, we will be providing postal kits to anyone who identifies as Transgender which include all available sampling options. There will be clear instructions for each sampling element of the kit, and individuals will be able to complete the appropriate samples according to the type of sex they are having and their anatomy.

We offer one to one support for individuals who would like help to reduce their risk of HIV and STIs. Regardless of gender identity, risk taking can include having unprotected sex with multiple sexual partners or use of chems as part of the sex you are having. 

Please email us and include your name, age, telephone number and town and a member of our team can call your for a confidential chat. We may text you first to tell you we are about to call you. If you prefer that we do not text, please tell us in your email.

If you would like support specifically related to your gender identity, journey or transition, a list of resources and support services has been provided below.

The content of this page was written in conjunction with support from trans people and community partners to our service, as well as allies who work with transgender, non-binary, intersex and gender diverse people. If you have any comments or feedback regarding the content of this page, or our website in general, please let us know here. We continually evaluate our service and the care we provide, and therefore take all feedback seriously.