Welcome to the Northern Region Gender Dysphoria Service (NRGDS)
The following information concerns New Victoria Hospital’s decision to stop providing masculinising genital surgery from 1 December 2026.
We recognise how upsetting this decision might be for those affected. If you have been referred for surgery already, you will remain on the national waiting list with Gender Dysphoria National Referral Support Service (GDNRSS).
Other parts of your care and treatment within NRGDS will not change.
NRGDS will make referrals for masculinising genital surgery, following the processes required by NHS England. There are no expected impacts on feminising genital surgery or masculinising chest surgery as a result of this change.
Unfortunately, NRGDS currently has no further information on what this decision will mean for the surgical care pathways or waiting times for individuals. We can't answer questions about waiting times for surgery or surgical choices for this reason.
GDNRSS is the service commissioned by NHS England to communicate between the NHS Gender Identity Clinics and the NHS Surgical Providers. They have developed a website where they will provide updates about surgery providers, which can be found here: National Referral Support Service - AGEM_Gender_Services
Answers to frequently asked questions are available here: Adult Surgical - AGEM_Gender_Services
GDNRSS has a support service to help you with questions and advice. If you need further advice or support from their team you can contact them here: NHS Gender Dysphoria National Referral Support Services
NHS England is working with healthcare organisations to work out the next steps. If you need support during this time, you can contact our Peer Support Team by email at NRGDSPeerSupport
If you are currently on a Patient Initiated Follow Up pathway, you can request an appointment with the service, to allow you to access peer support.
NRGDS is unable to provide mental health support or any form of crisis or emergency response. However, we have a set of resources and support you may find helpful.
You can also contact your GP, Crisis team or NHS 111 for support.
- Oestrogen equivalence products (February 2024)
- Formulations and dose equivalents of transdermal testosterone preparations (31 January 2024)
Accessibility note: These files may not be suitable for assistive technology. If you need this information in a more accessible format please email communications
If there is a supply issue with injections
If a long-acting injectable testosterone is unavailable (for example, Sustanon or Testosterone Enantate):
- First, try to source either Sustanon or Testosterone Enantate locally
- These can be used at the same doses and intervals
If injections cannot be sourced
If neither injectable option is available:
- You may need to use a testosterone gel for a short period
- Start the gel on the day the injection is due
Recommended starting dose:
- Tostran 40 mg once daily
- Adjust the dose depending on blood test results
If Tostran is not available
Use the equivalence table to find an alternative gel. For example:
- A 40 mg equivalent dose would be one 40.5 mg Testogel sachet once daily