Information for professionals

If you are a healthcare professional looking for information on hormone prescribing please see our Guide to hormone prescribing

What is gender/gender dysphoria?

The concept of gender has many different facets including, but not limited to, gender identity, gender role, gender expression and biological sex. Each of us will have our own unique experiences of how we define ourselves and our gender.

Many factors affect the way in which a person becomes aware of their gender, meaning that these expressions and explorations can happen at any or all stages of life. Gender identity is not a choice or a decision, but a deeply felt, integral part of a person’s sense of self and expression.

Gender dysphoria arises from a sense that a person’s feelings about their gender are not congruent with some part of their life. This might be their body, gender role, gender expression or any other gendered experience. Gender dysphoria is not, in and of itself, a mental health condition. However, transgender people often suffer from mental distress. This can be caused by living in a society which is not typically gender affirming and can often be discriminatory and transphobic. It can also be as a result of the distress caused by experiencing gender dysphoria and/or the difficulties associated with social and medical transition, which include major life changes and an increasingly long wait for assessment and treatment.

A quick guide to terminology

Biological Sex – The classification of an individual as male or female -based on genital/physical characteristics

Gender diversity – A range of genders inherent in a society

Gender dysphoria/incongruence – The sense of (often profound) unease and discomfort or discrepancy that a person may have because of a mismatch between their gender identity and their biological sex or other aspects of how they move through the world.

Gender identity – The inner felt sense of one self as male, female, both or neither. Different from biological sex. Self-defined and integral to personhood.

Gender role/expression – Created by societal norms and expectations. Things that men and women traditionally are expected to do or not do. Usually these underpin ideas about what is acceptable, appropriate or desirable. They can change with time and between cultures.

Intersex – Umbrella term that describes biological aspects of bodies that fall outside the strict male/female binary. There are lots of ways someone can be intersex.

Non-binary – An umbrella term for a person who identifies with or expresses a gender identity that is neither entirely male or entirely female – androgynous, gender non-conforming, gender fluid, agender, gender queer.

Sexuality/Sexual Orientation – Romantic/sexual attraction

Other terminology resources

Gender Identity Research and Education Society (GIRES) – Gender Variance (Dysphoria)
Gender Identity Research and Education Society (GIRES) – Terminology
Stonewall – What does trans mean?
Stonewall – List of LGBTQ+ Terms
Stonewall – A beginner’s guide to pronouns

Useful resources/reading

Transgender people’s voices
TransActual – Trans Lives Survey 2021: Enduring the UK’s hostile environment
TransActual – Transition Access Survey 2022
Stonewall/YouGov – LGBT in Britain: Trans Report
LGBT Foundation – Pride in practice LGBT Patient Experience Survey 2021
NRGDS – NRGDS Service User Evaluation – 2019
Transforming Futures Partnership – Trans People’s Experience of Healthcare in England

NHS – Guidance for GPs, other clinicians and healthcare professionals on the care of gender variant people
Stonewall Scotland – Inclusive language in the NHS – Why does it matter?
NHS England – Gender dysphoria clinical programme
WPATH – Standards of care for the health of transexual, transgender and gender non-conforming people
LGBT Foundation – Integrating Care for Trans Adults – Review of the integration of trans healthcare
IMAP – Statement on hormone therapy for transgender people

Medical practitioners
The General Medical Council (GMC) – Trans-healthcare
British Medical Association (BMA) – Managing patients with gender dysphoria
Royal College of General Practitioners (RCGP) – The role of the GP in caring for gender-questioning and transgender patients
Care Quality Commission (CQC) – Adult trans care pathway: what the CQC expects from GP practices
NRGDS – Guide to hormone prescribing
Hospice UK – “I just want to be me” Trans and Gender Diverse Communities’ Access to and Experiences of Palliative and End of Life Care

Royal College of Nursing (RCN) – Fair care for trans and non-binary people

Royal College of Psychiatrists (RCP) – Supporting transgender and gender diverse people
Also has a Rainbow Special Interest Group – to promote and research the mental health to LGBTQ+ people

The British Psychological Society (BPS) – Guidelines for Psychologists Working with Gender, Sexuality and Relationship Diversity
British Association for Counselling and Psychotherapy (BACP) – Gender, Sexual, and Relationship Diversity (GSRD)

Speech and Language Therapists
Care Quality Commission (CQC) – Adult trans care pathway: what the CQC expects from speech and language therapy services

Training available from NRGDS and other organisations

We are always happy to offer support and guidance to healthcare professionals seeking advice. We receive a large number of requests asking that we offer education or information about the work that we do. We are passionate about education in our field but are unable to meet requests to speak to small numbers of people except if the query is related to a specific service user open to our service.

In order to offer training and education more efficiently and effectively, we plan to provide a series of educational events, aimed at different professional groups. The first event of this type is planned on 26th April 2023 from 9am to 1pm, at The Grand Hotel Gosforth Park, Newcastle. This pilot event is open to medical doctors and senior clinical staff who work in healthcare settings and deliver care to gender diverse people. Additional information is available here.

Please note that this pilot does not include wider professional groups at this time. However, we hope to deliver events in the future that focus on other healthcare staff that work with gender diverse people. If you wish to be informed of future educational events please email [email protected] and ask to be placed on our training register.

There are many excellent organisations run by people with personal experience of gender diversity who are well placed to offer education and guidance, if you want to arrange training specifically for your organisation. Further information can be found below and on our Resources and Support page.

Other organisations offering training:

Gender Identity Research and Education Society.

Gendered Intelligence