Gender dysphoria and incongruence

If you have gender dysphoria or incongruence, you may want to live as a different gender and may feel your body does not match who you feel you are.

If a GP thinks you may have gender dysphoria or incongruence, you'll be referred to a gender dysphoria clinic for an assessment with specialists.

Treatment for gender dysphoria or incongruence may include talking therapy, hormone therapy, voice therapy or gender reassignment surgery.

The main sign of gender dysphoria and incongruence is feeling your gender identity is different to the sex you were registered at birth.

You may want to live and be treated as a different gender, or feel your body or parts of your body do not match who you feel you are.

These feelings can make it hard to enjoy everyday life and may affect your mental health. For example, you may feel depressed or anxious, or feel like self-harming.

• you think you or your child might have gender dysphoria or incongruence

If you're aged 18 or over and you think you may have gender dysphoria or incongruence, a GP can refer you to an NHS gender dysphoria clinic for an assessment.

If you're aged 17 or under, a GP can refer you to a child specialist (paediatrician) or to children and young people's mental health services. They can refer you to the NHS children and young people's gender service.

While you're waiting for an assessment

Waiting times to get assessed at a gender dysphoria clinic are currently very long. Most clinics say on their website how long you can expect to wait.

If you're struggling with your mental health related to your gender identity, speak to a GP about what support is available while you wait.

If you're aged 17 or under, you can get support from children and young people's mental health services.

If you're aged 18 or over, you can refer yourself to an NHS talking therapies service for certain mental health conditions such as depression or anxiety.

There are also private gender clinics that have shorter waiting times, but you will need to pay for any treatment.

If you have been diagnosed with gender dysphoria or incongruence, there are different treatments available.

Treatment for adults

If you're aged 18 or over, treatment may include:

• hormone therapy
• voice and communication therapy
• talking therapy and counselling
• surgery to change parts of the body (gender reassignment surgery)

Surgery

A gender dysphoria clinic may refer you for surgery.

Masculinising surgery may include:

• removing the breasts and chest reconstruction (sometimes called top surgery)
• removing the womb (uterus), ovaries and fallopian tubes (hysterectomy)
• construction of an artificial penis, scrotum and testicles

Feminising surgery may include:

• removing the penis and construction of an artificial vagina
• removing the testicles

Breast implants, hair transplants and facial feminisation surgery are available privately, but not usually on the NHS.

Treatment for children and young people

If you're aged 17 or under, treatment will usually include talking therapy and counselling.

It's strongly recommended you do not use or buy treatment that has not been prescribed for you.

If you're taking medicines, such as hormones, that are not prescribed by a health professional, speak to a GP.

Some treatments may affect your fertility. You can be referred to a fertility service to preserve your eggs or sperm for future fertility treatment.