GPs are increasingly denying hormone replacement therapy (HRT) to transgender patients. HRT includes oestrogen, progesterone, and testosterone and is used for gender-affirming care and menopausal symptoms. Reports document GPs refusing HRT to transgender patients, including long-term users, after the Cass Report and a UK Supreme Court ruling on the legal definition of sex. A TransActual investigation found 215 people were refused hormone prescriptions; over a quarter had NHS gender clinic recommendations and 45% had been on HRT for more than five years. GPs cited lack of training, perceived incompetence, absent policy, and personal beliefs; surveys reported misgendering, prescription disruptions, and loss of NHS records after gender-marker changes.
Campaigners have warned of a "staggering increase" in the number of GPs denying hormone replacement therapy ( HRT) to transgender patients. HRT broadly refers to several hormone therapies, including oestrogen, progesterone, or testosterone. It is used by some trans and non-binary people as part of gender-affirming healthcare. Feminising HRT increases breast tissue size, makes body hair lighter and softer and decreases testosterone levels while masculinising HRT can stop periods, deepen the voice and make body hair appear thicker and darker.
Last October, TransActual published a report detailing how 215 individuals had been refused a prescription for hormones. The results, shared with QueerAF and What The Trans, who had both carried out a broader investigation, showed that more than a quarter of them had a recommendation from an NHS gender clinic. Forty-five per cent of those had been on HRT for more than five years.
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