An initial fee (£275/ €320) will be required when booking your first consultation.

If the patient proceeds with a gender affirming treatment plan a monthly subscription (£80/ €95) will commence following your consultation. The subscription secures each patients access to regular medical and psychological review while treatment is titrated up to a full adult level.

The payments will continue for a total of 24 months, by the end of this period, we anticipate that your hormone levels will be stable and that you can either attend for an annual review or your GP can continue to monitor your care.

These fees include the 6 monthly medical psychological review meetings, provided as part of the holistic care pathway.

Initial Fee: £275/ €320

Monthly Fee: £80/ €95 (Monthly x 24 Months)

Total: £ 2,195/ €2,600 (over 24 months)

The Transfer of Care pathway to Gender Plus Hormone Clinic (GPHC), the UK’s first independent CQC registered gender clinic for those aged 16 years and above. To access this expedited pathway in the UK you must be between the ages of 18-25 years old and have been on gender-affirming hormone therapy for at least 12 months. You must have your summary of care documents and/or previous gender assessment report ready in order to access this transition of care pathway.

We do accept transfer of care requests for those 16 & 17 years old however that pathway will follow our adolescent model of care, for more details please contact us on admin@genderplushormoneclinic.com

The pathway and costs to transition care to Gender Plus Hormone Clinic:

• One transition of care assessment appointment with our psychologist to confirm your prescription and recommend treatment, for £275. Visit https://uk.genderplus.com to book this appointment.

• One transition of care consultation with our hormone clinic, Paul Carruthers Nurse Consultant, to take over care and prescribe hormones, for £275.

• For those on masculinising hormone therapy (trans men, transmasculine or non-binary people): Discharge to your GP following these two transition of care appointments and remain on the hormone pathway for 12 months before being discharged to their GP, for a £40 per month subscription fee that covers the cost of follow-on reviews, medical oversight and blood monitoring, and prescriptions when required.

• For those on feminising hormone therapy (trans women, transfeminine or non-binary people): Discharge to your GP following these two transition of care appointments and remain on the hormone pathway for 12 months before being discharged to their GP once you have been taking the blocker and your levels are stable. Those who have been taking cyproterone acetate (Androcur) or spironolactone (Aldactone) will need to switch to GnRHa and remain on the hormone pathway for 12 months before being discharged to their GP, for a £40 per month subscription fee.

• The total cost for transition of care would be approximately £1030. This does not include prescription costs (if required) although those will be reduced if the GP is willing to prescribe in a shared care agreement.

• Gender Plus has a shared care protocol document for GPs and so far most GPs (70-80%) have been willing to prescribe in a shared care agreement.

Important notes:

• This is less expensive, by about 50%, than the usual pathway to access our service because the hormone pathway will likely be shorter and the level of input likely reduced as the patient has already been on treatment for a period of time, as well as the additional psycho-social support not being included.

• You may have to undergo further assessments (at additional cost) if the Clinical Psychologist or Nurse Consultant deem it necessary.

• Once your pathway with our service is complete, the team will assess readiness to discharge your care to your GP. They will liaise with your GP to offer training and support them and/or get them involved in care to ease transfer post-discharge. This means you will receive maintenance care directly from your GP after your time with Gender Plus Hormone Clinic.

• If you are currently taking Cyproterone Acetate (Androcur) or Spironolactone (Aldactone), you will need to switch to GnRHa in your care with GPHC However, as most GPs are agreeing to do shared care with GPHC the cost of this medication may be lessened.

The Transfer of Care pathway to Gender Plus Hormone Clinic (GPHC). To access this expedited pathway in Ireland you must be between ages of 18 years old or above and have been on gender-affirming hormone therapy for at least 12 months. You must have your summary of care documents and/or previous gender assessment report ready in order to access this transition of care pathway.

We do accept transfer of care requests for those 16 & 17 years old however that pathway will follow our adolescent model of care, for more details please contact us on admin@genderplushormoneclinic.com

The pathway and costs to transition care to Gender Plus Hormone Clinic:

• One transition of care assessment appointment with the clinical psychologist, Dr. Aidan Kelly, to confirm your prescription and recommend treatment, for €320.

• One transition of care consultation with the endocrinologist, Dr. Tomás Ahern, to take over care and prescribe hormones, for €320.

• For those on masculinising hormone therapy (trans men, transmasculine or non-binary people): Discharge to your GP following these two transition of care appointments if your levels are stable.

• For those on feminising hormone therapy (trans women, transfeminine or non-binary people): Discharge to your GP following these two transition of care appointments if you have been taking spironolactone (Aldactone) and your levels are stable. Those who have been taking cyproterone acetate (Androcur) will need to switch to GnRHa or spironolactone (Aldactone) and remain on the hormone pathway for 24 months before being discharged to their GP, for a €45 per month subscription fee.

• The total cost for transition of care would be approximately €640-€1720 depending on the above factors. This does not include prescription medication costs (which can be covered by the Drugs Payment Scheme or Medical Card).

Important notes:

• This is less expensive, by about 50%, than the usual pathway to access our service because the hormone pathway will likely be shorter and the level of input likely reduced as the patient has already been on treatment for a period of time, as well as the additional psycho-social support not being included.

• You may have to undergo further assessments (at additionaf cost) if the psychologist or endocrinologist deem it necessary.

• Once your pathway with Gender Plus is complete, the team will assess readiness to discharge your care to your GP. They will liaise with your GP to offer training and support them and/or get them involved in care to ease transfer post-discharge. This means you will receive maintenance care directly from your GP after your time with GenderPlus.

• If you are currently taking Cyproterone Acetate (Androcur), you will need to switch to GnRHa or Spironolactone (Aldactone) in your care with Gender Plus. However, this medication will be accessible using the Medical Card or Drugs Payment Scheme due to the prescription coming from an Irish consultant, meaning your prescription expenses may be lessened.

• If you have been on hormones for less than 2 years or your dosage is not stable, you may need more than one endocrinologist consultation.

• If you have private health insurance, it may cover some of the costs of the clinical psychologist and endocrinologist appointments.

To get started, book the Transition of Care Assessment appointment with Dr. Aidan Kelly online at https://ie.genderplus.com. As a reminder, this is for people over the age of 18 who have been on hormone therapy already with another service for at least 12 months. Do not book this appointment if you do not meet this criteria.

If you have been assessed at GIDS with a report stating you/ your child has been recommended for hotmone reatment then you can access an expedited assessment pathway via Gender Plus, who can then refer to the Gender Plus Hormone Clinic once the patient is aged 16 years +. To learn more about this and to arrange an assessment please contact Gender Plus on admin@genderplus.com.

In advance of your first appointment, you will receive a letter confirming that the referral has been discussed and agreed at a multi-disciplinary meeting. We will also request that you have baseline blood tests undertaken and a copy of your GP medical record is sent to us, both of which are mandatory.

Information on the medical pathway will be made available for you to watch/read online. It is a mandatory requirement that this is read/watched. The content of this will be discussed further at your first appointment and you will have the option to ask any questions.

The first appointment will be an in-person appointment and will also be attended by a member of the psychosocial team. This will be in either Dublin, Birmingham or Leeds. Treatment options, side effects and the medical pathway will be discussed. If agreed by you and the consultant, consent will be taken to commence treatment.

This appointment is a safe space for you to ask as many questions as is necessary.

Before your first consultation a letter will be sent to your GP practice to establish if they will a) prescribe the medication we recommend and b) administer the medication.

If your GP does not agree to prescribe the medication we will be able to issue the prescription (how this works is different depending on whether you are in the UK or Ireland).

If your GP practice won’t administer the injectable medication, you can attend an injection clinic with the Gender Plus Hormone Clinic. This may require an additional charge.

Repeat prescriptions will only be issued if monitoring appointments are attended.

At Gender Plus Hormone Clinic we only use medications that are widely used in gender healthcare and are evidenced as safe to use. Within our treatment schedule there may be some choice, for example a topical testosterone over an injectable testosterone.

Yes, as discussed above we will offer shared care with your GP practice. Titration of medication and blood test monitoring will remain our responsibility. Following two years of monitoring we will request your GP take over the prescribing and monitoring as per NHS adult gender service guidelines.

Every patient is different and may require more frequent monitoring but the standard review process which includes blood monitoring, medical and psychological review will occur every six months.

We will ask for you to have these undertaken with your GP and forward us the results. If your GP will not take these blood tests you can have them done privately at a cost.

You may wish to find a private service locally. We have compiled a list below of private providers that may be able to help

• Clinic T in Brighton

• 56 Dean Street in London

• CliniQ in London

• Trans Clinic if you are registered with a Sutton GP

• genderhealthcare.co.uk

• Randox Health

• Medichecks

• The Spire

• www.optimale.co.uk