Frequently Asked Questions
General FAQs
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We are a trans-positive organisation. We believe that our clients deserve excellent care, which, from our perspective, includes a thorough, holistic and compassionate assessment. We start from the position that people are the experts in their individual experience. As experts in this field, we then bring our knowledge to help people to navigate their journey. Our intention is for people to look back on their experience with us and feel like we did as good a job as possible, independent of what happens in the future. We do not have a preferred outcome for our clients and are not trying to change people's minds.
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Each of our clinicians is regulated through their professional registration body (e.g. HCPC, UKCP, NMC and Irish equivalents). The Gender Plus Hormone Clinic is led by our endocrine nurse consultant who is registered with the NMC (UK) as a non-medical prescriber and NMBI (Ireland) as a nurse. The Hormone Clinic is registered in England with the Care Quality Commission (CQC) and was found to provide an 'Outstanding' service at its most recent inspection in January 2024. This regulation increases the likelihood of GPs agreeing to shared care.
The service has clarified with the Care Quality Commission (CQC) that Gender Plus, the holistic psychosocial arm of the service we provide – which includes gender, mental health and neurodevelopmental assessment and support – does not fall under their remit and as such is not eligible for CQC registration.
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Depending on how complex and detailed your questions are, you can either email them in, and one of our non-clinical team can respond, or if you wish to speak to a clinician you can book an non-assessment appointment (£175 for 50 minutes) to discuss any questions you may have from a clinical perspective.
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For those over the age of 18, gender assessment appointments can take place remotely. However, our hormone clinic team can only prescribe to those registered with UK or Irish primary care doctors.
Services FAQs
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It's easy! Select 'Book Appointment' at the top of the screen and select 'Gender Assessment - First Appointment'. You will be prompted to complete a referral form and, once completed, you can book and pay for your appointment. Depending on availability your first appointment could happen within a couple of weeks.
Please note that, in the case of gender assessment, those over 18 will typically require two sessions, those under 18 will require 6 sessions. Please visit ‘Transfer of Care’ for specific information about this pathway.
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Appointments can take place in person or over Zoom as a video call. We find that most people are happy to conduct the majority of the assessment over Zoom and come to an in-person appointment towards the end of the process. For those under 18, at least one of the appointments would need to be in person. We currently have offices in London, Birmingham, Leeds and Dublin.
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Gender assessment length varies depending on the age and circumstances of the client. For those under the age of 18, the assessment process is typically made up of six sessions which take place over a six month period. These offer an opportunity to explore the young person's holistic development from birth to the present day. Sessions take gender identity development into consideration as well as family life, friendships, school life, mental health, neurodiversity, sexuality, general health and significant life events. If indicated, time is also given to considering gender-related medical interventions. For those aged 18 or older, the process involves fewer appointments, typically two.
A report is written at the end of the process, which may include a diagnosis and/or referral to the Gender Plus Hormone Clinic, as appropriate.
Psychological support sessions are client-led and driven by the goals of the young person and their family, or in the case of those over the age of 18, the adult. These may include exploring and making sense of their relationship to their social world or peer group while considering factors such as sexuality, gender, or other relevant factors. It may also include developing strategies and interventions to manage any associated anxiety or distress. Support sessions can consider the emotional, relational and practical implications of living as trans, non-binary or cis. These sessions tend to take place on a more frequent basis such as weekly or fortnightly.
Psychological support sessions are different from assessment sessions in that the cost only covers the time spent meeting with the clinician. If any liaison work or report writing is required, in addition to the psychological support meetings, they will be charged at a separate rate. Assessment sessions on the other hand have the cost of liaison and report writing incorporated into the fee.
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Depending on the age of the individual, the assessment process can involve a different number of appointments. For those under 18, the full assessment process typically involves six appointments over a six month period, although this can vary. For those aged 18 or older, the process requires fewer appointments, typically two.
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The first appointment is a space for you to ask any questions you may have about the assessment process, share your hopes and worries, and start to build an understanding of your gender identity development. For the first session with young people under the age of 18, it is helpful for at least one parent or guardian to attend.
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The clinician meeting with you for your assessment will want to learn about what brought you to Gender Plus and your hopes for the future. If you are someone who becomes very anxious about meeting people for the first time, it is a good idea to speak to a loved one beforehand. Writing down what you want to cover, or ask about, in your first appointment is also a great idea. We know it can take time to build trust with a clinician. It helps if you can be open about your experiences. We will work hard to make you as comfortable as possible and agree on the best way to support you. If you have preferences of how you want a clinician to speak or communicate with you, please let them know.
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While there is no formal agreement between Gender Plus and the NHS, we write NHS equivalent assessment reports and most of our clinicians have worked in gender services in the NHS. Our clinicians are known and trusted by clinicians working within the seven NHS Gender Identity Clinics, so our hope is that the Gender Plus assessment would be taken into account.
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Yes and no – the process is different for everyone who accesses our service, because we treat people as individuals. We understand that many gender diverse people are also neurodivergent and we can make reasonable adjustments to accommodate any additional needs. Please let us know if you have any communication preferences, such as using the chat function.
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In-person availability can change so is not always visible through our booking system. If you would like your first appointment (or all of your appointments) to be in person, get in touch with us. We can arrange this.
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Our booking system automatically generates a Zoom link for all appointments, which allows the link to be used if plans change without you needing to rebook. If you would prefer an in-person appointment please select the option when booking. Your appointment confirmation email will include 'IN PERSON' in the subject line.
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Most of our slots are available during working hours, however you can get in touch to request appointments slightly earlier or later than those you see in our booking system and we may be able to accommodate your request. Evening appointments are not available.
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If you click on the green 'Change/Cancel Appointment' button in your confirmation email and then 'Reschedule' you will see your clinician's available appointment slots.
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To discuss individual concerns please contact: admin@genderplus.com.
Financial FAQs
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Our current fee structure for appointments is below:
Specialist Gender Assessment appointments: £325/€395 per 1 hour appointment.
Non-assessment psychological support appointments: £175/€215 per 50 minute appointment.
Family therapy appointments: UK only. £200 per 75 minute appointment.
Surgery referral appointments: £325/€395 per 1 hour appointment.
Autism assessment appointments: UK only. £650 per appointment (NB: for the full process and report, three appointments lasting 60–90 minutes are required at a total of £1950).
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With the support of a generous donor, we recently offered a Reduced Fee Pathway to four eligible clients randomly selected from a wider pool of applicants. We hope to offer further opportunities for reduced fee pathways in future, though this is dependent on the support of further donations. Please keep an eye on our website and social media where we will advise on any future reduced fee options.
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In Ireland, income tax relief – typically 20% of the cost of appointments – is available. See: https://www.revenue.ie – health expenses. In the UK, although rare, we have had some people successfully apply for an Individual Funding Request through their local CCG/ICS. Additionally, we are recognised by different insurance providers both in Ireland and the UK. The amount covered will depend on the individual plan. If you have private healthcare insurance, first check with the company and then contact us with your authorisation number to arrange a first appointment.
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Dr. Igi Moon, Dr. Rosie Jones and Dr. Claudia Zitz are registered with BUPA and can offer gender therapy, specialist gender assessments and surgical assessments. Dr. Aidan Kelly is registered with BUPA and can currently offer surgical assessments. You will need pre-approval for services under one of these BUPA codes: GG014, GG019, GG075 or GG077. Please use our contact form to get in touch and include your pre-authorisation code, the type of appointment you are looking to book and the number of sessions agreed, and we will arrange these for you.
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UK: An initial consultation costs £275 and the monthly subscription is £90 per month for a period of two years.
Ireland: An initial consultation costs €320 and the monthly subscription is €110 per month for a period of two years.Please note, prescription medication is not included in your subscription. This is charged separately, unless you are able to secure a shared care arrangement with your GP.
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UK: The monthly subscription is £50 per month for one year, for those transferring over from another provider.
Ireland: The monthly subscription is €60 per month for one year, for those transferring over from another provider.
Please note, prescription medication is not included in your subscription. This is charged separately, unless you are able to secure a shared care arrangement with your GP. -
If your GP is happy to prescribe your treatment and undertake blood tests as part of a shared care agreement with the Gender Plus Hormone Clinic, there will be no additional costs other than your standard prescription fee, unless you are exempt.
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If your GP will not prescribe your treatment, additional costs would be charged by the pharmacy for any medications prescribed privately by the Gender Plus Hormone Clinic.
NB: Indicative pricing - these vary by pharmacy and we recommend you compare prices prior to handing over your prescription.
Decapeptyl (Triptorelin) - 22.5mg - 1 injection | £580
Decapeptyl (Triptorelin) - 11.25mg - 1 injection | £265
Sustanon - 25mg/ml - 1 injection | £7.99
Testosterone Enanthate - 250mg/ml - 3 injections | £129
Nebido - 1000mg/4ml - 1 injection | £110
Testogel 16.2% - 88g - 1 canister (approx 70 pumps) | £59.50
Oestrogel 0.06% - 80g - 1 canister (approx 64 pumps) | £15.30
Progynova - 1mg (Estradiol Valerate) - 28 tablets | £7.99
Progynova - 2mg (Estradiol Valerate) - 28 tablets | £7.99
Evorel 100mcg - 8 patches | £14.00
Evorel 50mcg - 8 patches | £14.00
Evorel 75mcg - 8 patches | £14.00Utrogestan 100mg - 30 tablets | £12.00
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Leuprorelin - costs covered by the primary care reimbursement scheme.
Tostran Gel (or Oestrogel) - 50 cent per item per month until the patient’s primary care physician transfers to a general medical scheme prescription.
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Leuprorelin - costs covered by the primary care reimbursement scheme.
Tostran Gel - €80 or Oestrogel - €20-€40NB: this is until the patient’s primary care physician transfers to a general medical scheme prescription.
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Months one in three: Leuprorelin + Tostran Gel (or Oestrogel) - €80
Months two in three: Tostran Gel (or Oestrogel) - €80 (€20-€40)
G+ Hormone Clinic FAQs
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Once your onward referral has been accepted by the Multidisciplinary Team (MDT), you will be contacted within a week or two to progress your hormone clinic referral.
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All referrals to the Gender Plus Hormone Clinic must be made via a Gender Plus clinician and patients should book a Gender Assessment appointment to request that onward referral. See more info on our referral process here.
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Your monthly subscription covers reviews with the endocrine team and the psychosocial team if required (NB: this includes up to a maximum of eight sessions over a 24 month period). You can also access the team at any time should you have any concerns or queries. Subscription fees must be paid on a monthly basis in 12-month blocks, with the option of 'stepping-off' at the end of each 12-month block.
Please note the costs of your medication are not included in your subscription unless you are able to secure a shared care arrangement with your GP.
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We are happy to consider a transfer from other providers. Please visit our Transfer of Care page for further information on transferring from another provider.
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In the UK, shared care between private healthcare providers and GPs refers to a formal agreement where a GP takes on the responsibility for prescribing and monitoring medications for a patient who is being treated by a private specialist. This works to reduce costs for the patient while ensuring they have the necessary expertise in place.
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While shared care is not always available, more than half of our UK patients achieve shared care with the NHS GP when starting on hormones with Gender Plus. This is a figure we are working hard to increase.
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The GPHC team will write to your GP following your initial hormone clinic appointment to request they prescribe treatment under shared care with our service.
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Some clients choose to inform their practice ahead of a referral to establish their GP's willingness to work in collaboration with GPHC.
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Where shared care is not an option, you may wish to move to a more inclusive GP practice. If this is not possible, we can provide private prescriptions. However, this will require you to cover the cost of the medication. We will continue to support you to obtain shared care with your GP.
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Yes. We can request private blood tests with our provider Nationwide Phlebotomy. Nationwide charge £53 per test, for the tests we require. In addition they charge a phlebotomist fee (usually between £35–£50).
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Once your referral to the Hormone Clinic has been accepted in the multidisciplinary team meeting, you will be contacted within a week or two to progress your Hormone Clinic referral. You will be asked to have blood tests and provide a brief medical summary, which you should obtain from your GP. Once you have these, you can book an appointment, usually within a month or so (Ireland appointments are currently booking three months in advance).
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After a 24 month period, your ongoing hormone treatment regime will have been established by GPHC and you are ready for discharge to the care of your GP who will take over continued prescribing of your treatment. If your GP refuses, GPHC can offer an ongoing package of care in order to continue prescribing and monitoring your treatment. The fee will be a monthly subscription in line with our Transfer of Care package which is currently £50/€60.
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Testosterone as either transdermal gel or IM injections
Oestrogen as either transdermal gel, patches or occasionally oral preparation
GnRHa Decapeptyl in the UK and Leuprorelin in Ireland
Progesterone tablets in the UK
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(UK prices only)
Decapeptyl (Triptorelin) – 22.5mg | 1 injection | £580.00
Decapeptyl (Triptorelin) – 11.25mg | 1 injection | £265.00
Sustanon – 250mg/ml | 1 injection | £7.99
Testosterone Enanthate – 250mg/ml | 3 injections | £129.00
Nebido –1000mg/4ml | 1 injection | £110.00
Testogel 16.2% – 88g| 1 canister (approx. 70 pumps) | £59.50
Oestrogel 0.06 % – 80g | 1 canister (approx. 64 pumps) | £15.30
Progynova – 1mg (Estradiol Valerate) | 28 tablets | £7.99
Progynova – 2mg (Estradiol Valerate) | 28 tablets | £7.99
Utrogestan - 100mg | 30 tablets | £12.00
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While the team within the psychosocial arm of the organisation (Gender Plus) can see patients of all ages, the Gender Plus Hormone Clinic is only registered to see patients aged 16 years plus, for gender-affirming hormones. We can do an assessment and develop a care plan for young people aged under 16 years, but there are currently no options to access hormone blockers in England.
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Progesterone is a hormone that has long been reported by trans women to have benefits in feminising hormone therapy. Gender Plus is now offering it following a landmark randomised controlled trial (Dreijerink et al., EPATH 2025) - the first study to provide objective evidence supporting those reported benefits.
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The study found that trans women receiving progesterone alongside estradiol showed breast volume increases of 13-37% compared to those on estradiol alone, with results reaching statistical significance. It's the first time objective measurement tools have been used to study this in trans women.
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The study found no serious treatment-related adverse events. Reported side effects included tiredness (44%), breast and nipple tenderness (27%), and mood changes (22%) - manageable effects that will be discussed with each patient individually.
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Progesterone is currently available to patients who have been on feminising hormone therapy for at least 12 months, have desired oestradiol levels, and are in stable physical health. Progesterone is available to patients regardless of whether they have had vaginoplasty or orchiectomy. It's also worth noting that the Dreijerink study specifically included participants who had undergone vaginoplasty or orchiectomy, which means further research is needed to fully understand progesterone's role for those who haven't had surgical intervention. Individual circumstances are always assessed carefully before any decision is made.
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We have begun exploring the possibility of introducing this service in Ireland and will share any updates via the website.
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Previous research found no empirical evidence of breast development benefits, and older studies on cisgender postmenopausal women raised concerns about risks. However, those findings aren't directly applicable to trans women, who have distinct hormonal histories - and now trans-specific evidence exists.
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Patients will begin on a low dose, titrated where clinically needed, with progress and side effects monitored at three and six month intervals.
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Raise it at your next appointment, or get in touch to book a consultation. The team will assess your individual circumstances, discuss realistic expectations, and determine whether progesterone aligns with your goals and medical history.