Guidance and Support for Managing Transgender Patient

  • Patients can request a change to name and gender marker without a Gender Recognition Certificate (GRC).
  • Whilst a gender marker change usually involves issuing a new NHS number, as of mid‑2025, PCSE allows the gender marker to be updated on the existing record (keeping the same NHS number) if the patient prefers. Further details here.
  • It’s important to note that data protection must be carefully considered when making these changes. As per the Gender Recognition Act 2004, it is unlawful to disclose a patient’s gender history without their consent.
  • Protected information can only be disclosed when it is to another health professional, and if it is for a medical purpose. Furthermore, protected information can only be discussed where there is a reasonable belief that the patient has consented to the disclosure.
  • Once a new NHS number is issued or a gender marker is changed, the patient will no longer be automatically invited for screening linked to their birth-assigned sex.
  • It is important that the patient is made aware of the implications of this and that the conversation is documented.
  • Patient’s need to take an active role in ensuring they remain up to date with screening. This responsibility needs to be clearly explained and documented. Guidance stresses the importance of this discussion and recommends recording it in the patient’s notes.

In terms of what process a practice might follow, current best practice includes:

  1. Explaining the implications of a gender marker change to the patient and confirming they understand their responsibility for future screening.
  2. Documenting this discussion clearly in the medical record.
  3. Setting up an internal flag or register of patients who have changed their gender marker so that manual recalls can be arranged when screening is due.
  4. Using internal searches or clinical system alerts to identify these patients and ensuring appropriate invitations are sent, or referrals made, at the correct intervals.
  5. Reviewing and auditing the process regularly to make sure patients are not missed.