Sussex Gender Service

We're an NHS adult gender service pilot in Sussex, which has been commissioned to provide local transgender healthcare for trans and non-binary people.

This includes assessment and diagnosis for gender incongruence which involves a holistic assessment of an individual's needs and offers referrals and signposting to other services.

Alert Information

We recognise the term gender dysphoria can be difficult for some individuals so we are using the term gender incongruence. We know that having a label isn't something that everyone feels okay with but it is necessary to be able to access some of the treatments provided at the Sussex Gender Service.

About the Sussex Gender Service

The Sussex Gender Service is staffed by an experienced multi-disciplinary team and receives clinical support from the gender identity clinic at Nottingham Centre for Transgender Health. We have care navigators with lived experience that work with people who access our services to provide support and signposting to local organisations. 

The service follows the same service specification from NHS England as other gender service pilots, which is similar to the existing gender identity clinics.

The service is a two-year pilot which may be extended for a further year, following an independent evaluation.

We can only see you if you're registered with a GP in Sussex, and are already on the waiting list of one of NHS England’s seven national gender identity clinics.

We offer a range of specialist treatments including speech and language therapy, psychological support, referrals for hormone therapy, surgery, fertility preservation and hair-reduction.

We will make sure that we support you to be well informed about any choices that you make by sharing knowledge, explaining options, promoting health and supporting you to make decisions that are right for you, and at your pace.

Care navigators

Care navigators are trans, non-binary or intersex (TNBI) community members who work alongside the Sussex Gender Service to offer you help and advice. The role is still under development and welcomes your feedback. The aim is to support you as you journey through the service pathways and help you access information about the Sussex Gender Service. They can support you with a variety of issues while you are seen by the service, through group and individual support.

Care navigators are employed by The Clare Project and work closely with the Sussex Gender Service, but are independent of the NHS.

Please find more information about care navigators on The Clare Project website.
 

Here's some information about what you can expect to help you feel more confident and help make your first appointment feel a little easier. 

Appointments may be face to face or be held virtually. We always try and accommodate your preference for the type of appointment.

At your first appointment we'll talk about how things are for you. This will be between yourself and a clinician, who may be a nurse, GP or a psychologist.

We'll ask you questions so we can establish some background information about you and your gender identity. We'll discuss with you about what NHS treatments you are hoping to access. 

Don’t worry if you're unable to answer some of the questions. We don't expect you to have all the answers. This is a chance for us to chat with you about you and your gender identity, what treatment options are available, how we can help, and any treatments you may wish to have.

After your first appointment you will be offered a further appointment. This is because we normally do two assessments before we can give a diagnosis of gender incongruence. 

Once a diagnosis has been given, our clinicians will help support you to make informed decisions about any treatment you decide to have. They will be able to explain how you can access treatments, what you might need to do to prepare, what they will involve, and any potential risks there might be. 

The treatments we offer in-house, or we can refer you on to, include:

Hormone therapy

This is used by transgender and non-binary people to produce physical changes in the body called secondary sex characteristics. This can help better align your body with your gender identity. One of our doctors will assess your suitability for hormone treatment and make recommendations. 

Speech and language therapy

Our speech and language therapist will offer specialist voice and communication therapy that can help you develop a voice that is congruent with your gender identity. 

Hair reduction

While not everyone will want or require hair removal, it is a common step for many people when transitioning. Hair reduction on the facial area can help you achieve the physical appearance you want.

Our staff will be able to refer you to a number of external NHS approved providers with a number of treatments for hair removal on the facial area such as laser-based treatments and electrolysis. Types of treatments and their frequency will vary depending on your hair type (such as colour and thickness). Clinicians can give you information on how long each treatment will last, how effective it could be, and any side effects such as redness and post-treatment care. 

Fertility preservation

Hormone treatments can affect fertility, and some gender affirming genital surgery will have a non-reversible impact upon fertility. It is important to give this consideration as, for some people, having a child that is biologically related to them can be important. Also, your feelings about your fertility now may be different in the future as you get older, or your circumstances change. We can help to refer you to a service that can help preserve genetic materials by providing storage of embryos, oocytes and sperm for up to 10 years. 

Surgery

We work with the Nottingham Centre for Transgender Health to offer onward referral for certain types of surgery that are available on the NHS. These surgeries aim to align your body with your gender identity and identity expression goals. The following surgeries are available through the NHS for trans and non-binary people

Transmasculine (including non-binary) people may want to access:

Mastectomy/top surgery

Mastectomy (also known as top surgery) is the surgical removal of breasts and the construction of a more masculine chest. There are several different surgical techniques depending on various factors.

Phalloplasty

A phalloplasty is the surgical creation of an artificial penis, scrotal sac and testes. It involves taking skin from a donor site to create the penis. An insert is then used in order to make the penis erect when desired. 

Metoidioplasty

A metoidioplasty is a non-reversible surgical creation of a mini phallus which uses existing genital tissue to create a small penis. While the phallus created is very small, patients also have a urethral lengthening which enables them to urinate when standing up.

Hysterectomy

A hysterectomy is a surgical procedure to remove the womb (uterus).

Transfeminine (including non-binary) people may want to access:

Vaginoplasty surgery

A vaginoplasty is an operation which aims to remove the penis and testes and create a vagina, which is either sexually functioning or not.

Vulvoplasty 

A vulvoplasty is a type of surgery that uses skin and tissue from a penis to create the outside parts of a vagina (except for the vaginal canal).

Orchidectomy

Orchidectomy is a surgical procedure to remove a testicle.

Not all people choose to have surgery. As with any treatment, surgery comes with a number of risks as well as benefits. Therefore, it's important that you consider whether this is an appropriate option for you and if you're ready for a referral. Our staff can help support and make recommendations for surgery for those who are suited to the available operations.

Psychological support

The psychology team at the Sussex Gender Service will provide psychological support for people experiencing psychological, emotional or relational distress relating to or linked to their gender identity.

We are a team of LGBTQ+ people and dedicated allies working collaboratively to bring together a broad range of expertise and experience.

The team is made up of a range of professionals including our administrators, care navigators, nurses, speech and language therapist, psychologists, GPs, service manager and clinical lead. We work closely with our local community of trans, non-binary and intersex people in developing and delivering our service. 

Find out more about the roles within the team:

Clinical lead

Provides clinical leadership to the Sussex Gender Service and is responsible alongside the service manager for the delivery and implementation of the Sussex Gender Service.

Service manager

Responsible for the delivery and implementation of the Sussex Gender Service. 

Nurses

Provide specialist assessments and follow up appointments with patients as well as access to some interventions.

GPs

Provide specialist assessments and make referrals for hormone treatment, surgery and other interventions/treatment pathways.

Psychologists

Offer therapeutic sessions to patients who are experiencing psychological, emotional or relational distress relating to or linked to their gender identity. They have expertise in working with people who are neurodivergent. 

Speech and language therapist

Provides a specialist speech and language therapy service to patients.

Admin coordinator and support workers

Contacts patients and helps to book appointments. They also help the team with other administration, such as processing letters, ordering equipment, organising diaries and taking minutes for meetings.

Care navigators

Provide a coordinated approach of essential practical support and non-clinical advice to individuals who are accessing or wishing to access the service.

  • To be eligible to join the Sussex Gender Service waiting list you must be on the waiting list for an adult NHS gender identity clinic
  • You must have joined that waiting list prior to 31 March 2023
  • You must have been registered with a Sussex GP prior to 31 March 2023 
  • You must still be currently under the care of a Sussex GP 
  • You have not had an appointment with another NHS gender identity clinic.

Our admin team are currently contacting patients who are eligible to transfer to our waiting list. We will be contacting patients in date order. The patients that have been waiting the longest will be contacted first.

At present we are still recruiting and training staff. We started seeing patients from the beginning of October 2023 but have not yet reached full capacity. 

We will endeavour to provide information about waiting times on our website once the service is running at full capacity. This is anticipated to be at the beginning of April 2024. We are currently contacting people who were referred to a gender clinic before and up to the date 25/08/2020.

You may need to turn to someone for help, advice and support – this is where our Patient Advice and Liaison Service (PALS) can help.

PALS is a confidential advice and support service that can help you sort out any concerns that you may have about any aspect of your care.

  • Call: 0300 304 2198
  • Email: pals@spft.nhs.uk 
  • Write to: Patient Advice and Liaison Service, Swandean, Arundel Road, Worthing, West Sussex, BN13 3EP.

You can also share your feedback via our Sussex Experience Survey.

Let us know how you'd like to get involved and we'll be in touch.

Email: sussexgenderserviceinfo@spft.nhs.uk

If you'd like to find out how people have been working with us to develop the Sussex Gender Service, please read our engagement summary.