Initial appointment
Your first appointment is about gaining a comprehensive gender history and getting to know you to understand your goals and expectations from the service. We offer two assessment appointments. It is the second appointment that we discuss diagnosis of gender incongruence and treatment options.
Here is some information about what you can expect at your initial appointment at Sussex Gender Service.
Your first appointment is about gaining a comprehensive gender history and getting to know you to understand your goals and expectations from the service. We offer two assessment appointments. It is the second appointment that we discuss diagnosis of gender incongruence and gender affirming care options.
Please bring a full medication list (including the dose and timings you take them) or your boxes of medications.
We encourage you to bring along anything that will make you feel more comfortable and settled during your appointment, such as fidget toys or comfort items. You are welcome to bring a friend, carer or family member to your appointment if you wish.
You may wish to write down a list of questions to ask us, to help you remember. If we are unable to answer your questions during the first assessment, we can find out the answers and get back to you, or advise you of who might be able to help.
Don't worry if you forget any of these items, they help the appointment to run smoothly but are not requirements.
You will see one of our clinical (healthcare professional) team. Our clinical team consists of the following:
- Clinical nurse specialists
- GPs
- Psychologists
Each member of the clinical team has been trained for this appointment. As you continue through the service, you may be allocated a certain team member depending on your care plan.
This can vary, depending on what you would like from your appointment. Everyone is at a different stage in their journey, and may have accessed medicines or services already. This means you may need a longer or shorter appointment.
We estimate that your first assessment will take from 45 minutes up to 2 hours.
We appreciate that some people may want to record their assessment to help them remember what was discussed. As per other healthcare consultations, we ask that you are open about this request, and discuss with your clinician before recording.
Please be assured that we will not record your consultation.
Your first assessment will be a time you for to tell us what is important to you. This may include your personal journey before your referral, and what has happened since then. We also invite you to tell us your care goals, and specific services or gender affirming care options you wish to access.
There is also some specific information that we will ask you. This is quite thorough and can include personal and sensitive information. If you feel uncomfortable or if you need a break, please let us know. Asking these questions ensures we are being safe, and we do not miss any important information which may shape the care we provide.
The information you tell us is confidential and held within our clinic medical notes, and is not shared with anyone without your consent.
Examples of questions: asking about smoking - smoking can affect some choices for medication or surgery, so asking this question means we can provide extra support and advice to help people reduce smoking if needed.
Here are the questions you will be invited to answer at your appointment, and why we ask them:
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We will invite you to answer |
Why we ask you this |
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Discussion about whether you consent to us sharing our consultations with your GP and other NHS health providers |
We assume you do NOT want us to share information with your GP. We can explore what your consent would mean during your assessment |
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Your gender and pronouns |
To ensure you are addressed correctly
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Your journey to date |
Any previous experiences or gender affirming care options you may have already accessed or tried before
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Gender affirming care goals |
What you would like from the service. There is no set pathway as everyone's identity is individual.
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Relationship and sex history |
Some gender affirming care options may affect mood and sexual activity, we can also discuss contraception and fertility implications
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Medication and physical health |
To ensure we offer safe gender affirming care options dependent on any health conditions you may have
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Family medical history |
Some medical conditions run in the family, and may need to be considered for medication options
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Height and weight
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We ask you this information because there are certain gender affirming care options where this information is needed (hormone treatment and surgeries) |
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Communication and adjustments |
This includes neurodiversity, visual and hearing impairments, learning difficulties and mobility difficulties. We can discuss any additional needs that you may need |
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Mental health history |
We can provide extra support if needed, or advise you of further services which may help you
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Smoking, alcohol, drugs |
This can affect some medicines or gender affirming care options
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Whether you have a criminal record |
Some medications can change mood or behaviour, and we have a supportive pathway for people who have any forensic history and may require additional expertise
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Who you live with, your work, hobbies |
This gives us a background to how you are day-to-day
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After these questions, we ask you which options you wish to consider. This is so we can book you in with the appropriate clinician for your second assessment. You may be interested in knowing more about some, all, or none of the options. We can provide written information about each option after your first assessment.
There is more in-depth information on our website regarding these options.
Gender affirming care options include:
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Gender affirming care option |
Details
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Hormone therapy |
This is discussed at your second assessment, but we can provide some written information to read before then. You may already have read a lot about hormone treatment or be taking it already
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Hair reduction sessions |
Laser-based or electrolysis for facial hair reduction
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Voice training |
With our speech and language therapists
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Referral for surgery |
This includes chest and genital surgery, which will be discussed briefly during your second assessment. For a formal referral, a separate (third) appointment is made for you to give you the space and time to fully explore which referral you need. Genital surgery requires a separate (fourth) appointment via video with our specialist team in Nottingham
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Psychosocial support
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With our trained psychology team. This is available for people struggling with their mental wellbeing and related to gender. Our team can offer a number of different therapeutic approaches including Cognitive Behavioural Therapy, Eye Movement Desensitisation Therapy, Acceptance and Commitment Therapy. The team can also offer further sessions to help someone to get a better understanding of what things are impacting on their wellbeing. |
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Fertility specialist advice |
As some gender affirming care options affect your fertility, we can discuss your options if you wish to preserve fertility (freezing eggs or sperm)
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Support |
Details |
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Care navigators |
These are members of staff with lived experience who can provide non-clinical support to service users throughout their time in the Sussex Gender Service. This might include help with signposting, referrals or general support with appointments.
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You will be able to ask us any questions you may have as the assessment goes along, or at the end, if you prefer.
You will be offered a second assessment which is likely to be between 8 and 12 weeks after this first assessment.
The second assessment is when a diagnosis of gender incongruence and gender dysphoria might be offered. Some people find a diagnosis is helpful, though others find this challenging. Having a diagnosis of gender incongruence allows us to offer various gender affirming care pathways, if you feel ready. Your care plan is personalised to you, and the decisions you make with our support. If you feel you need more time to decide, we can offer a third assessment at a later date.
The service specification requires a diagnosis of gender incongruence to be made in a recognised Gender Identity Clinic (including pilots like Sussex) to access NHS gender affirming care. Therefore if you already have an existing diagnosis from another source you will still need to discuss diagnosis in your appointments.