Haverthwaite Surgery: What does their trans patient policy actually say?
A review of this GP practice's approach to supporting trans patients
Organisation: Haverthwaite Surgery
Type: GP practice Location: Cumbria, England
Policy reviewed: Gender Dysphoria Policy (Clinical Guidance Document)
Policy date: Current (references 2013 NHS England guidance; mentions 2021 review)
Status: Current
Link: HAVERTHWAITE SURGERY: Clinical Guidance Document - Gender Dysphoria Policy
At a glance
🟢 Name and title: Staff must use patient’s preferred name and title at all times
🟢 Pronouns: Staff should ask and use correct pronouns
🟢 Medical records: Can be changed without GRC or updated birth certificate
🟢 Referrals: Direct to Gender Identity Clinic; no mental health assessment or CCG approval required
🟢 Confidentiality: Strong protections; references GMC guidance and GRA Section 22
🟢 Screening: Thoughtful approach based on organs present, with safeguards against falling out of recall systems
🟠 Non-binary inclusion: Not explicitly addressed
🟠 Language: Some dated terminology
Key: 🟢 Supportive 🟠 Limited or conditional 🟡 Restrictive or denied
Summary
This is a practical, largely supportive policy focused on ensuring trans patients receive appropriate care. The policy is operationally detailed, covering everything from how to process a gender marker change to ensuring patients don’t fall out of screening programmes. It explicitly requires all staff to use patients’ preferred names, titles and pronouns. Referrals to Gender Identity Clinics can be made directly without requiring a mental health assessment or CCG approval first. The policy’s strength lies in its administrative thoroughness, though it could be strengthened with explicit recognition of non-binary patients.
The detail
Names and pronouns
Will my name and pronouns be respected?
What the policy says: “It is imperative that patients who are transitioning or have transitioned are addressed in the correct manner. All staff at Haverthwaite Surgery are to use the patient’s preferred name and title at all times.”
On pronouns: “Where doubt exists, staff should ask the patient ‘How do you prefer to be addressed?’ and, if necessary, ‘What pronoun do you use?’”
What this means: Yes. The policy is clear that staff must use your preferred name and title, and should proactively ask about pronouns if unsure. This is framed as imperative, not optional.
Medical records
Can I change the gender marker on my medical records?
What the policy says: “A patient’s request to change the sex that is indicated on their medical records will be accepted. The patient does not need to have been issued with a Gender Recognition Certificate or have an updated birth certificate for their records to be amended.”
“Trans patients have a legal right to change their name and gender on their healthcare records. Patients may request to change gender on their patient record at any time and do not need to have undergone any form of gender reassignment treatment to support this request.”
What this means: Yes, without barriers. You don’t need a GRC, updated birth certificate, or any medical treatment to change your records. The policy correctly recognises this as a legal right.
Referrals
Can I be referred to a Gender Identity Clinic?
What the policy says: “All GPs in England can refer those patients who request treatment for gender dysphoria directly to a GIC. There is no requirement for a GP to first refer the patient for a mental health assessment, nor do GPs need to request prior approval from their Clinical Commissioning Group (CCG).”
What this means: Referrals should be straightforward. The policy explicitly states that no prior mental health assessment is needed and no CCG approval is required. This reflects correct understanding of the pathway.
Confidentiality
Is my trans status kept confidential?
What the policy says: The policy quotes GMC guidance: “It is unlawful to disclose a patient’s gender history without their consent. When communicating with other health professionals, gender history need not be revealed unless it is directly relevant to the condition or its likely treatment.”
It references Section 22 of the Gender Recognition Act 2004 and notes that when records are changed, “any information relating to the patient’s previous identity should not be included in the new record.”
What this means: Strong protections. The policy recognises both GMC guidance and legal requirements around confidentiality. When you change your records, your previous identity should not carry forward into your new record.
Screening
Will I still receive appropriate health screening?
What the policy says: “It is considered reasonable and pertinent to screen for the organs present, not the gender.”
The policy provides detailed guidance on ensuring trans patients don’t fall out of automated screening systems when their NHS number changes, including: explaining which screening may be affected, working with patients to ensure screening happens, placing reminders on records, and advising patients to keep track of when screening is due.
What this means: The approach is medically sensible and patient-centred. The policy recognises the real risk that changing gender markers could cause patients to miss important screening, and sets out a clear process to prevent this.
Administrative process
What happens when I request a gender marker change?
What the policy says: The policy sets out a detailed process: the patient provides a statutory declaration, the practice notifies PCSE, a new NHS number is issued, and a new medical record is created with all previous medical information transferred but without information relating to previous identity.
The policy notes this should be completed within five working days to ensure no interruption to care.
What this means: The process is well-documented and includes safeguards for continuity of care. The five-day target shows commitment to not leaving patients in limbo.
What’s missing
Non-binary inclusion: The policy doesn’t explicitly address non-binary patients. The administrative guidance notes that only “M” or “F” should be selected as sex category, not “I” (indeterminate). While this reflects current NHS systems limitations, the policy could acknowledge non-binary identities and explain how patients who don’t identify as male or female will be supported.
Patient-led language: While practically supportive, the policy is written from a clinical rather than patient perspective. Terms like “gender dysphoria” and “transsexual” appear throughout. The definition of “transsexual” as someone who “feels that they belong to the opposite sex” is dated.
Psychiatric framing: The policy notes that “some patients may have psychiatric comorbidities” and may require “formal psychiatric intervention.” While acknowledging mental health needs is reasonable, the framing could inadvertently pathologise trans patients.
What’s notable about this policy
Explicit requirement to use preferred name, title and pronouns
Clear statement that no GRC, birth certificate, or medical treatment is required to change records
Direct referral pathway to GICs without gatekeeping
Strong confidentiality protections referencing both GMC guidance and the GRA
Detailed, practical screening guidance that prioritises continuity of care
References to RCGP guidelines and intercollegiate good practice guidelines
Named data controller for confidentiality queries
Overall assessment
This is a solid operational policy that should result in respectful, appropriate care for most trans patients. Its strength is in the practical detail: it tells staff exactly what to do, references the correct guidance, and has clear processes for common situations. The explicit requirement to use preferred names, titles and pronouns is welcome, as is the clear statement that no GRC or medical treatment is needed to change records.
The policy could be improved by explicitly recognising non-binary patients, updating some dated language, and framing the content more from a patient perspective. But in terms of what it commits to do, this policy should work well in practice.
For trans patients registered at this practice, or considering registering: this policy suggests you should be treated with respect and have your administrative needs handled appropriately. The screening guidance in particular shows thoughtful consideration of how to ensure trans patients don’t fall through gaps in the system.
Questions to ask any GP practice
Based on this policy, here’s what to look for elsewhere:
Will they use my preferred name, title and pronouns?
Do I need a GRC or medical treatment to change my records?
Will they refer me directly to a GIC without requiring a mental health assessment first?
How do they ensure I won’t fall out of screening programmes?
Who is responsible for handling confidentiality queries?
Is non-binary identity explicitly recognised?
Have a policy you’d like reviewed?
If your GP practice, hospital, or healthcare provider has a trans patient policy you’d like me to review, send it to me.