Hundreds of trans and non-binary people have been refused gender-affirming healthcare from their NHS GPs over the last few months, according to a campaign group.
TransActual says at least 382 trans people have had their Hormone replacement therapy (HRT) prescriptions refused by GPs from January 2024, when they began collecting the data, to May 2025.
Of them, 102 had a letter from an NHS gender clinic asking a GP to prescribe the treatment, while 293 had already been taking hormones.
Doctors have also refused to renew pre-existing HRT plans, with 126 trans people reporting this to TransActual.
It comes after one of Europe’s top equality officials said the government’s treatment of trans people could breach their human rights.
HRT for trans people involves taking hormones to spur physical features like beards or breast growth. If a trans person stops HRT, some effects, such as hair growth and muscle mass, will reverse.
Metro spoke with four trans and non-binary people whose GPs have refused them HRT, only speaking on condition of anonymity out of fear of losing their healthcare.
‘I used to pay £200 for HRT – now I pay nearly £2,000’
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Jordan*, an application developer in the West Midlands, had been on a shared care agreement for three years when her GP ended it last October.
In a letter seen by Metro, the practice said: ‘Given the complexity and unique medical considerations involved in hormone therapy, we believe it is crucial for such prescribing and monitoring responsibilities to remain under the direct oversight of a specialist with specific training and experience in transgender healthcare.’
Jordan, 25, said this came without any warning. ‘It wasn’t a refusal to get involved, as they framed it. It was an active choice to cut me off,’ she said.
‘If I hadn’t been able to shoulder the cost of going fully private, I would’ve been left without access to the hormone therapy I’ve relied on for years.’
While on the agreement, Jordan paid around £200 for HRT. Privately, she pays:
- £480 a year for estradiol patches, which create a hormone similar to estrogen
- £90 per blood test
- £140 for an annual checkup with an endocrinologist
- Up to £1,200 every year for testosterone blockers
Accessing HRT as a trans person in the UK
HRT is available on the NHS by first seeing a Gender Identity Clinic (GIC) – the average waiting time for a first appointment is 25 years, according to news outlet QueerAF.
People can also go through a private clinic, or have a shared care agreement drawn up – the private gender specialist will review the patient’s care, while the GP will prescribe medication.
Jordan and her mum met with her GP, but during the consultation, the doctor referred to her as a ‘guy’ and shrugged off her situation as ‘political’.
‘She made me feel like an inconvenience; she wanted me out the door,’ Jordan claimed. ‘We entered the appointment searching for answers but left feeling powerless as if there was nowhere left to turn.’
‘Trans people are expected to navigate endless admin, inconsistent care and dehumanising treatment just to access HRT that cis people get without question,’ she added.
‘We shouldn’t have to fight this hard just to stay on the medication we’ve already been safely taking for years.’
In August, the practice apologised to Jordan about the withdrawal of the shared care agreement, as well as the meeting with the GP.
In a letter seen by Metro, a practice representative said that the doctor’feels genuine remorse for any upset she may have caused’.
The letter added: ‘While we have prescribed hormone treatments in the past, we had to carefully review the shared care request from your clinic. Unfortunately, it was determined that continuing with those prescriptions was not suitable.
‘I understand this decision was difficult, and it has been shared with you and your consultant for clarity.’
Jordan said she has since switched to a different clinic that, while it cannot offer her a shared care agreement, it will be happy to work with an NHS GIC once she begins treatment there.
‘I’m almost four years into [the waiting list],’ she said, however, ‘and I’m expected to wait another seven years more.
‘As long as I can continue to afford it, I’ll probably continue with private for the foreseeable future.’
‘My GP laughed in my face’
Avery*, a non-binary person in their 30s, has encountered issues with their GP because they don’t have a shared care agreement.
The shop worker has been on the waiting list for healthcare for five years. To get by, they have turned to DIY HRT – purchasing hormone pills, patches or injections without a prescription.
In 2023, Avery told their south west England GP that they had been self-administering and asked for a bridging prescription, a temporary order of HRT for people on a waiting list.
The GP refused. ‘I’ve essentially been flying blind because private blood tests on private are too much,’ Avery told Metro. ‘I knew it would be an uphill battle and I was doing pretty fine on my end.’
Avery had a vaginoplasty, a type of gender-reassignment surgery, in February, and an orchidectomy, surgery to remove one or both testicles, limiting their ability to naturally produce sex hormones.
Like Jordan, Avery said they had a doctor appointment in May to discuss treatment, which ‘went even worse’ than expected.
‘He denied oestrogen but suggested I do testosterone and I laughed in his face and said, “No, thanks” because it was ridiculous. After 10 minutes, I got up and left and knew I’d just get too upset,’ Avery said.
In GP notes seen by Metro, the doctor misgendered Avery and wrote: ‘[They are] concerned that [they are] now not producing [their] natural hormones due to surgery. I have explained that [their] natural hormone production would be testosterone, not oestrogen.’
The doctor’s office told Avery that due to administrative errors on their part and on Avery’s private clinic’s, a prescription wasn’t possible.
The practice offered Avery annual blood tests, stating: ‘Please understand that GPs are entitled to decline prescribing in cases where the standards for shared care are not met, particularly when care is initiated by a pilot clinic. However, we acknowledge that the way this was communicated to you in clinic could have been handled more sensitively.’
For Avery, they said they feel their GP’s handling of their HRT is ‘inadequate to the point of being unsafe’.
‘If I didn’t have access and could no longer afford to DIY, I would just get sick for no reason, or I’d have to go private,’ they said. ‘They would leave me, which they would never do to a cis person.’
‘I get called a “biological male” a lot’
Riley* knows this feeling well. Screening tests found she had a hormone disorder, with an NHS endocrinologist recommending her north-central England GP write her a prescription for testosterone shots.
‘I suggested that I didn’t want to go on testosterone as I wanted to be a girl, actually,’ Riley told Metro, ‘and she conferred with my private gender endocrinologist and decided that estrogen HRT would work.
‘I went back to my GPs, they were quite iffy about it, but eventually I managed to read my medical notes to them and they agreed I needed HRT for non-trans reasons and that could incidentally be gender-affirming too.’
Yet, Riley claimed that when she sees her GP for blood work or a medicine review, doctors are ‘hostile’ towards her.
A phlebotomist – a medical professional who takes blood samples – once refused to take her blood, Riley alleged.
‘She accused me of wasting NHS funds,’ Riley said, ‘I get called a “biological male” a lot by two GPs in particular.
‘I’m just really tired from having to fight them every single time… I just feel like my GP can, at any given time and for any given reason, ruin my life.’
‘My GP called HRT unsafe’
Parker*, who lives in a rural town, told Metro that their GP tore up their hormone prescription last October. Their GP called their regimen ‘unsafe’, despite them being on it for 16 years.
‘They justified their stance by claiming they suddenly lack the competence to provide care to trans folk and it’s for my safety,’ said Parker, who was discharged from their GIC more than a decade ago.
‘They suggested I either go private or stop HRT completely, which would put my health at risk.’
A third option they gave Parker was to refer back to their GIC, which does not prescribe hormones long-term.
‘I had no intention of returning to a place that I found deeply harmful,’ Parker added.
TransActual director, jane fae, said there are many reasons why GPs are withdrawing trans healthcare right now.
Some practitioners may feel ‘nervous’ to do so following a Supreme Court ruling on the definition of ‘woman’. ‘Work-to-rule’ policies in some GPs, such as capping appointments, have also been a factor.
‘Also, inevitably, straight out bigotry hiding behind a mask of concern,’ fae added.
‘This is unethical. Worse, when GPs withdraw treatment from trans folk who are post-op, it is downright dangerous. Potentially fatal.
‘The NHS needs to step up and tell GPs that this is unacceptable.’
An NHS spokesperson told Metro: ‘To support GPs in prescribing for adults with gender dysphoria, NHS England has already set up a number of pilot adult clinics that are led by primary care, staffed by specialist GPs who are available to provide quick and effective support to colleagues.
‘We are currently carrying out a review of adult gender services, which will look at how to overcome the challenges that some individuals face in accessing a timely prescription.’
* Names have been changed by Metro to protect their anonymity
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