Transgender Woman Faces Barriers to Hormone Therapy Access in the UK

A transgender woman from West Sussex is experiencing difficulties accessing ongoing hormone therapy through her general practitioner (GP), raising concerns about increasing barriers to healthcare for transgender individuals in the United Kingdom. Joanne Monck OBE, a transgender rights advocate, has been informed by New Pond Surgery in Lancing that she must now travel to a gender specialist clinic in Brighton to obtain her prescriptions.

Years of Access Suddenly Disrupted

Monck, who has been receiving hormone prescriptions from her GP for 12 years, expressed frustration over the change. “It’s totally wrong. Why have they stopped giving it to me? Why do I have to go to a gender identity clinic now to acquire it? I was furious. I know my gender,” she told ITV News Meridian . Monck began hormone therapy and gender surgery in 2017, after living as David for 58 years.

A Growing Trend

This situation is reportedly becoming more common across the country, according to transgender charities. Chay Brown from Trans Actual stated, “We found that trans people often avoid having to the GP for other medical appointments and often have little confidence or they’re not very confident. They feel healthcare professionals aren’t going to understand their needs and this is coming from experiences like being refused their hormone prescription and just generally feeling like they’re getting poorer treatment than they would get if they weren’t trans.”

NHS Guidance and Shared Care Agreements

NHS England explains that hormone prescriptions should be managed through shared care agreements between specialist gender clinics – where patients are assessed and diagnosed – and local GPs who administer and monitor treatment. However, a recent review of adult gender services highlighted that many GPs feel they lack the necessary expertise to support transgender patients, citing limited experience and the complexity of prescribing.

GP Surgery’s Explanation

New Pond Surgery stated that the change in policy is due to a prescribing audit and updated guidance, and aims to ensure patient safety. The surgery will only provide prescriptions for patients supported by an Enhanced Shared Care Agreement (ESCA). In a statement, the surgery explained that it is not currently enrolled in the NHS Sussex TNBI (Transgender, Non‑Binary and Intersex) Locally Commissioned Service, as it does not have the specialist skills required to provide this level of care safely. The surgery will continue to prescribe until the specialist team takes over care, ensuring no interruption in treatment.

NHS England’s Response and Future Plans

NHS England is working to establish sustainable local arrangements for hormone prescribing and long-term health monitoring, including piloting local hormone prescribing models. The goal is to ensure all Integrated Care Boards (ICBs) have local primary care support for hormone prescriptions and monitoring. Gender clinics will initially manage hormone prescribing for at least one year to stabilize hormone levels before transferring care to primary care physicians.

Understanding Hormone Replacement Therapy (HRT)

Hormone replacement therapy (HRT) is commonly used to manage menopause symptoms by replacing declining estrogen and progesterone levels. It is also utilized by trans women to induce feminine physical traits through the administration of estrogen.