{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T20:27:26Z","timestamp":1780086446007,"version":"3.54.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2017,4,1]],"date-time":"2017-04-01T00:00:00Z","timestamp":1491004800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J R Soc Med"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:p>In this review, we introduce the topic of transgender medicine, aimed at the non-specialist clinician working in the UK. Appropriate terminology is provided alongside practical advice on how to appropriately care for transgender people. We offer a brief theoretical discussion on transgenderism and consider how it relates to broader understandings of both gender and disease. In respect to epidemiology, while it is difficult to assess the exact size of the transgender population in the UK, population surveys suggest a prevalence of between 0.2 and 0.6% in adults, with rates of referrals to gender identity clinics in the UK increasing yearly. We outline the legal framework that protects the rights of transgender people, showing that is not legal for physicians to deny transgender people access to services based on their personal beliefs. Being transgender is often, although not always, associated with gender dysphoria, a potentially disabling condition in which the discordance between a person\u2019s natal sex (that assigned to them at birth) and gender identity results in distress, with high associated rates of self-harm, suicidality and functional impairment. We show that gender reassignment can be a safe and effective treatment for gender dysphoria with counselling, exogenous hormones and surgery being the mainstay of treatment. The role of the general practitioner in the management of transgender patients is discussed and we consider whether hormone therapy should be initiated in primary care in the absence of specialist advice, as is suggested by recent General Medical Council guidance.<\/jats:p>","DOI":"10.1177\/0141076817696054","type":"journal-article","created":{"date-parts":[[2017,4,6]],"date-time":"2017-04-06T05:27:57Z","timestamp":1491456477000},"page":"144-152","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":59,"title":["Gender identity and the management of the transgender patient: a guide for non-specialists"],"prefix":"10.1177","volume":"110","author":[{"given":"Albert","family":"Joseph","sequence":"first","affiliation":[{"name":"Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Cliffe","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Hillyard","sequence":"additional","affiliation":[{"name":"North West Thames Foundation School, Imperial College Healthcare NHS Trust, London W2 1NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azeem","family":"Majeed","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,4,6]]},"reference":[{"key":"bibr1-0141076817696054","unstructured":"General Medical Council UK.\n                      Advice for doctors treating transgender patients\n                      . See http:\/\/www.gmc-uk.org\/guidance\/28851.asp (2016, last checked 23 August 2016)."},{"key":"bibr2-0141076817696054","unstructured":"Douglas N. Trans Guidance for GPs.\n                      Brighton and Hove CCG\n                      2016."},{"key":"bibr3-0141076817696054","doi-asserted-by":"crossref","unstructured":"Parameshwaran V, Cockbain BC, Hillyard M and Price J. Is the lack of specific LGBTQ health care education in medical school a cause for concern? Evidence from a survey of knowledge and practice among UK medical students.\n                      J Homosex.\n                      Epub ahead of print 2016. DOI:","DOI":"10.1080\/00918369.2016.1190218"},{"key":"bibr4-0141076817696054","doi-asserted-by":"publisher","DOI":"10.1179\/1753807614Y.0000000045"},{"key":"bibr5-0141076817696054","unstructured":"National Centre for Transequality, USA.\n                      Transgender Terminology.\n                      See http:\/\/www.transequality.org\/ (2014, last checked 23 August 2016)."},{"key":"bibr6-0141076817696054","volume-title":"Sexing the Body: Gender Politics and the Construction of Sexuality","author":"Fausto-Sterling A","year":"2000"},{"key":"bibr7-0141076817696054","unstructured":"Stryker S and Whittle S.\n                      The Transgender Studies Reader\n                      . New York: Routledge, 2006."},{"key":"bibr8-0141076817696054","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-53630-3.00004-X"},{"key":"bibr9-0141076817696054","doi-asserted-by":"publisher","DOI":"10.1007\/BF01541769"},{"key":"bibr10-0141076817696054","doi-asserted-by":"publisher","DOI":"10.3109\/09540261.2012.741575"},{"key":"bibr11-0141076817696054","first-page":"34","volume":"1","author":"Maguen S","year":"2010","journal-title":"Psychol Sex"},{"key":"bibr12-0141076817696054","first-page":"850","volume":"3","author":"Robles R","year":"2016","journal-title":"Lancet"},{"key":"bibr13-0141076817696054","unstructured":"Ministry of Justice.\n                      Gender Recognition Certificate Statistics\n                      . See https:\/\/www.gov.uk\/government\/collections\/gender-recognition-certificate-statistics (2004\u201314, last checked 23 August 2016)."},{"key":"bibr14-0141076817696054","unstructured":"Reed B, Rhodes S, Schofield P and Wiley K\n                      . Gender Variance in the UK: Prevalence, Incidence and Growth and Geographic Distribution\n                      . Surrey: Gender Identity Research and Education Society (GIRES) UK, 2009."},{"key":"bibr15-0141076817696054","unstructured":"Lyons K.\n                      Gender Identity Clinic Services Under Strain as Referral Rates Soar\n                      . London: Guardian Media Group, 2016, https:\/\/www.theguardian.com\/society\/2016\/jul\/10\/transgender-clinic-waiting-times-patient-numbers-soar-gender-identity-services."},{"key":"bibr16-0141076817696054","first-page":"25","volume":"7","author":"Kennedy N","year":"2010","journal-title":"GJSS"},{"key":"bibr17-0141076817696054","first-page":"e1","volume":"20","author":"Crissman HP","year":"2016","journal-title":"Am J Public Health"},{"key":"bibr18-0141076817696054","doi-asserted-by":"publisher","DOI":"10.1177\/1524838015585318"},{"key":"bibr19-0141076817696054","unstructured":"UK Parliament. Gender Recognition Act, 2004."},{"key":"bibr20-0141076817696054","unstructured":"UK Parliament. Equality Act, 2010."},{"key":"bibr21-0141076817696054","doi-asserted-by":"publisher","DOI":"10.1080\/15532739.2011.700873"},{"key":"bibr22-0141076817696054","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-014-0186-2"},{"key":"bibr23-0141076817696054","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i1694"},{"key":"bibr24-0141076817696054","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcte.2015.02.003"},{"key":"bibr25-0141076817696054","unstructured":"Royal College of GPs.\n                      E-learning for GPs on Gender Variance.\n                      See http:\/\/elearning.rcgp.org.uk\/course\/info.php?popup=0&id=169 (2016, last checked 23 August 2016)."},{"key":"bibr26-0141076817696054","unstructured":"NHS England.\n                      Interim Gender Dysphoria Protocol and Service Guideline 2014\n                      . https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2013\/10\/int-gend-proto.pdf (last checked 29 December 2016)."},{"key":"bibr27-0141076817696054","first-page":"834","volume":"105","author":"Korte A","year":"2008","journal-title":"Deutsch \u00c4rztebl Int"},{"key":"bibr28-0141076817696054","unstructured":"Millet D. GMC transgender advice could push GPs to prescribe beyond competence, warns GPC. GP Online 2016."},{"key":"bibr29-0141076817696054","unstructured":"NHS Choices.\n                      NHS Pharmacy Services Explained: The Electronic Prescription Service.\n                      See http:\/\/www.nhs.uk\/NHSEngland\/AboutNHSservices\/pharmacists\/Pages\/eps.aspx (2016, last checked 24 December 2016)."},{"key":"bibr30-0141076817696054","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-0345"}],"container-title":["Journal of the Royal Society of Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0141076817696054","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0141076817696054","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0141076817696054","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:46:31Z","timestamp":1777527991000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0141076817696054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,4]]}},"alternative-id":["10.1177\/0141076817696054"],"URL":"https:\/\/doi.org\/10.1177\/0141076817696054","relation":{},"ISSN":["0141-0768","1758-1095"],"issn-type":[{"value":"0141-0768","type":"print"},{"value":"1758-1095","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4]]}}}