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The pathway through primary care to specialist services is a particularly precarious time for trans people, and misinformation and poorly applied protocols can have a detrimental impact on wellbeing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We recruited trans participants from an HIV Self-Testing Public Health Intervention (SELPHI) trial to interviews which explored contemporary gender-affirming service experiences, with an aim to examine the path from primary care services through to specialist gender services, in the UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A narrative synthesis of vignettes and thematic analysis of in-depth qualitative interviews were conducted with twenty trans individuals. We summarise positive and negative accounts of care under three broad categories: Experiences with primary care physicians, referrals to gender identity clinics (GICs), and experiences at GICs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We discuss implications of this research in terms of how to improve best practice for trans people attempting to access gender-affirming healthcare in the UK. Here we highlight the importance of GP\u2019s access to knowledge around pathways and protocols and clinical practice which treats trans patients holistically.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12913-021-06661-4","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T19:06:11Z","timestamp":1624907171000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Accessing and utilising gender-affirming healthcare in England and Wales: trans and non-binary people\u2019s accounts of navigating gender identity clinics"],"prefix":"10.1186","volume":"21","author":[{"given":"Talen","family":"Wright","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily Jay","family":"Nicholls","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison J","family":"Rodger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona M","family":"Burns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Weatherburn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Pebody","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne","family":"McCabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aedan","family":"Wolton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitzy","family":"Gafos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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Ethical approval was sought from and granted by the University College London (UCL) (ref: 11,945) and the London School of Hygiene and Tropical Medicine (LSHTM) (ref: 9233\/001). All participants provided informed consent ahead of their involvement with the RCT and qualitative sub-study. All procedures performed were in accordance with the ethical standards of the institutional research committees.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Due to the remote nature of these studies, RCT consent was online written consent; sub-study consent was verbally recorded at the beginning of each interview as approved by UCL and LSHTM research ethics committees. All participants gave consent for the findings of this study to be published.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"609"}}