TransPlus, “the first integrated Gender, Sexual Health and HIV service commissioned by NHS England”, operates out of the 56 Dean Street clinic in Soho. This gender dysphoria service originally came out of on-the-ground clinic work, since trans patients self-medicating hormones would regularly ask Dean Street for hormonal bloods monitoring; accordingly, it has a different feel to most gender clinics, with a sunnier atmosphere and more visibly queer staff. It is, however, still a gender clinic, and in my view all gender clinics should be approached with caution.
TransPlus has taken on a lot of new patients in the past year, as NHS England asked them to help with the Tavistock’s backlog. Accordingly, you cannot be directly referred to TransPlus via your GP at the moment – its new patients appear to near-exclusively be referrals from the Tavistock’s extensive waiting list. As one of those new patients referred from the Tavistock list, who just had an initial appointment with the clinic, I’ve taken some notes as to what to expect in initial appointments. This advice isn’t going to be fully generalisable to other clinics, as TransPlus is a ‘new style’ clinic (and therefore somewhat more clued in than ‘old style’ clinics), but it’s always best to go into a GIC appointment with some sense of how they operate.
As a background on me: I was on the Tavistock list for almost five years, and five years seemed like a common figure for those who have been referred from Tavistock to TransPlus. I have not received correspondence from the Tavistock since I was referred in 2021, but I was emailed out of the blue in July 2025 that I was being reallocated to TransPlus in July 2025 (a transfer I could choose to opt out of, but TransPlus is a lot better). I attained a dysphoria diagnosis, HRT and surgery privately before I ever saw the inside of an NHS clinic, and having a diagnosis that met their criteria meant that I skipped the‘two-hour initial assessment’ to diagnose me with dysphoria. (If you have a GenderGP diagnosis, or one from another provider that doesn’t meet GPs’/surgeons’ accreditation standards, I think they will probably put you through the initial assessment. I would recommend doing so regardless if your diagnosis is from GenderGP, because surgeons rarely accept those.)
My initial appointment was a one-hour appointment with a HIV/GUM clinic worker to complete administrative paperwork, do a patient history, and talk about what I wanted out of the clinic. Since I’m already on hormones, I didn’t get prescribed them by the clinic (though they did contact my GP about a potential regimen adjustment), but the couple of other patients I talked to in the waiting room said it had been a 1-2 month wait between their initial appointment and starting hormones.
Here are the most salient things I observed/experienced during my appointment, broken down into sections for ease of sharing:
The Location
It’s incredibly easy to find, just go to Tottenham Court Road, follow the exits marked Dean Street, and go most of the way to the end of the road. (It’s also easy to access from other underground stations like Piccadilly Circus.) The clinic does look ‘clinical’, it’s clearly a healthcare facility, but there are touches to make it look friendlier – peach walls, a box of stim toys on the table in the waiting room, rainbow flags downstairs. Only real location note is that if you do the STI tests, the hatches you leave your tests in aren’t present on the floor the gender clinic is located on, so you’ll have to go to a bathroom on a different floor.
The Questions
The staff member who conducted my appointment was friendly and informative, and appeared to be trying various strategies to keep me comfortable within the appointment setting, such as explaining the reasoning behind certain questions (or specifying ‘we ask everyone this question’), chatting to me about my interests, and phrasing certain questions as creative prompts that I could choose to answer cursorily or in depth. They also made a few cursory references to other GICs tending to ask inappropriate questions, such as about sexuality (‘over the top’), and there was more active recognition of things like minority stress and of a need for accommodations than I’ve heard of at other clinics. As TransPlus is still a gender clinic, they’re careful about acknowledgment of the harm gender clinics can do (or of the strain of the 5 year waiting list you likely had to navigate to get there).
I was asked, essentially, to rehash my timeline of transness, with the clinician using prompts/markers they had gleaned from my previous diagnosis reports. I hadn’t fully been expecting this as I’d skipped the diagnostic appointment.The requests for narrativisation were friendly, but there did feel like a pressure to hit the classic beats of a trans history, even as it’s hard to tell if I was being prompted on the basis of what the last clinician had written or what the current clinician wanted me to say. (You felt disconnected from femininity/masculinity as a child, right, &c.) There were also various questions that were potentially weighty enough that you should be aware of the possibility of being asked them in advance:
- Are you neurodivergent / have any diagnosis as such
- Do you have any mental health conditions and if you take any regular medications
- Describe your gender and sexuality
- Under stress do you have or have you had thoughts of self-harm or suicide
- Do you have experiences of non consensual sex and of sex work
- Do your experiences with hormones/surgery have included any negative effects
- Do you have any criminal convictions
RE: that last question, I asked about what happens if you do have forensic convictions, and the clinician was a little unclear about specifics, but they said that people who have a criminal history may need specialist care from clinicians who have experience with that, and “therefore we would probably refer them back to the Tavistock” (at the top of the waiting list, they said with clarification). I don’t know if that means you automatically go back to the Tavistock if you have convictions or whether it’s patient-specific, but that’s worth being aware of.
Sexual Health Clinic
I knew that Dean Street was a sexual health clinic, but I wasn’t aware of the degree of integration that the gender and sexual health parts of the clinic had. I was offered a sexual health screening partway through my appointment, after I’d answered a bunch of questions about when I knew I was trans, when I came out, if people were supportive, etc. I said that the opportunity for a screening sounded good, and this meant I was then asked a bunch of questions about my sex life in order to indicate what STI tests and other healthcare I needed/wanted. After the gender parts of the appointment I got a full STI workup, and after expressing interest in PrEP I was prescribed it on the spot,including being given useful information about PrEP protocols vis-à-vis different types of sex.
On the one hand, this was a very helpful set of resources to access for free and without having to pursue additional appointments elsewhere. I am non-monogamous and accordingly test for STIs routinely every 3-6 months, and this was much smoother, faster, and more comprehensive than at-home kits;this was the first time I’d successfully managed to do a HIV test in years, since I can’t get enough blood out of my own fingers. In general, I was very happy with the medical resources they offered, as someone who has had a lot of problems getting previous GPs to do my bloods and test the right things.
On the other hand, I hadn’t expected to be offered a screening and I hadn’t prepared myself to answer questions on my sex life in that setting. Gender clinic appointments are nerve wracking and vulnerable settings and I’d been dreading being asked inappropriate sexual or invasive questions, so even though the questions I ended up being asked were medically appropriate (and the clinician clarified when I asked that I would not have been asked them if I hadn’t opted in), I still found it somewhat distressing and draining to talk about my sex life in depth in the appointment, particularly as accurately describing your sex life can feel risky given the edict to perform transness correctly within the gender clinic. Plus, to do the STI tests, I had to do the swabs, so I had to end the much-stressed-over gender clinic appointment by going to the third-floor bathroom and sticking a series of cotton buds in various orifices. And the inclusion of the sexual health stuff made the end of the appointment somewhat rushed, including missing a couple of important bits that I’ve been asked to get done at my own GP (blood pressure being one).
If you have a TransPlus initial or follow-up appointment, know going in that they will likely offer you sexual health services. Equally, doing a hybrid appointment may be emotionally inadvisable. I can at least vouch that, in my experience, they seem very unlikely to say judgmental/inappropriate things about your sexual or romantic life.
Information About Wider Trans Healthcare
I asked a few follow-up questions about trans healthcare in the UK where I could, though I don’t think I got much in the way of new information. I asked about the current status of phalloplasty availability in the UK, given that TransPlus is attached to Chelsea and Westminster Hospital, the hospital that seems to be the centre of UK phalloplasty at the moment. They said that a surgeon from ‘outside the UK’ had a ‘team set up’ at Chelsea and Westminster, who – per TransActual’s timeline update on NHS phallo and meta – is likely to be Dr Marlon Buncamper. I don’t know how many surgeries are happening with the teams at C&W, but I know that C&W appear to be taking people off other waiting lists for phallo who have been waiting 5-6 years.
I specifically asked about facial / body masculinisation options on the NHS and my clinician confirmed that they are not currently offered, with no mention of any plan in place to offer them. They did say that being with Trans Plus can be useful when seeking private care, though, since the clinic may be able to do bloods for free that the private team may request hundreds of pounds for. My main focus, in my own appointment, was safeguarding my access to hormones. I believe TransPlus is good if you need an authoritative letter to a GP who is iffy about prescribing or unwilling to enter into a shared care arrangement. My clinician presented the clinic as, essentially, something that can back me up in bad situations, and that can mail me hormones if needed, which is reassuring. (I’ve seen multiple other TransPlus patients on Bluesky and Twitter report getting hormones by mail from TransPlus when they lost GP access.)
Overall, TransPlus appears to rank with Manchester’s Indigo as the better gender clinic options in the country, with a more empathetic approach and more queer/trans staff. It is, however, still a gender clinic, and the gender clinic is not your friend, which can be more jarring than expected if you genuinely believe that the clinician you’re talking to wants to help you. And they can help you, but they should still be treated with caution.
Come prepared with the usual things a gender clinic wants, namely a) a narrativisation of your transness through childhood, adolescence and adulthood, b) an account of why you want to transition and why the transition you seek is good and necessary for you, and c) an account of yourself and your life (work and goals, hobbies, friends, family, support network, mental health,mood) that you feel comfortable having on your medical record. Also, if you are already on hormones and take them daily, try to take them 4-6 hours before your appointment, or your readings will be off if they take your levels. I don’t think they informed me they were going to take mine.
Appointments at gender clinics, particularly first appointments after life-alteringly long waits, are deeply surreal experiences. It is difficult to know what to feel when you’re in there; you may feel unmitigated anger, or fear, or relief, or any mixture of emotions. Don’t feel guilty about anything that you feel. We should not be subjected to the gender clinic system, regardless of if the clinic is ‘good’. But there is space for what you feel when you get out of that room. While you’re in it, focus on getting as many resources as you can. You need them, and you deserve them, and they’re there.