Adhering to WPATH Standards of Care

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Transgender Hormone Therapy

Hormone replacement therapy for transgender or gender variant individuals, also sometimes called cross-sex hormone therapy, is a form of hormone therapy, is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender, or gender variant individuals, for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. These hormones vary based on whether the aim of treatment is feminisation or masculinisation.

  • Feminisation therapy for transgender women – oestrogens and anti-androgens
  • Masculinising hormone therapy for transgender men – androgen.

Our aim at London Transgender Clinic is to support our patients in a compassionate, caring and effective manner adhering to The World Professional Association for Transgender Health (WPATH) guidelines and standards of care version 7. We offer psychological assessment with Consultant Psychologist Dr Penny Lenihan, hormone consultations with our nurse prescriber Mary Burke-O’Brien and specialist surgery with world renowned surgeon Mr Christopher Inglefield.

Cross-sex hormone therapy has been shown unquestionably to have a positive physical and psychological effect on the transitioning individual. Transgender individuals experience discord between their self identified gender and their biological sex. The World Professional Association for Transgender Health (WPATH) has created transgender specific guidelines to help service a framework for providers caring for transgender or gender variant individuals. These guidelines are mostly based on clinical experience from experts in the field. Guidelines for hormone therapy in transgender men are mostly extrapolations from recommendations that currently exist for the treatment of hypogonadal natal men and oestrogen therapy for transgender women is based on treatments used for postmenopausal women.

Hormone therapy must be prescribed on an individualised basis depending on a patient’s goals, the risk/benefit ratio of medication, consideration of other medical conditions and social and economic issues. Hormone therapy can provide significant comfort to patients who do not wish to make a social gender role transition or undergo surgery or who are unable to do so.



We support and endorse the Guidelines for the Standards of Care for transgender, trans-individuals set out by the World Professional Association for Transgender Health (WPATH).

Frequently Asked Questions

We recommend that hormone therapy should be initiated once a psychological assessment has been completed by Dr.Lenihan, the patient has been determined to be an appropriate candidate for hormone therapy and informed consent reviewing the risks and benefits of starting therapy has been obtained.

Your initial consultation will cost £250, this includes an assessment with our experienced Nurse Prescriber who will record a full medical and social history, blood pressure, inBody analysis, weight, height, nicotine test or pregnancy test if appropriate. You will also be seen by Mr Christopher Inglefield, Specialist Transgender Surgeon, for a physical examination. If there are no contraindications following your consultation with Mary Burke O’Brien you will usually be prescribed hormone therapy at this appointment.

At London Transgender Clinic, Mary likes to see her patients for a follow up to ensure they have made contact with their GP and shared care has been agreed. This follow up consultation is included in your initial consultation fee so there is no additional charge. If it is difficult or costly for you to travel, Mary is always happy to support you via email, skype or call.

Yes, these can be arranged prior to your appointment with Dr Lenihan by your GP.

Following your initial consultation with Mary Burke O’Brien a letter will be sent to your GP including all the necessary information about your hormone therapy and a Shared Care Agreement which will include all the information your GP will require to continue your care.

In your Shared Care Agreement it clearly states which blood tests you will require and the recommended timing for these. It also outlines any further investigations, procedures or ultrasounds that may be recommended.

No, guidelines do not require this step and instead it is recommended that patients transition socially with hormone therapy at the same time. During Dr Lenihan’s assessment she will be able to discuss this in greater detail. 

In the past the guidelines recommended patients undergo  “real-life experience” prior to starting medical therapy. This test required patients to live full-time in their self affirmed gender for a predetermined period of time, approximately one year, before starting cross sex hormones. The recommendation was intended to help patients transition socially, however, this step is unreasonable for many patients. Social transition can be very challenging if there is incongruence between the individual’s self affirmed gender and their physical appearance.

No this is not a requirement.

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