Making referrals
Making referrals
We see people with a range of issues to do with gender identity. This includes people who identify as trans, non-binary, genderqueer and anything else under the transgender umbrella.
Not everyone who comes to us will be sure that they want treatment and we are happy to see people who wish to have support to explore issues to do with their gender.
People do not have to have any kind of diagnosis before coming to see us and do not need to have had psychotherapy or a psychiatric assessment before attending.
Due to the recommendations given in the Levy Review of Adult Gender Services in England, as of 19th December 2025 individuals being referred to us must be 18 years of age or older to meet our minimum age requirement. Any referrals received before this date will not be subject to this requirement.
We ask that referral letters are written using the pronouns and name that the patient would prefer. While patients do not automatically see the letter, they have the right to request their notes. Seeing the wrong name and pronoun can be distressing to a trans person so we ask that you kindly use the correct information on advice from the patient.
Making a referral to our services
In response to recommendations from the National Review of Adult Gender Services, a new, nationally managed waiting list for adult gender services is being created to:
- streamline the referral process
- reduce waiting times
- reduce duplication and ensure referral information is kept up to date
- ensure patients are kept informed and supported while they wait
New arrangements for how referrals are made were introduced from 17 August 2026 on a phased basis. If you have any questions about what these changes might mean for you, please go to National Referral Support Service - AGEM_Gender_Services
Referrals can continue to be made directly to The Nottingham Centre for Transgender Health, and they will be immediately forwarded on to the National Adult Gender Referral Support Service (GNRSS) for processing on to the national waiting list. Alternatively, referrals from GPs or healthcare professionals can be submitted directly to the national waiting list by email to agem.agsreferrals@nhs.net
From 1st October 2026 The Nottingham Centre for Transgender Health will stop taking referrals. Instead, referrals will only be made directly to GNRSS.
Adult Gender Services are working with the National Improvement Network and GNRSS to better support patients and help reduce waiting times.
Other mental health issues
If someone has a mental health diagnosis such as bipolar disorder or schizophrenia it does not mean that they cannot be seen. However, it is important that any symptoms are well managed before attending any appointments. Any drug or alcohol problem will also need to be managed prior to attending.
Smoking increases risks with hormone treatment, people seeking hormones should start to give up smoking now.
Referrals from other health professionals
People who wish to see us should request a referral from their GP or other health professional. If a patient is referred by another NHS health professional, their GP needs to be informed and support the referral. Unfortunately, we can't accept self-referrals.