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GPs could become sole gatekeeper of gender change process under Labour

GPs could become sole gatekeeper of gender change process under Labour

GPs could be asked to take on sole responsibility for approving gender recognition certificates under a Labour government.

The Times has reported that Labour is considering making GPs gatekeepers of the certificates which legally recognise a gender change. 

Last year, the party’s shadow women and equalities secretary Anneliese Dodds announced plans to ‘modernise’ the process for transgender people by removing ‘invasive bureaucracy’. 

Currently, applicants for a gender recognition certificate need a diagnosis of gender dysphoria from a doctor, and the application is then reviewed by a panel of people with legal or medical qualifications. 

Labour said this process is ‘dehumanising’ for transgender people and has previously said that a diagnosis by one doctor should be sufficient. 

The party is reviewing whether GPs could take on this role due to concerns that if a specialist took it on, a GP would still need to make the referral, according to the Times.

However, Labour highlighted that any decision to reform the gender recognition process would be subject to consultation if they come into power.

The requirement for a gender dysphoria diagnosis would remain, in line with current NHS practice, the party said. 

Ms Dodds said that Labour is the ‘party of equality’ and they believe ‘everyone should be treated with dignity and respect’.

She continued: ‘We want to see the process for gender recognition modernised, while protecting single sex spaces for biological women. 

‘This means stripping out the futile and dehumanising parts of the process for obtaining a gender recognition certificate, while retaining important safeguards.’

The RCGP has raised concerns with Labour’s idea of ‘shifting sole responsibility’ for signing the certificates onto GPs. 

‘We do, of course, support improving the care patients with gender dysphoria receive, including tackling the long waits they face for treatment and services – and we understand how important formal recognition of a change of gender will be to them,’ RCGP chair Professor Kamila Hawthorne said. 

But she emphasised that most GPs do not have sufficient expertise to take on this role.

Professor Hawthorne said: ‘We would need to see Labour’s proposals in full before we can comment properly, but for most GPs, detailed management of gender dysphoria is outside of our area of expertise, so whilst in some cases completing these forms might be straightforward, for more complex cases, without specialist involvement, the clinical and medico-legal risk placed on GPs would be high, especially if we were the only clinician involved.’

She also raised capacity concerns, saying that GPs are ‘already working under considerable pressure’.

Last month, in a landmark review of NHS gender services for children and young people, Dr Hilary Cass found that those seeking care for gender-related distress had been let down by the ‘remarkably weak evidence base’ and increasingly toxic public debate.

The review also concluded that GPs should not be expected to enter into shared care arrangements with a private provider.

Last year, NHS England walked back its plan to limit who can refer patients to its service for transgender children, after proposing to shift all responsibility for referring onto just GPs and healthcare professionals. 

A consultation revealed that a majority of respondents – including clinicians, patients and parents – disagreed with the change. 

For adult gender dysphoria services, one ICB has called on NHS England to ‘urgently’ clarify the role of primary care, highlighting that responsibility for treatment should not lie with GPs.


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Please note, only GPs are permitted to add comments to articles

Some Bloke 20 May, 2024 6:07 pm

is anyone aware of any tactical voting sites that try to stop the reds getting into the government?

win win 20 May, 2024 6:49 pm

Try blue

christine harvey 20 May, 2024 7:19 pm

Not on your/his/her Nelly !

Dr No 20 May, 2024 7:40 pm

@some bloke. Vote “‘NO”, you know it makes sense. Dr No is a member of 3 protected minority characteristics and is actively working on number 4. This is no more bothersome than signing one of those prescription charge exemption forms,

Sandra Teare 20 May, 2024 7:41 pm

No! No! No!
This is just a tactic for gaining votes.
We are not in a position to diagnose Gender Dysphoria in GP. We possess neither the expertise nor the time. How can we replicate in a 10 minute appointment the assessments that should occur in a specialist clinic of at least 2 sessions with different clinicians, including robust mental health assessment. GPs would be put under pressure by patients, and could damage relationships if there is disagreement.
Just because there are huge waiting lists, that should not warrant shoving everything onto GPs who are already doing a vast amount of secondary care work, and are struggling to cope with their own workload without taking on everyone else’s.

Just Your Average Joe 21 May, 2024 12:39 am


Sorry not trained or willing to take on this role even if you paid 1000 pounds per certificate.

Need a consultation with a specialist to sign this off.

Hacked Off 21 May, 2024 6:56 am

The fact is politicians of all colours have always viewed General Practice and the GP contract as a dumping ground for anything the rest of the NHS finds medicolegally problematic, time consuming or politically contentious. BMA RCGP et al can object all they want but with minimal notice anything can be imposed. Which ever party wins the next election, Pulse will still feature similar headlines on a regular basis. And the impositions will continue.

Dylan Summers 21 May, 2024 8:29 am

“Gender-critical views” are a protected characteristic under equality law. Presumably this means that any individual GP who wished to opt out from the task of certifying gender change for any of their patients could do so without penalty?

Jonathan Gregson 21 May, 2024 10:07 am

What expertise does one need to diagnose gender dysphoria? Seems straightforward to me. ” I was born biologically male but would like to live my life as a female” = gender dysphoria. I recognise you as the human being you wish to be – simple.

Not on your Nelly 21 May, 2024 3:29 pm

You called?

Truth Finder 22 May, 2024 2:41 pm

What a silly idea from a future clueless government. Don’t vote the reds or blues. We need someone new.