Loughborough University
Outcome of treatment draft 3 BJ.pdf (208.19 kB)

Investigating the outcome of the initial assessment at a national transgender health service: Time to review the process?

Download (208.19 kB)
journal contribution
posted on 2017-10-06, 12:36 authored by Beth Jones, Nicola Brewin, Christina Richards, Marnix Van Eijk, Alex Stephenson-Allen, Jon Arcelus
Background: Globally, there is a lack of a standardized assessment process prior to the initiation of gender affirming medical interventions and consequently there is a discrepancy in this process among different transgender health services. Aim: The main objective of this study is to investigate the outcome of the initial assessment process at a national transgender health service. Method: The outcome of people over the age of 17 years, assessed at a large national transgender health service in the United Kingdom during a 2-year period was categorized into: (1) recommendation for cross-sex hormone treatment, or (2) no recommendation for cross-sex hormone treatment. In addition, 200 case notes were reviewed in order to investigate the level of agreement between the two clinicians involved in the assessment process. Results: During the study period, a total number of 617 people completed their assessment at the service. Following assessment 380 (61.6%) patients were recommended for cross-sex hormone treatment, leaving 237 (38.4%) patients who required a longer assessment period or were discharged. The factors associated with being recommended for cross-sex hormone treatment were having socially transitioned, not smoking, having initiated cross-sex hormones prior to assessment, being older, and assigned male at birth. Out of the 200 case notes reviewed, agreement between assessor 1 and 2 (3 months apart) was found in 88% (n = 176) of the cases. Discussion: Although the results of the study may not be generalizable to other international centers, questioning the assessment process and the role of the assessors is important to ensure treatment is offered in a timely and efficient manner. The findings from this study suggest that the routine inclusion of two assessors needs to be reviewed.


Bethany Alice Jones was supported by a PhD studentship co-funded by Leicestershire Partnership NHS Trust and Loughborough University.



  • Sport, Exercise and Health Sciences

Published in

International Journal of Transgenderism


1 - 6


JONES, B.A. ... et al, 2017. Investigating the outcome of the initial assessment at a national transgender health service: Time to review the process?. International Journal of Transgenderism, 18 (4), pp. 427-432.


© Taylor & Francis


  • AM (Accepted Manuscript)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

Publication date



This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Transgenderism on 20 September 2017, available online: http://www.tandfonline.com/10.1080/15532739.2017.1372838.






  • en

Usage metrics

    Loughborough Publications


    Ref. manager