Leicester Gender Identity Service
A service for the management of women transsexuals has been available at Leicester General
(NHS) and Leicester Nuffield (private) hospitals since 1994.
The Leicester Gender Identity Team currently consists of a Psychiatrist, 2 Reconstructive Urologists, Plastic Surgeon, ENT Surgeon, Endocrinologist, Speech
Therapist, Specialist Nurse Practioner and Counsellor. There is an internal MDT meeting every 8 weeks to review cases and every 3 months
there is a supra-regional meeting which includes Gender Teams from Nottingham, Sheffield and Leeds. Leicester is the hub for the provision
of genital and breast surgery. Referrals for genital surgery are also received from all areas of the UK, Europe and North America.
Patients are currently managed according to the criteria set out in the 1998 Standards of Care document prepared by the Harry Benjamin International Gender Dysphoria
Association. New UK guidelines for the management of patients with gender dysphoria are presently being constructed by an Intercollegiate Working Party chaired
by Dr Kevan Whylie (Sheffield)and may be ready for usage in late 2006 or early 2007.
New patients need an initial psychiatric evaluation to establish diagnosis and initiate a real life test if appropriate. Part of the real life test involves the administration of feminising hormones
together with regular blood monitoring and blood pressure estimations. Patients must show that they can exist comfortably in their chosen gender role in appropriate
settings. At the conclusion of the real life test (usually 12-18 months) patients need a further psychiatric/psychological assessment before they may
undergo genital surgery. A consultation to discuss genital or other surgery is most appropriate towards the completion of the real life test
.Not all patients choose genital surgery and genital surgery itself may range from bilateral orchidectomy only (removal of testes), to a
cosmetic genitoplasty (removal of penis ,testes and scrotum with creation of a clitoris, labia and shortened urethra in other words the
outward appearance of female genitalia but without a vagina )or complete feminising genitoplasty which includes the former plus the construction of a vagina.
About 40% patients request breast augmentation (implantation of breast prostheses) which may be performed before, simultaneously or more often after feminising
genitoplasty.
Post-operative counselling is available for all patients.