First
Team talk
We name the choice in front of you and what your goals shape.
The pathway
Eight steps, at your pace.
Each step has the same shape. We name the choice, lay the options out side by side, help you weigh what matters to you, and let you build a list of questions to take to your appointment.
How each step works
Three things repeat at every step, once you've used them once, they're yours.
Then
Option talk
Each realistic option is laid out side by side, with benefits, risks, timelines and what's known and unknown.
Finally
Decision talk
You reflect, save questions, and arrive ready for the conversation with your clinician, where the decision is actually made.
Carry this with you
The BRAN questions
Four short questions you can ask about any choice. Use them in clinic. Use them with your GP. Use them in your head.
- BBenefits, what are the possible benefits for me?
- RRisks, what could go wrong, and how likely?
- AAlternatives, what other options do I have?
- NNothing, what happens if I wait, or do nothing for now?
The eight steps
Understanding gender services
Orientation: what an adult GIC does and doesn't do, key terms in plain language, and how to use this tool.
Referral and waiting well
How referral works under the changing system, bridging prescriptions and shared care explained, and a "waiting well" menu.
Assessment: what to expect
A biopsychosocial assessment is a conversation, not an exam. Prepare what you want to say and what you want to ask.
Social transition and support
Non-medical steps, name, pronouns, presentation, documents, at the pace and depth that fits your life.
Hormone options
Balanced, non-directive information on feminising, masculinising and individualised approaches, and on waiting.
Fertility and reproductive choices
What hormones can do to fertility, what preservation options exist, and what NHS funding looks like in practice.
Surgery and what is NHS-funded
An honest map of surgical options, NHS pathways, and what isn't routinely funded, so you can plan with clear eyes.
Lifelong health and sexual health
Ongoing monitoring, screening by the organs you have, and accessing trans-inclusive sexual health and primary care.