Lifelong health and sexual health.

Anyone taking gender-affirming hormones needs routine blood tests and a periodic clinical review. The exact schedule depends on which hormone, your dose, your route, and your individual health, but a typical pattern is more frequent in the first year (every 3 months), then settling to annual or six-monthly once levels are stable.

Monitoring isn't gatekeeping. It catches problems early, clots, raised haematocrit, liver or lipid changes, bone density, and lets your clinician adjust before something becomes a bigger issue. Skipping it isn't worth the risk.

The principle is simple: if you have the organ, you're entitled to the screening, regardless of how you're registered with the NHS. Practice still varies, and an automatic NHS invitation may not always arrive, so it's worth knowing the picture and asking.

• Cervical screening, if you have a cervix, this is offered every 3–5 years between roughly 25 and 64. People registered as male on NHS records may not be invited automatically; you can ask your GP to opt you in.
• Breast / chest screening, if you have breast tissue (whether natal, hormone-developed, or augmented), screening is relevant from ~50. After masculinising chest surgery, residual tissue is small but not zero.
• Prostate awareness, if you have a prostate, the same UK guidance applies as for anyone else; oestradiol does not eliminate prostate cancer risk.
• Bowel cancer screening, abdominal aortic aneurysm screening, and diabetic eye screening apply to everyone in the relevant groups; gender does not change eligibility.

Sexual health is part of healthcare, not a separate file. Trans and non-binary adults are entitled to the full range of NHS sexual-health services, STI and HIV testing, PrEP, PEP, contraception, HPV vaccination, smear tests where applicable, support around fertility and pleasure, and care for sexual difficulties.

Many sexual-health clinics in the UK are explicitly trans-inclusive, and some, particularly the larger urban services in London and other cities, are widely considered exemplars of integrated, one-stop trans care, where gender, sexual health and general wellbeing are addressed in the same visit. Ask your GP, or look up your nearest service on the NHS website. The Resources page lists national signposts.

If you take hormones, your sexual function may change, libido, arousal, orgasm, sensation, lubrication, erection. Some of this is welcome, some isn't, and most of it is discussable with a clinician used to trans patients. You're allowed to want a good sex life; the NHS can help.

Your GP is the long-term anchor of your healthcare. If yours isn't a good fit:

• You can ask to be seen by a different GP in the same practice.
• You can change practices, as long as the new one's catchment includes you.
• Some primary care networks have trans health leads, ask.
• If you experience discrimination, you have the right to complain via the NHS complaints process, and you have legal protection under the Equality Act 2010.