Annual/Biennial review appointments

Why we have contacted you?

We have contacted you because our records indicate you are taking gender affirming hormones as part of your gender identity healthcare.

The guidance for hormone treatment issued by the National Gender Identity Clinical Network for Scotland (NGICNS) Endocrine and Fertility Preservation guidance in 2022 recommend that we review patients on testosterone treatment annually and those on estradiol, every other year.

Chalmers GIC will be in touch when you are due for your review. If you have not been contacted yet but feel that you are overdue for a routine review, please contact the GIC secretaries on 0131 536 1570.

What happens at the review?

This review is offered at the Chalmers Centre in Edinburgh. We ask that you arrive 15 minutes before your appointment time to use the health monitor located in the main reception and to give yourself time to complete the questionnaire provided. This will ask questions about your up to date; hormone regimen, medical history, medications, family history, and lifestyle choices.

One of our specialist senior clinical support workers will collect your completed questionnaire and invite you through to a clinical room. The rest of this appointment will involve measuring your blood pressure, height and weight. Routine blood tests may also be conducted.

If you are taking testosterone gel – please apply your gel 2-6 hours prior to your appointment.

If you are self administering Sustanon – please book an appointment for the day you are due an injection, however, wait until after your blood test to administer this.

If you are receiving Sustanon or Nebido via your GP practice – you should have blood samples taken at your next injection administration appointment, and then please book an appointment with Chalmers Gender Identity Clinic for a review the following this. If you do not live in Lothian, please bring a copy of your results with you.

Estrodiol levels do not need checked once your hormone levels are stable. However if you would like these to be measured please ensure that you request this at your appointment:

If you are taking estradiol tablets or gel – please take them/apply 4 – 6 hours prior to your appointment time.

If you are taking estradiol patches – please ensure you are on day 2 or 3 of wearing your patch.

At the end of this appointment you will be offered an appointment with a nurse, either by telephone or face to face.

How do I book my review?

You can book your appointment online or by calling the clinic on 0131 536 1570. If you are booking online you will need your AN number and passcode that was sent to you by text.

Who will I see?

Your review will usually be carried out by one of our specialist senior clinical support workers. At the end of your appointment you will be offered a nurse appointment to review all the information gathered and discuss your results, this will be by telephone or face to face.

When will I know the outcome?

We will run over all information and results with you at your second appointment. Following this second appointment, a letter detailing the outcome of your review will be sent to you by post within two weeks. A copy of this letter will be sent to your GP for their information.

What happens if my risk has changed?

We will discuss this with you at your second appointment. We will explore possible reasons for this and suggest options for how we might be able to lower your risk. Example options include changing from tablets to estrogen that is applied to your skin, and in some cases we may suggest healthier lifestyle options.

A more detailed letter will also be sent by post within two weeks, and a copy will be sent to your GP for their information.

Why isn’t this done at my GP?

Your GP is an expert in generalist healthcare but unlikely to be a specialist in gender care. We have agreed these arrangements with your GP as being a safe and reliable way to ensure that your results have had specialist and expert oversight and for you to be able to link in with us if you have any questions.

If your GP has told you that they are happy to do these tests locally, most likely if they are doing them in relation to another health condition, then please call us on 0131 536 1570 and we will contact your GP to ensure we are able to access the results.

What happens if I don’t book a review?

We will try to contact you by other means using information you have provided to us to let you know about your review. If despite our best efforts we are unable to reach you, or you choose not to participate, we will need to contact your GP to discuss this which may include considering whether it is safe to continue prescribing long term without any monitoring.