many trans people are looking at a minimum period of three to four years from first speaking to their GP (a step that in itself can take a great deal of courage and time) to a point when they hope to start medical transition. Moreover, when hormones are recommended, gender clinics do not themselves prescribe. Instead, they direct the person’s GP to prescribe. This can bring with it another problem: it is not uncommon for GPs to refuse to prescribe hormones – even with the direction of the gender identity clinic – as they believe prescribing to trans patients is beyond their competence.
