Gender reassignment

No, children and young people under the age of 18 cannot change their gender marker on their medical record. They can change their name or title (see questions related to these options for more information). An independent review has identified a serious safeguarding risk in the current process of re-assigning gender and sex identity in medical records for children and young people.

In response, the Secretary of State for Health and Social Care has directed that the process for changing gender markers and NHS Numbers in relation to gender amendments for children and young people under 18 is stopped.

If a patient is over 18, a practice can submit a gender reassignment request and the patient will usually be given a new NHS Number, and would be registered as a new patient at your practice. All previous medical information relating to the patient would then need to be transferred into a newly created medical record. When the patient informs the practice that they wish to change gender, the practice must inform the patient that this will involve a new NHS number being issued for them, which is not reversible. To revert back to their original gender, they would receive a third NHS number. The practice also needs to ensure the patient is aware of the implications in issuing a new NHS Number, including potential loss of old medical record, potential screening concerns, and potential loss of place on NHS waiting lists. The practice should confirm this has been discussed with the patient when notifying PCSE.

It is important that practices are aware of the steps that need to be taken when a patient changes gender. Following the process will ensure continued patient care and ensure there isn’t an impact on your practice payments.

The process for changing a patient’s NHS Number, if the patient has been fully informed of the implications this may cause, is as follows:

• GP practice notifies PCSE that a patient wishes to change gender, and be allocated a new NHS number via the secure Gender Reassignment online form.

Please note: To submit a Gender Reassignment you must be a verified contact. Please ask the main contact we hold for your organisation to register you on PCSE Online via the User Management section. Alternatively, the main contact can submit the Gender Reassignment notification.

Top tip: When entering the patient's details into the online form, enter only the first part of their postcode, then scroll to the bottom of the drop down menu and select Not Listed. The practice can then manually enter the postcode to ensure the address is accurate and can be matched. 

• PCSE allocates the patient a new NHS number with the patients ‘new’ details as provided on the online form and removes the patient under the previous NHS number. Notification of this will be sent back to the practice with an instruction to register the patient under the newly allocated NHS number.
• GP practice accepts the deduction and registers the patient using the new details provided by PCSE. Important: Do not update the patient’s original record with their new NHS number. If this happens they may not be registered correctly under the new NHS number and may miss out on continuity of care.
• GP practice transfers all previous physical medical information from the original medical record. Electronic clinical information should be transferred from the old clinical system record to the new one.  Any information relating to the patient’s previous identity should not be included in the new record.

Please consult the various screening programmes websites for advice on what action is required in relation to the programmes

• Cervical Screening
• Breast Screening
• Abnormal Aortic Aneurysm  

 It is important that practices complete the new registration for the patient within five working days to ensure no interruption to patient care.

Please note: NHS England is reviewing this process, and further information and guidance will be published in due course.

Yes, a patient over the age of 18 can change their gender marker without changing their NHS Number. This needs to be discussed with the patient, and preferably a form signed by patient and included in their medical records.

A patient can be known as the title they wish while remaining with their current gender. For example, a gender listed as male with a title of “Miss”. You can also state in the free text why the change is occurring so the registration team do not mistake the change as an administrative error.

An adult (18 years old and above) patient’s gender can be changed to indeterminate or “I”. This will be reflected as “Not specified” on PDS.

It is up to your GP practice to define its own procedures about whether or not you ask patients to provide evidence for a name change.

There is no legal requirement for your practice to request evidence, although it is considered best practice to do so.

PCSE does not require confirmation that evidence has been seen in order to change the name, although we may contact your practice by phone or email to confirm the changes made

This change can be made for both adults and children and young people under the age of 18.

If you need to submit a query regarding a Gender reassignment for a patient who is aged 18 years or older, please use our secure Gender Reassignment online form.