Gender Change on NHS Medical Records

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Patients can request a change to their gender marker at any time and do not need to have undergone any treatment, or have a Gender Recognition Certificate. In fact, no formal deed of change of name is legally required. Children and young people under the age of 18 however cannot change their gender marker on their medical record.

Title changes without gender marker change

Please be aware that changing a patient’s name will not change the gender marker on their medical records. Their title will change, but their record will still state the gender given upon registration. 

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.

With the current IT system that is used by PCSE (NHAIS), it is not possible to have a perceived mismatch between title and gender marker. For example, on the system it is not possible to be a “Mrs” with a male gender marker. An unmatched notification will be sent if this is attempted as the NHAIS system regards this as being inconsistent. The procurement of a new system by PCSE that underpins its work will apparently have this functionality in the future.

Process at Statham Grove Surgery 

If a patient requests a change of gender they are booked a GP appointment to ensure they have been made fully aware of the implications- this includes the time frame, potential delays in existing referrals and the implications for recall for screening programmes (further detailed later in the policy).

When a patient changes gender, the current process on NHS systems requires a new NHS number and to be registered as a new patient. If the patient currently has an Online Services account, they will need to re-register once they receive their new NHS number and patient record.

• PCSE allocates the patient a new NHS number with the patient’s ‘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. 
• 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. The patient’s previous name and any gender specific terms should be removed as should previous NHS number. A black marker can be used to redact the record. Electronic notes should be printed, redacted and re-scanned onto the new patient record.

Once PSCE issue a new NHS number we will aim to re-register the patient within 5 working days to avoid delays in patient care. 

Important information to consider

Cervical screening tests

Trans men and non-binary people who have had a total hysterectomy to remove their cervix do not need cervical screening. Trans men and non-binary people who still have a cervix should have cervical screening to help prevent cervical cancer.

If a trans man is registered with a GP as male, they will no longer receive automatic invitations. If the patient wishes to still have cervical screening they can request this by contacting the GP practice.

Breast screening

Trans men and non-binary people who are registered as female will receive breast screening invitations automatically. If a trans man is registered with the GP practice as male, they will no longer receive automatic invitations. 

If a trans female has had feminising hormones for longer than 2 years, they can have breast screening. The patient can contact the breast screening programme directly or discuss with a member of the GP practice. 

Abdominal Aortic Aneurysm (AAA) screening

AAA screening is recommended for anyone assigned male at birth aged over 64 years. This includes men, trans women and non-binary people. Trans women changing their gender to female will no longer be automatically recalled for screening. They can request to have screening and added to practice recall if they consent, and advised to work alongside the team to request screening.  

Important information regarding ongoing referrals

If the patient has any outstanding referrals or are on any waiting lists, changing their gender and receiving a new NHS number/record should not affect your place on these lists, but patients are advised to contact any clinic or hospital they have ongoing care with to ensure they have their new NHS number and record on their system to ensure continuity of care.