When you see one of our clinicians, they will discuss with you your need for attending the clinic.
Each consultation is personal and tailored to you. We will ask rather than assume your sexual orientation, sexual practices and behaviours, hormone use or history of any surgery. This is information we will ask you so you can answer. Information you share is up to you, but we can help you best if we have all the information we need. We will ask you each time you see us in case anything has changed.
In order to provide you with the most appropriate care, we need to ask you questions about the type(s) of sex you are having. Remember, our service is confidential and non-judgemental. Please answer any questions honestly so we can provide you with the best care and support.
Our registration forms ask about a person’s sex assigned at birth as well as gender identity. The reason why we require information about your anatomy is to ensure the health information, advice and consultation we provide does not make assumptions. We want to hear from you about the language you would like us to use to describe your body, genitals and anatomy. The clinician will use language and terminology which you find most appropriate. You can use the descriptions you feel most comfortable using when talking about your anatomy and that of partner/s.
If you have had genital reconstructive surgery performed (‘lower’ or ‘bottom’ surgery) please let the clinician know the type of surgery you have had, and which tissue was used in the reconstruction. This helps the clinician understand how to best help you in relation to the type of sex you are having and when undertaking investigations or examinations. Any concerns, questions or worries you have will be dealt with sensitively and professionally.
We will ask you about any medication you are presently taking. If you are taking any hormonal medication or Gonadotropin Releasing Hormone (GnRH), please let the clinician know when they ask you about medication. It is important we know about any medication you are taking in case you need any treatment which may be affected by your existing medication. It is important you let us know about all prescribed and non-prescribed medication, if this applies.
Examinations
If you have no symptoms, we do not need to look at your genitals.
If you have symptoms, we may need to perform an examination. This will be tailored to you in order to provide you with the care you need.
- You will be offered a chaperone during the examination, if available. This is another member of sexual health staff.
- The examination process will be explained to you in full.
- You will be asked for consent to undertake the examination. You can ask to stop at any time.
- The examination will be tailored to you based on your anatomy, the type of sex you are having, and the need to provide you with appropriate care.
- If you have any questions about the examination, you can ask the clinician you are seeing.
- Samples may be taken during your examination. The clinician will explain what these samples are for, how they will be taken, and how they are processed. Some samples can be self-taken.
You will be given time and privacy to remove any items which may relate to your transition or gender history such as binders, breast forms, gaffs or packers or STP devices (if necessary) to undertake your consultation. You will be provided with privacy to do this.
Testing
If you are being tested for Sexually Transmitted Infections (STIs) the clinician will discuss the testing options with you. All the different sampling options will be explained to you, how they are taken, and what they test for. Some sampling options provide more accurate results than others based on your anatomy. From this information, you can choose which is most suitable for you based on the type of sex you are having. As a guide for standard STI testing in a Sexual Health clinic the following sample collection methods are available:
- Vaginal (frontal) swab. If you were assigned female at birth, this will test for Chlamydia & Gonorrhoea. This can be taken by yourself or the clinician, depending on symptoms, if you have any. If you take the sample yourself the clinician will explain how to do this.
- If your vagina has been constructed, a urine sample (see below) will give a more accurate result.
- Urine sample. This will test for Chlamydia & Gonorrhoea. You take this sample yourself. The clinician will explain how you take your sample. This is for people with a penis or constructed vagina.
- People assigned female at birth with a vagina can provide a urine sample but a swab (see above) provides more accurate results.
- Rectal (anal) swab. This will test for Chlamydia & Gonorrhoea. This can be taken by yourself or the clinician, depending on symptoms, if you have any. If you take the sample yourself the clinician will explain how to do this.
- Throat swab. This will test for Chlamydia & Gonorrhoea. The clinician will take this sample for you.
- Blood sample (usually from your arm). This will test for HIV & Syphilis. The clinician will take this sample for you.
If any other samples or tests are required, these will be explained to you.
Contraception
If there is a risk you could become pregnant from the type of sex you have, you can get free contraception from us. The clinician will explain all the different options available to you. They are all implemented and work in different ways. You will be given all the information in order to make the choice which is best for you. The clinician will answer any questions you have.
If you are taking any hormones, please let the clinician know when they ask you about any medication you take. This is so the clinician can advise you on which options are most suitable.
Discussions around contraception are very individual as no two people are the same. The consultation will be tailored to you in order to give you the best care.
If you are looking to lessen or stop your periods as part of your transition, our service can offer hormonal contraception for this purpose.
Treatment
Similar to examinations detailed above, if you require any treatment this will be explained to you in full beforehand. You will be told what the treatment will involve, and you can ask any questions you may have. All sexual health treatment is free, but if you prefer to take a prescription to a Pharmacy you may be charged.
If you are taking any hormones, please let the clinician know when they ask you about any medication you take. It is important for a clinician to understand medications you are taking when considering treatment options to ensure this is most effective.
Vaccinations
Based on the type of sex you are having, we may be able to offer you vaccinations for Hepatitis A & B, and Human Papilloma Virus (HPV). The clinician will discuss your risk and eligibility with you in your consultation.
PrEP
PrEP is a pill you can take which protects you from HIV. PrEP may not be right for you, but if you feel it is something you would like to discuss, we are here to help you. If eligible, PrEP is available for free from the NHS.
There are different ways to take PrEP, and this depends on a number of individual factors. Similarly to attending for a sexual health screening, when you speak to us about PrEP we will talk to you about the type of sex you are having, and your level of risk.
PrEP is very safe with hormone treatment. Your clinician will discuss any medication or treatment you are taking before you start taking PrEP.
We provide continued follow up care through your journey with taking PrEP.
In your consultation we will discuss the different way to take PrEP, side effects, and interactions with other medicines. More information on PrEP is available on our PrEP page.
To find out if PrEP is right for you, you can use the PrEP Tool.
