ABSTRACT
Referrals to the Charing Cross Hospital Gender Identity Clinic are accepted only if they are made by a community mental health team psychiatrist or psychologist, or the child and adolescent gender identity disorder services. Before the administration around funding referrals was introduced, it used to be that general practitioner (GP) referrals were accepted. There were considerable problems with this arrangement. The first problem was that many GPs seemed unwilling to refer direct to a tertiary centre, no matter how insistent the patient or how appropriate the referral would have been. The second problem was the reverse of the first. It was that of GPs who seemed willing to refer to a tertiary service regardless of the appropriateness or otherwise of the ensuing consultation. Sometimes the patient and assessing gender identity clinic were bemused by the sorts of referrals. If direct GP referrals were reintroduced, there might be no increase in inappropriate referrals.
