ABSTRACT
A patient with gender dysphoria has a psychological experience of them self as male or female that is incongruent with their external sexual characteristics. It is estimated that there may be up to 15 000 people in the UK receiving some form of medical intervention for gender dysphoria. In 1979, the Harry Benjamin International gender dysphoria association first introduced standards of care to articulate the international associations’ professional consensus about the psychiatric, psychological, medical and surgical management of gender identity disorders. Increasingly, with subspecialization of primary health-care physicians, the overall management of patients with gender dysphoria can be more usefully seen as being best placed within the province of primary health care rather than within the traditional hospital clinic service. This is exemplified by the financial constraints in cities such as Vancouver and Sydney resulting in a need for services to change.
