If you are seeking transition support through the NHS in Wales, you will first need a referral to the Welsh Gender Service (WGS). This referral can be made by a GP, though as understanding of gender issues varies, some may be of more help than others – the University Health Centre has typically been very supportive.
Following this referral, you will be contacted to discuss what support you are looking for and referrals for support such as speech therapy may be made, however you will not be able to access medical transition support such as hormone replacement therapy before having an initial appointment with the central WGS. The waiting time for a first appointment at time of writing is 20 months – updates on the waiting time can be found here: https://gender.wales/.
It is important to note that if you leave Wales and switch to a Gender Identity Clinic in another part of the UK, you may have to start at the bottom of their waiting list, so you need to think carefully about whether you are likely to be remaining in Wales for the duration of your time on the waiting list.
Following your consultations with WGS, you will be discharged to the regional clinic to continue your care. The Swansea regional clinic is based with the Sexual Health Clinic at Singleton Hospital and can provide care such as blood tests, hormone monitoring and administration of injections. The central WGS will also be responsible for surgery referrals if that is care you wish to pursue.
In the UK you are required to have been on hormone replacement therapy for a year and receive two referrals for surgery.
If you are accessing gender-affirming care privately, your GP may agree to prescribe for you under a shared care agreement, however this at the discretion of the GP and they are not required to do so. The University Health Centre has agreed to this in the past, but you will need to agree it between your GP and private care provider.
Prescriptions from a GP in Wales that are dispensed from a pharmacy in Wales are free so this may help you with costs.