Information for trans young people having difficulty getting healthcare

This information is for patients at the Brackenburn Clinic, the adult Gender Identity Service for Northern Ireland in Belfast. It may not apply to you if you are at a different provider.
  • For general information on trans healthcare in Northern Ireland, see our information page
  • If you’re having problems with trans healthcare which haven’t been answered here, please get in touch.

Some young trans people have difficulty getting access to healthcare at the Brackenburn Clinic due to several reasons. This page contains information that may help you get access to healthcare, especially if you are experiencing resistance or denial of treatment.

Every trans person who goes through a gender identity clinic will have a different experience than the next, but you have a right to timely, appropriate and respectful healthcare through Health & Social Care NI.


If you are aged 18 or over, you can get a referral to the Brackenburn Clinic from your GP, or any general or specialised mental health service. You can not currently self-refer.

Your GP or other medical service should not refuse to refer you. You do not have to first be referred to a psychiatrist or psychologist, or any other service.

¬†“Real Life Experience”

Historically, trans people had to undergo a certain period after socially transition (changing your gender presentation in public) before getting access to hormone replacement therapy and other treatment. This is known as “Real Life Experience”, or RLE.

The Brackenburn Clinic follows the latest Royal College of Psychiatrists guidelines on trans healthcare, and as such, a period of 1 year of RLE is required for genital surgery, but no RLE, or promise to start RLE, is required to get access to hormones, laser hair removal, chest surgery, speech and language therapy or any other treatment.

What you should expect

If you want or need to start hormone replacement therapy or other treatment that isn’t genital surgery, you should be able to, after the Clinic’s initial assessment period. You should not have to socially transition, or promise to do so, to get access to treatment.

A therapist who refuses to refer you for hormone therapy or other treatment because you cannot or do not wish to socially transition is going against the best practice guidelines.

  • If you are having trouble with a “Real Life Experience” requirement, or something similar, please let us know. We may be able to help!

Proof of Eligibility for Treatment

We’re aware that many patients at the Brackenburn Clinic are being asked to prove their eligibility for healthcare, including new and existing patients. We’re concerned at the particular difficulty of trans patients fulfilling the identity proof requirements of the process, and that a great number of patients are receiving this. The letter is similar to the excerpt below.

We are currently investigating this.


  • If you have questions related to this, or wish to let us know that you’re having this problem, please get in touch.

Other Information

  • If you have other questions about trans healthcare in Northern Ireland that haven’t been answered here, please get in touch.
  • Answers will be published on this page, unless they contain personal or sensitive information.