We understand that you may have a lot of questions about Indigo Gender Service - we're a new service and a new model for delivering gender services. We want to make sure you have the answers and information you need.
We've compiled a list of the most frequently asked questions about Indigo. If your question isn't answered below, please get in touch with us at firstname.lastname@example.org, and one of our team will get back to you soon.
If you are a GP, please see our frequently asked questions section here.
Indigo Gender Service is a Greater Manchester-based two-year pilot for a new way of delivering trans healthcare. We are a partnership between gtd healthcare and LGBT Foundation, and supported by the Nottingham Centre for Transgender Health (NCTH) to deliver a service designed by and for trans and non-binary people.
Indigo is a new model of trans healthcare - whilst the current gender identity clinics (GICs) are a specialised centre which all trans and non-binary people must attend if they wish to pursue medical transition, Indigo is based in primary care. This means our clinical team is based in GP practices across Greater Manchester, and we also have additional services such as voice coaching and therapeutic services delivered in settings around Greater Manchester.
We are a team of trans, non-binary and LGBQ practitioners and allies working collaboratively to bring together a broad range of expertise and experience.
We take a holistic and flexible view of transition, helping people to be informed and supported to make decisions that are right for them.
Services we offer include:
- support and advice around gender identity;
- assessment and diagnosis of gender incongruence;
- voice and communication therapy;
- hair removal;
- recommendation of hormone therapy;
- assessment and referral for top surgery;
- first assessment for lower surgery;
- one-to-one and group psychological support;
- care navigation, peer support and social prescribing.
Indigo is a pilot NHS service and in order to be a patient with Indigo, you must meet the following criteria before 1 December 2020:
- aged 17 or over;
- registered with a GP in Greater Manchester and eligible for NHS treatment;
- on a waiting list for a gender clinic and have not yet had you first appointment.
To find out more about accessing our services and elligibility click here
We employ and work with a range of people from an array of professional backgrounds. Many of the people working in both patient facing, administrative and senior roles are trans and/or non-binary themselves, and trans and non-binary people have been part of leading and designing the service from the very beginning.
No, Indigo is an NHS service, and we are free to access for those who are eligible for NHS treatment.
You may not have heard from us for a number of reasons. For instance, we may not be aware that you are currently on a waiting list for an NHS GIC and eligible to access Indigo services, or you may have changed your contact details since your last visit.
If you think you are eligible, but you haven’t yet heard from us, you will be able to contact us and check your eligibility for the service. You can email us at email@example.com or call us on 0161 710 1196.
We are working through a historical waiting list of over 700 people from the existing Gender Identity Clinics. Our care navigators are calling every person individually in time order so it may take a while. If you think you meet the eligibility criteria but haven’t been contacted, email firstname.lastname@example.org and we can confirm if you are on our list.
Whilst everyone’s experience is unique, most will begin with a care navigator - someone with lived experience who will listen to your experiences and priorities and ensure that the service meets your specific needs. Our experienced GPs are able to provide you access to treatments in the ‘gender dysphoria non-surgical specification’, including hormone replacement therapy.
We also offer a range of other support you may wish to access, including talking therapies, support with deed polls, document updates, and hair removal. There is no one standard transition pathway, so you can choose the services that you wish to access without pressure to follow a specific route.
A member of team Indigo will be in touch to speak with you about the new service. You will then be contacted by a care navigator who will be your main point of contact and will help guide you through your time with us. You will also have the chance to ask the care navigator questions about the service.
We understand that choosing your gender clinic is a big decision. You don’t have to give us an answer on the spot and we want you to have all the information you need to make the best choice for you. Take some time to read through our FAQs and any information we send you. We’ll call you back in seven days to see if you would like to book your first appointment with us.
Booking your appointment:
We’ll contact you and ask if you’re ready to book your first appointment. If you are, we’ll arrange a time and a date that’s convenient for you to see one of our clinicians online or in person at one of our sites in Greater Manchester. We’ll text you the details of your appointment, and you’ll also get a reminder text a few days before your visit.
We’ll ask you to notify your existing GIC that you are transferring your care to Indigo as soon as possible (if you haven’t already).
That is fine! If you’ve read through all of our information and decided that Indigo isn’t right for you, it won’t count against you in any way.
You don’t need to give us a reason and you can keep using any other services provided by LGBT Foundation and gtd healthcare without any issues.
Your first contact with the service will be with a care navigator with lived experience, who will welcome you to the service. This is an opportunity for you to explore the services we offer in more detail and to ask questions about various aspects of social or medical transition. The Care Navigator will explain how the service works and explore if you would like any additional holistic support, like a peer support group for non-binary people, or if you would like any support with reducing your drinking or drug use. You might want to bring a list of questions that the care navigator can support you with.
Your first appointment will be with a GP with specialist skills in trans health. We will most likely discuss:
- your gender and how you feel about it;
- your hopes and goals for the future;
- various aspects of your life, such as hobbies, work, or education;
- your wellbeing and mental health;
- your relationships and support networks;
- what will happen next.
If you want to medically transition, we will ask about any health conditions you have and any medication you take. One of our clinicians will measure your height, weight and blood pressure, and take some blood tests. You will have a minimum of two 1-hour appointments with the GP to make sure you are supported to make decisions that are right for you.
As this is a pilot and new service, we are being supported by clinicians from the Nottingham clinic. This may mean that clinicians may ‘dial in’ to remote consultations and give clinical advice Indigo clinicians about your care.
Sometimes it may be necessary to refer you on to a specialist at the Nottingham Centre for Transgender Health; this additional support pathway is to make sure you get the best and safest care.
You are encouraged to bring anything that you need to make your appointment most comfortable. This might be a list of questions for us, something to take notes with, a comfort object, or a friend, partner, family member or advocate. We also encourage you to wear whatever you feel comfortable in. It won’t affect your treatment if you present in a certain way, and we want you to have the best possible experience with us.
Present however makes you feel comfortable!
We do not expect anyone to conform to gender stereotypes or present in any way that is inauthentic to you. We are an affirmative service and want you to present as you. Our remote consultations are via video chat or in person - in line with NHS England guidelines. We plan to continue offering a mix of face to face and video chat consultations in the future. If you do not have a smartphone or laptop with webcam you can see us in person.
We can recommend and support your own GP to start hormone therapy at your second appointment if:
- you’re diagnosed with gender incongruence at your second visit;
- you feel confident that you’ve understood the information we’ve shown you, including the possible risk and side effects of any treatment options;
- you’re feeling ready to start hormones;
- it’s medically safe for you to do so.
We understand that some people may wish to wait and/or access additional support before starting hormone therapy (if they choose to take hormones at all). Indigo offers a range of services designed to support you to make the best possible choices about your care.
It’s important that you think about your future fertility before you start taking hormones as you may want to consider egg or sperm storage. We recommend that you look at the information from the Human Fertilisation & Embryology Authority about trans and non-binary people and fertility preservation.
Yes, we can refer you for top surgery in collaboration with our linked gender identity clinic in Nottingham.
We can help by referring you to our linked gender identity clinic in Nottingham to be assessed for lower surgery, however we are currently unable to refer you directly.
If you want to start hormones, or if you are taking hormones already, you will need to have some blood tests. Someone from our clinical team can do these for you, or we can send some information to your own GP practice to help the staff do your blood tests there if you prefer.
An important part of hormone care is having regular blood tests to check your hormone levels, your liver and kidney function, and your full blood count. If you start taking new medications as part of your Indigo care, we will support your GP practice to check your blood at regular intervals (one, three and six monthly). After you are stable on your medication, you will need blood tests every six months to one year.
We will work with your GP practice to start you on your medication and help them to feel competent and confident to carry out your blood monitoring and prescribing in the long term.
It depends how long you have been on the waiting list for your current GIC. We will make sure that we see the people who have been waiting the longest first, and we will let you know where you are on the list.
The Indigo pilot has been commissioned for two years. By the end of the pilot, we anticipate that all Indigo patients will be discharged from the service. After this we hope that Indigo will go from being a pilot to a permanent service for trans and non-binary people across Greater Manchester.
The time between your first and second appointments can vary as this depends on a number of factors including waiting for test reults. Some people may choose longer periods between appointments for different reasons e.g. to access additional support or services or to spend more time considering the various options available to them. We’re a flexible service and we’ll be led by you. Please be assured, you will be supported and receive regular contact from your care navigator throughout your journey with Indigo.
Not necessarily. We want to make sure that Indigo is as accessible as possible, and we understand that many people will have been diagnosed in private services or abroad. Some people may have started hormone therapy or had some surgeries before being seen at Indigo.
Yes. As long as you meet the eligibility requirements for Indigo, it doesn’t matter if you’ve had some treatments before you come to see us. We know that everyone’s experience and life is different, and our role is to support you to get the care that is right for you.
We want to make sure that your care is safe, inclusive and affirmative. We may need to adapt the way that our services are delivered to ensure both you and our teams are safe. All of this will be discussed with you by your care navigator. Some of the adjustments we are taking include:
- care navigation will be delivered remotely, at least for now while certain restrictions are in place; we can discuss the different ways we can do this, either through video calls or telephone calls;
- clinical appointments can be remote or in person (with risk reduction measures and PPE in place for safety);
- blood tests and medical checks will be carried out safely in person;
- voice and communication will be delivered remotely while certain restrictions are in place;
- talking therapies will be delivered remotely while certain restrictions are in place;
- hair removal offer may be reduced under certain restrictions due to mainly being offered by beauty salons; we will discuss options for this with you.
One of our partner organisations, LGBT Foundation, can provide services to support your mental health and sexual health, and to help you with your substance use or if you are experiencing domestic abuse. Our care navigators will be able to talk you through the different types of support available to you, including services provided by different organisations and groups throughout Greater Manchester.
Yes. The current process for obtaining legal gender recognition in the UK requires an application for a Gender Recognition Certificate in accordance with the Gender Recognition Act 2004. See the Gov.UK website for further details.
Our teams can support you with this process, and provide some of the evidence needed for your application. If this is something you are interested in, you can discuss this with our team in one of your appointments.
Absolutely! We are recruiting for our Patient Advisory Group – where you can feed back
and help shape the Indigo service. We will also be starting a volunteer group in the future.
Email email@example.com if you’re interested.