Supreme Court Ruling

On Wednesday 16 April 2025, Supreme Court judges ruled that the legal definition of ‘woman’ is based on biological sex for the purpose of the Equality Act 2010. We understand that this ruling will have a significant emotional impact on some people.

First, we want to reassure you that the Northern Region Gender Dysphoria Service is not changing or closing as a result of this ruling.

It is also important to note that the Supreme Court reaffirmed that the Equality Act protects trans people against discrimination, based on Gender Reassignment, and will continue to do so.

The NHS will need to take the time to digest the full implications of the ruling and to understand what this will mean on both legal and practical levels.

However, in the meantime, there will be no immediate impact on the care or services we provide. The ruling does not affect our commitment to support the rights of trans people and there are no changes to CNTW Gender Identity Services.

It’s also important that you still attend all your healthcare appointments and any health screenings as usual.

Here in CNTW, we remain committed to ensuring an inclusive approach to our model of care and support, the support we give to our workforce, and enabling and defending the rights of all of our people and the people we serve.

Resources

If you have been affected by the Supreme Court ruling and the discussion around it, it is important to focus on looking after your own safety and wellbeing. Things that often help people include:

  • Eating regularly and as healthily as you can.
  • Moving as much as you can to manage anxiety. This can be anything from a walk, climbing stairs, yoga or following free exercise videos online.
  • Trying to get enough sleep.
  • Avoiding using drugs and alcohol, as these often make things worse for your wellbeing afterwards.
  • Talking to safe people online or in person. (See our mental health resources page for details of some helplines.)
  • If you feel more anxious about going out to places that usually feel OK, it is important to try small trips to test out feeling safe outside again, and remind yourself that most things haven't changed.
  • Avoid places on the internet where you might see transphobic or upsetting content, especially the comments sections of posts.

If you are struggling with your mental health, then you can find more resources on our mental health resources page.

If you would like to talk to one of our peer supporters, you can find out more about our peer support service.

If you think you have been the victim of a crime because of your gender identity, you can:

How to contact us
The best way to contact the service is by email

nrgds@cntw.nhs.uk

Welcome to the Northern Region Gender Dysphoria Service (NRGDS). We’ve put a range of information and resources together to try and answer your questions and help you to find sources of support and guidance.

If you still can’t find an answer to your question or you would like to provide feedback on the service, please email us at: NRGDS@cntw.nhs.uk.

Oestrogen equivalence products February 2024

Formulations and dose equivalents of transdermal testosterone preparations updated 31 January 2024

(These files may not be suitable for assistive technology. If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format. Please email communications@cntw.nhs.uk )

If a supply issue occurs with a long-acting injectable formulation of testosterone; such as Sustanon, or Testosterone Enantate in the first instance try and source whichever is in supply at a local level of either Sustanon or Testosterone Enantate as these can be used at equivalent doses and intervals.

In the rare instance that Sustanon and Testosterone Enantate cannot be sourced a gel preparation may be needed for an interim period. The gel should be started on the day an injection is due, and it is recommended that a starting dose of Tostran at 40mg once daily is acceptable, and the dose can be adjusted depending on blood test results.

If Tostran cannot be sourced, use the equivalence table above for any preparation you can source. For a 40mg equivalent in Testogel sachets, it would be one 40.5mg sachet daily for example.

GCLS Survey

This GCLS report is part of ongoing wider research on patient reported outcome measures (PROMs) and their applications to transgender health services. The research aims to investigate PROMs’ potential to assess the quality of care given by transgender services, from the perspective of service users. As of yet, no conclusions have been drawn on the GCLS or the research project at large due to its ongoing nature. This report has been published on the NRGDS website in the interests of transparency.