TNBI Annual Review

At The Health Centre, The University of Sussex, we are trying to improve the care we provide for our transgender, non-binary and intersex (TNBI) population. The aim is to better link in with our TNBI community to identify and address your physical, mental and sexual health needs. In addition, we hope to empower you with knowledge about your own health, hormone treatment and tackling known difficulties to overcome within the health service e.g. problems that the TNBI community face with the NHS national screening programmes.

We would like to invite you to complete the following questionnaire, so that we can keep your information and records up to date. If you are unsure or feel uncomfortable answering any of the questions then please leave them blank.

TNBI Annual Review

Section

Please confirm your established/preferred gender identity:
Please choose one.
Please confirm your pronouns:
Please select one is possible.

Physical Health Review

Both Height and Weight must be entered to calculate BMI.
e.g. 1.75
e.g. 60.6
Do you know your blood pressure? *

We also have a machine in our waiting room that you can access. Please sit at rest for 10mins before testing.

Are you a smoker?
Do you use recreational drugs?

Please confirm your assigned gender at birth:

This section is for those who were assigned female at birth

Are you experiencing any negative side effects to this medication?

Some helpful information regarding Testosterone treatment can be found here: hormone-treatment-masculinev1.0.pdf (gic.nhs.uk)

Please be aware that the timing of your blood test is important. This differs depending upon which preparation you use. Taking the test too early or too late will give unreliable hormone results.

  • For short acting injectable Testosterones (eg Sustanon) – 2 tests are required: Just prior to the injection and then 1 week later
  • For Testosterone Gels – a single test taken 4-6 hours after application of the gel (ensure no gel is applied to the arm)
  • For long acting injectable Testosterone (eg Nebido) – a single test on the day just prior to the injection.
If you have had surgery, please tick all operations that apply to you:

This section is for those who were assigned male at birth

Are you experiencing any negative side effects to this medication?

Some helpful information regarding Oestrogen treatment can be found below:

Please be aware that the timing of your blood test is important. This differs depending upon which preparation you use. Taking the test too early or too late will give unreliable hormone results.

  • For Oestrogen tablets – a single tests taken 4-6 hours after taking the dose
  • For Oestrogen gels (e.g. Sandrena) – a single test taken 4-6 hours after application
  • For Oestrogen patches - a single test taken 48hours after application
If you have had surgery, please tick all operations that apply to you:
To your knowledge, is your prostate gland still present?

This section is for all of our TNBI Community

Were you offered speech and language therapy input?
Is this something you would like to be seen for?

We will need your current address for this referral. If you have recently changed address, please can you update us by changing this online or contacting reception.

NHS Screening Programme

We aim to make NHS screening accessible and inclusive for all eligible populations. For people who are trans or non-binary, inequalities may exist because individuals:

  • Do not know which screening programmes they are eligible for
  • Are not invited for screening because of the gender they are registered as with their GP

For example, individuals registered as male may not be called for female specific cervical and breast screening, even though they might benefit from it.

To understand more about these issues, please visit: NHS Population Screening: Information for Trans and Non-binary People.

Mental Health Review

If you are having a mental health crisis or are considering self-harm, please seek help immediately by visiting Urgent Help for Mental Health.

Over the last month have you felt down/depressed/hopeless or have little pleasure in life?
Would you like help with these symptoms?
Do you frequently experience anxiety symptoms?
Would you like help with these symptoms?

Sexual Health Review

This section involves some sensitive questions and related to sexual activity and behaviour. The aim is to assess risk of sexually transmitted infections and promote good sexual health. If you feel uncomfortable replying to any of these, please leave them blank. Some great resources can also be found at: THT: Sexual Health

Please select:

Please outline information about your last sexual partner:

Their sex:
They are a:
Do you use protection (condoms/barrier methods)?
Do you think you have a risk of contracting HIV?
Do you take hormonal contraception?
Is hormonal contraception something you would like to consider?
Have you recently had a sexual health check up?

And finally...

If we identify areas in which you would benefit from being sent additional information or being linked in with one of our team members, would you be happy for us to contact you?