Gender Service

The Gender Service is a multi-disciplinary service based at the Royal Brisbane and Women’s Hospital for the purpose of providing assessment, support and affirmative treatment to older adolescents and adults who identify as Transgender, Gender Diverse or Non-binary (TGDNB). The service is available to people in Brisbane and throughout Queensland (via telehealth).

We provide short to medium term care to adults experiencing gender dysphoria/gender incongruence, who are seeking support through their gender transition. Patients have access to:

• Social Work
• Psychology
• Psychiatry
• Endocrinology
• GP with Special Interest (GPwSI)
• Speech Pathology

Our services

• Recommendations to referring GP for community linking and referrals to relevant community services/private providers for the patient.
• Assessment and affirmative treatment of adults with Gender Dysphoria/gender incongruence.
  *Please note that the service discharges care back to the referring GP for ongoing medical and mental health management once the patient is stable or when clinically appropriate.
• Time-limited support for patients with psychosocial adjustments related to Gender Dysphoria/Incongruence.
• Therapeutic assessment and affirmative treatment of gender issues (and co-existing mental health or neurodevelopmental conditions, which are directly and significantly impacting assessment and/or management of gender dysphoria/incongruence).
• Speech Pathology service provides voice feminisation and masculinisation services to adults experiencing gender dysphoria/incongruence, who have already been seen by the RBWH Gender Service. Patients cannot be referred directly to the Speech Pathology service.
• Assessment and report by Psychiatrist for gender affirmation surgery, where a patient cannot access this privately.
• Assessment (of capacity, mental health, medical status and risk) to determine patient suitability and readiness for gender-affirming hormone therapy (GAHT).
• Short-term review following commencement of hormone therapy, then discharge back to the referring GP for ongoing management (including ongoing prescriptions and monitoring of GAHT).

Out of Scope/Not offered

• Referrals for ongoing management of GAHT
• Referrals for mental health
• Direct referrals to Speech Pathology, Psychology, Social Work
• Referrals for neurodevelopmental assessment
• Referrals for support to access NDIS, DSP, etc
• Referrals for gender-affirming surgery (surgery is currently only available through private health options)

Eligibility 

• Referrals must come from a patient’s primary care provider, or their GP must have knowledge of the referral and understand that the patient will be discharged into their care for ongoing medical management of GAHT (where patients are initiated medical treatment in the service)
• Patient must be aged 17 years or above, at the time of referral
• Patients must be eligible for Medicare, or have appropriate health cover

Essential Information to include in the referral:

• If the patient is seeking to commence GAHT, or if they are being referred for a specialist medical consultation, the following pathology results must be included in the referral

               FBE; E/LFTs; glucose, lipids, TSH, FSH, LH, prolactin, oestrogen, testosterone, progesterone

• Brief gender-related history- preferred name, assigned sex at birth, gender identity, pronouns used.
• Patient’s goals from gender service e.g., wants masculinising hormones with goal of deeper voice, facial hair, fat redistribution.
• Relevant social history, including any safety concerns for the patient (including if nil issues).
• Capacity or medicolegal issues (including if nil issues).
• Nicotine (via smoking or vaping), alcohol and other substance use.
• Patient’s current risk of pregnancy and current pregnancy prevention.
• Patient’s desire to preserve their fertility with gamete (egg or sperm) freezing.
• Mental Health diagnoses (including if no mental health diagnoses or issues).
• Physical Health diagnoses (including if no physical health diagnoses or issues).
• Neurodevelopmental diagnoses
• Current medications (including if no current medications)
• Allergies

How to access this service

Other health professionals may refer their patient/client to the Gender Service, however the patient’s GP must be aware of the referral and the expectation that the patient will be discharged back into their care ongoing management (including management of GAHT), once discharged from the service. All referrers must include the essential information in their referrals, including the relevant blood test results.

For patients under 17 years, please refer to the Queensland Children’s Gender Service.

For gender-affirming service providers in Australia:

• AusPATH (Australian Professional Association of Trans Health)

What to bring

Frequently asked questions