The Surrey Heartlands Integrated Health System Area Prescribing Committee (APC) has agreed that topical testosterone should be prescribed generically, ideally using Drug Tariff descriptions.

After undertaking a review of previous decisions and resources relating to transgender health, the APC agreed an AMBER status for oestrogen, testosterone, cyproterone, finasteride, GnRH & medroxyprogeterone when used in adults. 

Primary care initiation of these drugs is supported by the APC if the prescriber is competent to exercise their share of clinical responsibility and is assured that the shared care protocol provides enough information for them to discharge their responsibilities safely.

A guide to support primary care prescribing for people who access gender identity services was also agreed by the APC. 

The guide includes information on children and young people, requests to prescribe, shared care, on-going care and private providers.