GIC Patients who have Self-Medicated with Hormone Therapy

Reference: 25-26368

Date response sent: 18/12/2025

Details of enquiry

1. The number of patients currently under your care who have been self-medicating with hormone therapy without an NHS prescription.
2. How many of the patients medicating without NHS prescription have had access to clinical supervision (if known)?
3. Any policies or protocols your clinic follows when a patient discloses self-medication with hormones.
4. Does your clinic record the source of hormones used by self-medicating patients (e.g., online pharmacies, overseas suppliers, etc.)?
5. The total number of patients currently being cared for at your clinic and the proportion of these in the 18-25 age range.

Response sent

The Trust has electronically extracted the data provided in our responses below from the electronic records of the GIC whose care post-dated the introduction of a new ‘Core Form’, introduced around November 2024. 

We have not extended our search for data prior to this period as previously if/where held, this would have been located within freetext notes sections within patient electronic records, – not in an electronically searchable/retrievable format, (ie no automated mechanism for the collation of the required data), and requiring manual review and processing,

We have estimated that to obtain the requested information, where held in less recent patient files, would require a manual search of all patient records amounting to thousands of electronic patient files, which, at an estimated 20 minutes per record would take approximately 333 hours per thousand records.  This would considerably exceed the limit to time and resource provisioned under S12 of the Freedom of Information Act 2000 (FOIA). (See Explanatory Note* on the Trust’s engagement of exemption S12 of FOIA, located at the end of the response below)

1. The number of patients currently under your care who have been self-medicating with hormone therapy without an NHS prescription.

124 patients..

2. How many of the patients medicating without NHS prescription have had access to clinical supervision (if known)?

The Trust cannot confirm whether there was ‘clinical supervision’ for non-NHS prescribed hormone consumers as our electronic patient records do not have an automated mechanism for the collation of this, ie no dedicated electronic data-field, and it would require manual review and processing of a large volume of patient files, considerably exceeding the limit to time and resource provisioned under the Freedom of Information Act 2000 (FOIA).

This data is therefore withheld under s12 of the Freedom of Information Act 2000, on the basis that the estimated time and resource required to conduct a manual search of 397 files at an estimated 20 minutes each would take around 123 hours – considerably exceeding the limit under FOIA to answer this whole request. (See Explanatory Note* on the Trust’s engagement of exemption S12 of FOIA, located at the end of the response below)

3. Any policies or protocols your clinic follows when a patient discloses self-medication with hormones.

As a gender clinic, we strongly advise against self-medication due to the significant risks involved. Please find enclosed our standard advice on self-medication for oestrogen and our standard advice on self-medication for testosterone.

4. Does your clinic record the source of hormones used by self-medicating patients (e.g., online pharmacies, overseas suppliers, etc.)?

The Trust does not record this data and anecdotal evidence has shown patients to be very reluctant to disclose this data.

5. The total number of patients currently being cared for at your clinic and the proportion of these in the 18-25 age range.

1269 patients are currently being treated by the GIC

Of these 46% are in the 18-25 age group.

Explanatory Note *

Under Section 12 of FOIA the Trust is not obligated to comply with a request for information if we estimate that the costs of complying with the request would exceed the appropriate limit of 18 hours of officer time

The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 has set the appropriate limit as £450 based on a generic charge of £25 per hour to determine whether the Trust holds the information, to locate, and then to extract it).

Section 12 of FOIA further states that the authority (ie this Trust) is not obligated to comply with a question for information if the authority estimates that the costs of complying with the question would exceed the appropriate limit for the whole request.

This means that as the time required to process your questions 2, and a remainder of data for question 1 fall outside the cost limit, your request for a reply to these questions is refused and exemption from disclosure has been engaged under s12 of FOIA.