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Draft guideline on the ‘Care of Trans and Gender Diverse People within Obstetrics and Gynaecology’ opens for consultation

27 Jul 2022

The Royal College of Obstetricians and Gynaecologists has opened a consultation on a draft guideline relating to the care of transgender and gender diverse people (TGD).

*Please note this consultation closed on Tuesday 6 September 2022

The ‘Care of Trans and Gender Diverse People within Obstetrics and Gynaecology’ Green-Top Guideline (GTG) draws on the latest available clinical evidence on areas of the speciality including childbirth, contraception, fertility, gynaecological procedures and cancer treatment and care. It seeks to address common learning needs of obstetricians and gynaecologists treating and caring for TGD people.

The guideline covers the advice TGD people should be offered about fertility preservation (protecting their future reproductive options) when they are considering interventions that can affect fertility. This includes, information about endocrine therapy in a gender diverse population, the purpose and techniques used in genital reconstructive surgery (for trans men and trans women) as well as explanation of gynaecological problems that are experienced.

In relation to the provision of obstetric care to TGD people, the authors have outlined considerations including the appropriate time to cease masculinizing hormone therapy (MHT) as well as advice on psychological care, mode of birth and infant feeding.


Mr Phil Rolland, Consultant Gynaecological Oncologist who worked on the guideline, said: “It is highly likely that if an obstetrician or gynaecologist hasn’t already consulted or treated a trans or gender diverse patient then it is only a matter of time before they do.

“We have developed this evidence- based guideline to enable and support healthcare professionals in providing inclusive and accessible care for all. We know that trans people are more likely to have poor experiences when accessing healthcare and we can do better.

“We acknowledge that language is evolving rapidly in this area and publishing this guideline for consultation is part of the process of ensuring the final version of this guidance meets the need of both our clinicians and our patients.”
Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said: “This is an important guideline which aims to improve the care and experiences of transgender and gender diverse individuals accessing obstetric and gynaecological services.

“Sadly, trans and gender diverse individuals say they often feel judged and misunderstood by the health service. This can act as a barrier for them when it comes to accessing vital care and we as healthcare professionals have a role to play in making them feel listened to and recognised.

“This draft guideline is our first attempt to ensure we are providing personalised care for all our patients. We welcome feedback on this draft to ensure the guideline is the best as it can be for clinicians and the trans and gender diverse individuals who use our services.

“The RCOG is committed to ensuring obstetricians and gynaecologists provide care to the highest possible standard for everyone that needs it. Guidelines can be particularly useful to manage the care of small populations as they make the care safer, with less variation.”
Asha Kasliwal, President of The Faculty of Sexual and Reproductive Healthcare, said: “We welcome RCOG’s initiative to develop a much-needed guideline to improve the obstetric and gynaecological care provided to transgender and gender diverse people.

“Gender diverse individuals often report poor experiences in healthcare, including being misgendered, feeling judged and being asked unnecessary and intrusive questions. This can result in many people failing to seek or continue healthcare because of concerns over how they will be treated. There are a number of reports detailing poor clinical outcomes as a result of failure to properly understand and evaluate gender diverse people’s healthcare needs. 

“This draft guideline seeks to break down barriers and improve the experiences of trans and gender diverse people accessing obstetric and gynaecological services. 

“This includes recommending healthcare professionals are sensitive in the language they use and the way they consult a trans and gender diverse person, for example using the correct pronouns when addressing someone and receiving any information about a person’s gender diversity neutrally and non-judgementally."


The draft guideline also recommends healthcare professionals are sensitive in the language they use and the way they consult a TGD person, for example using their preferred pronouns when addressing someone and receiving any information about a person’s gender diversity neutrally and non-judgementally.

The draft guideline will be open for consultation until Tuesday 6 September.



For media enquiries please contact the RCOG press office on +44 (0)7986 183167 or email


Notes to Editor:

The draft guideline is available to view. 

Green-Top Guidelines

The RCOG produces clinical Green-top Guidelines (GTGs) principally to support their membership to deliver high quality care.

GTGs comprise evidence-based recommendations that assist clinicians and individuals in making decisions about appropriate tests or treatment for specific conditions or circumstances. The recommendations are not intended to dictate an exclusive course of care or treatment. They must be evaluated with reference to each individual’s needs, as well as resources and limitations unique to the institution, and variations in local populations. It is hoped that this process of local ownership will help to incorporate these guidelines into routine practice.

To find out more visit our guideline development guide

Read the RCOG and Royal College of Midwives inclusivity statement. 

About the RCOG

The Royal College of Obstetricians and Gynaecologists is a medical charity that champions the provision of high-quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision.

  • Clinical and research
  • Pregnancy and birth
  • Fertility
  • Gynaecology