Form T452: Medical report for gender recognition

If you’re a registered medical practitioner or psychologist, fill in this form to support someone’s application for a Gender Recognition Certificate.


Medical report form for gender recognition (includes guidance)

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The Medical Report section of the gender recognition certificate guide explains broadly what the Gender Recognition Panel needs to be told when deciding to grant a certificate.

But this form asks for more detail in parts 11 and 12.

Part 11

In your answer, include:

  • the diagnosis
  • when the diagnosis was made
  • who made the diagnosis
  • the main evidence used to make the diagnosis
  • details of non-surgical treatment to date (such as hormone treatment)
  • what medication was prescribed and when
  • planned non-surgical treatment
  • date of referral for surgery or reasons why a patient hasn’t been referred

If you didn’t make the original diagnosis of gender dysphoria, confirm the diagnosis and list your evidence for confirming.

Part 12

You should:

  • state whether gender reassignment surgery has been carried out
  • list each distinct surgical procedure
  • give the date for each procedure
  • do the same for any planned procedures
Published 1 October 2014
Last updated 25 May 2018 + show all updates
  1. We added more detail about the information you need to give in parts 11 and 12 of the form.

  2. First published.