How do I change the gender on my NHS record?#
Ask your GP practice. In England the national record is kept by Primary Care Support England (PCSE), which runs patient registrations for NHS England, and your practice sends it the request through a secure online form. Before it does, the practice talks you through a choice between two routes: a new NHS number with a new record, or your existing number with only the marker changed.
GOV.UK says you do not need a Gender Recognition Certificate to update your medical records, and PCSE's guidance for practices mentions no certificate and no medical evidence. The change is open to adults only: since a direction from the Secretary of State for Health and Social Care, a gender marker is not changed for anyone under 18 (see below).
Should I get a new NHS number or keep my old one?#
It is your choice, and PCSE says a new number is the usual route. These are the differences its guidance sets out, as it stood on 12 November 2026.
| A new NHS number | Keep your NHS number | |
|---|---|---|
| What changes | The gender marker, the NHS number and your registration: you are registered as a new patient at the same practice | The gender marker only |
| Your medical history | Your practice moves your paper notes and electronic records into the new record, leaving out anything about your previous identity | Stays on the same record |
| Can it be undone? | No. Going back to your original gender means a third NHS number | PCSE does not say |
| Risks the practice must explain | Losing parts of the old record, screening problems, and losing your place on NHS waiting lists | PCSE lists none |
| Paperwork | The practice confirms to PCSE that it has explained the effects | Discussed with you, ideally with a form you sign that goes in your records |
| How long | The practice should complete the new registration within five working days | PCSE gives no time |
PCSE adds that NHS England is reviewing this process, so check with your practice before you decide.
What happens to my old record and NHS number?#
On the new-number route, PCSE gives you a new NHS number with your new details and removes your registration under the old one. Your practice then registers you as a new patient under the new number and transfers your medical history across. PCSE's instruction to practices is that information relating to your previous identity should not be included in the new record, and that the original record must not simply be given the new number, because you may then not be registered correctly and may miss out on continuity of care.
The NHS website says an NHS number is valid for life unless a new one is assigned for a reason such as adoption or gender reassignment. The national database, the Personal Demographics Service, covers England, Wales and the Isle of Man, and NHS England says it is used in all GP settings and the vast majority of hospital and other secondary care settings, so a change made through your practice reaches them from there.
Can I choose neither male nor female?#
Yes, if you are 18 or over. PCSE says an adult's gender can be changed to indeterminate, recorded as "I", which the national record shows as "Not specified". Its guidance does not say whether this comes with a new NHS number, and the screening guidance below does not say how a record marked "Not specified" is treated, so ask your practice how your screening invitations will be arranged. Changing your name as a non-binary person compares what other records can show.
Can someone under 18 change their NHS gender marker?#
No. PCSE says children and young people under 18 cannot change the gender marker on their medical record. An independent review identified a serious safeguarding risk in the process for under-18s, and the Secretary of State for Health and Social Care directed that changes of gender marker and NHS number for them be stopped. A child's name and title can still be changed through the practice in the usual way. Changing a trans child's name covers consent for the name.
Will screening invitations change?#
Yes, because NHS screening programmes in England invite people by the sex on their GP record. NHS England's guidance for trans and non-binary people, updated on 1 September 2026, says what each programme does.
| Screening in England | Invited automatically | If your record shows the other sex |
|---|---|---|
| Breast, every 3 years from 50 to the 71st birthday | People registered as female | Registered as male: no invitation, but your GP can refer you for mammograms at a hospital |
| Cervical, every 5 years from 25 to 64 | Women, and anyone who has opted in | Registered as male with a cervix: opt in through your GP or practice nurse, a sexual health clinic or a gender clinic. Registered as female without a cervix: you may still be invited, and the programme can update its records |
| Abdominal aortic aneurysm (AAA), at 65 | People registered as male | Registered as female: no invitation; the guidance says anyone assigned male at birth has a man's risk and can arrange a scan with the local service |
| Bowel, every 2 years from 50 to 74 | Everyone | No change |
The guidance says it is important that your GP keeps your record up to date, so that you are invited for the right screening.
Scotland: your CHI number#
NHS Scotland identifies patients by a 10-digit Community Health Index (CHI) number, used across its health services. NHS inform says one digit in it shows your sex, that it identifies you as male or female, and that whether to change it when you transition is your choice: speak to your GP practice. Screening in Scotland is arranged from the CHI number. NHS inform adds that if you changed your CHI number before 14 June 2015, or moved to Scotland from elsewhere, you may not be invited automatically, and that you can then contact your local screening service or, for cervical screening, your practice. NHS inform describes no option other than male or female.
Wales and Northern Ireland#
Patients registered in Wales are on the same Personal Demographics Service as patients in England, but PCSE's guidance is written for practices in England and we found no separate published process from NHS Wales, so start with your practice.
Northern Ireland issues a health and care number on a medical card through the Business Services Organisation (BSO). Asked in 2024 whether a new number is issued when a gender marker changes, the Department of Health said it did not hold that information and pointed to BSO, and we found no process for it on BSO's website. Ask your practice, or BSO, what it does before you decide.
Changing your name and title at the same time#
The name goes through your practice too. PCSE says each practice decides what evidence to ask for: the law does not require any, though asking is considered best practice. Take your deed poll, and see changing your name with the NHS and your GP for how a new name reaches the NHS App and hospitals. Your title is separate from your gender marker: PCSE says you can be known by the title you wish whatever your recorded gender, and a practice changes it on request. Who can see my former name? covers the other records that keep an old name.
Questions people ask
Do I need a Gender Recognition Certificate to change the gender on my NHS record?
No. GOV.UK says you do not need a certificate to update your medical records, and Primary Care Support England's process starts with you telling your practice. A certificate changes your legal gender, which is a separate matter (deed poll or Gender Recognition Certificate?).
Do I need a deed poll to change my gender on NHS records?
Not for the marker: Primary Care Support England describes no documents for it, only a conversation with the practice. For a new name it says each practice sets its own rule, that the law does not require evidence, and that asking for it is best practice, so take your deed poll with you.
Can I change it back later?
Yes, but not by undoing the first change. Primary Care Support England says a new NHS number cannot be reversed, and that someone who later goes back to their original gender is given a third number. Keeping your number avoids a second change of number.
Will I lose my place on a waiting list?
It can happen. Primary Care Support England lists a possible loss of place on NHS waiting lists, together with a possible loss of the old record and screening problems, among the risks your practice must explain before it asks for a new number. If you are waiting for treatment, ask the hospital how a new number would affect your referral before you decide.
Can I change my title without changing my gender marker?
Yes. Primary Care Support England says a patient can be known by the title they wish while their recorded gender stays as it is, and a practice changes a title, Mx included, for adults and under-18s. Changing your name with the NHS covers the name and title.
Something else? Ask us, and a person replies by email, normally the same working day.
