Clinical Fellow in Gender Dysphoria

Chelsea and Westminster Hospital NHS Foundation Trust is seeking an enthusiastic doctor to join TransPlus as a Fellow in Gender Dysphoria, with the opportunity to progress their CESR in Community Sexual & Reproductive Health (CSRH) or HIV and Sexual Health. This post is designed for doctors pursuing the Certificate of Eligibility for Specialist Registration (CESR) in Community Sexual and Reproductive Health or HIV and Sexual Health providing a structured programme of supervised clinical practice, leadership, governance, education and service development. We are seeking candidates with a realistic chance of achieving specialist registration within 18 months, based on clinical experience already gained. The successful candidate will spend 60% of their time (6 PAs) working within the multidisciplinary TransPlus service and 40% of their time (4 PAs) undertaking activities specifically designed to support acquisition of CESR evidence in their specialty. The post offers a unique opportunity to develop advanced expertise in gender medicine within one of the UK's leading specialist gender services, while simultaneously progressing towards CESR through structured clinical exposure, educational supervision, audit, research, quality improvement, leadership and teaching opportunities. The Fellow will provide care for trans and non-binary people accessing gender health, sexual health and reproductive healthcare services. They will work alongside consultants, specialty doctors, resident doctors, nurses, psychologists and allied health professionals to deliver holistic, evidence-based care and contribute to service innovation and clinical excellence. The fellow will work alongside junior and senior members of staff to help manage those with gender dysphoria and sexual health needs. They will assist with the prescribing of hormone therapy, management of results, and liaison with GPs and other associated health professionals. They will be responsible for the formulation of treatment plans for those diagnosed with gender dysphoria. The service refers for the range of services described in the NHS England service specification and agrees and co- ordinates treatment plans specifically tailored to address each service-user's goals and clinical needs. These services include: 1. An assessment, diagnostic, and person-specific treatment planning service, involving the client in every aspect of their care 2. Endorsement for surgical gender affirming surgeries 3. Referral for facial depilation 4. Referral for speech and language therapy 5. Advice and advocacy to support bio-psycho-social adjustment, Clinical (TransPlus) The post holder will work as part of the multidisciplinary TransPlus team to deliver high-quality, patient-centred care for individuals with gender dysphoria and associated sexual health needs. Key responsibilities include:

• Assessment and diagnosis Undertake comprehensive, holistic assessments of patients presenting with gender dysphoria, including medical, psychological, and social factors.
• Apply recognised diagnostic frameworks and ensure assessments are conducted in a sensitive, inclusive, and non-judgemental manner.
• Contribute to second opinions and complex case reviews where required.
• Treatment planning and ongoing care Develop, implement, and regularly review individualised care plans in collaboration with patients, ensuring shared decision-making throughout.
• Monitor patient progress, treatment outcomes, and wellbeing, adapting management plans in response to changing clinical needs.
• Provide continuity of care across assessment, treatment, and follow-up stages.
• Hormone therapy management Initiate, prescribe, and monitor gender-affirming hormone therapy in line with national guidance and local protocols.
• Interpret laboratory results and adjust treatment regimens safely and appropriately.
• Manage complications or side effects related to hormone therapy and escalate complex cases when required.
• Surgical referral and readiness assessment Assess readiness for gender-affirming surgical interventions in line with NHS England service specifications.
• Prepare and complete referrals for surgical services and support patients through the referral pathway.
• Liaise with surgical providers and ensure appropriate pre- and post-operative care planning.
• Sexual and reproductive health care Provide comprehensive sexual health services including risk assessment, screening, diagnosis, and management of sexually transmitted infections (STIs).
• Deliver health promotion and prevention advice tailored to the needs of trans and non-binary individuals, including HIV prevention and treatment where appropriate.
• Offer contraception and reproductive health advice relevant to individual patient needs.
• Promote cervical screening, fertility preservation discussions and reproductive healthcare access.
• Multidisciplinary working and liaison Work collaboratively with consultants, nursing staff, psychologists, GPs, and allied health professionals to ensure integrated care delivery.
• Provide specialist advice and guidance to primary care and other healthcare professionals managing TransPlus patients.
• Contribute to case discussions, MDT meetings, and joint care planning across services.
• Clinical governance and service development Contribute to the implementation, evaluation, and continuous improvement of clinical pathways and protocols.
• Participate in audit, quality improvement initiatives, and research activities to enhance service delivery and patient outcomes.
• Ensure all practice is compliant with Trust policies, national standards, and clinical governance frameworks.
• Supervision and leadership Support and supervise junior medical staff, nursing colleagues, and other team members in delivering patient care.
• Provide clinical guidance in the management of complex or unstable patients, including those with new diagnoses or treatment changes.
• Act as a role model for inclusive, compassionate, and evidence-based practice.
• Safeguarding and holistic care Recognise and respond appropriately to safeguarding concerns, including mental health, vulnerability, and social risk factors.
• Promote a holistic approach addressing bio-psycho-social aspects of care, including signposting to relevant support services.
CESR Development Activities The post holder will work as part of the multidisciplinary TransPlus team to deliver high-quality, patient-centred care for individuals with gender dysphoria and associated sexual health needs. Key responsibilities include: A key objective of this post is progression towards CESR in Community Sexual and Reproductive Health or HIV and Sexual Health. The Fellow will receive protected time for: · Clinical Competency Development
• Developing competencies mapped to the current CSRH/HIV and Sexual Health curriculum.
• Undertaking supervised clinical sessions across sexual and reproductive health services where required.
• Expanding experience in contraception, menopause, abortion care, safeguarding and integrated SRH services as appropriate to individual CESR requirements.
· Quality Improvement and Clinical Governance
• Leading quality improvement projects relevant to TransPlus and/or CSRH/HIV/Sexual Health services.
• Participating in clinical audit cycles.
• Contributing to guideline development, policy reviews and pathway redesign.
• Presenting governance work locally and nationally.
· Research and Service Evaluation
• Participating in research studies, service evaluations and outcome projects.
• Supporting dissemination of findings through presentations and publications where possible.
• Developing experience in critical appraisal and evidence-based practice.
· Teaching and Education
• Delivering teaching to multidisciplinary colleagues, trainees and students.
• Organising educational activities.
• Developing evidence of educational leadership and supervision.
• Participating in departmental teaching programmes.
· Leadership and Management
• Attending relevant leadership and management meetings.
• Contributing to service development initiatives.
• Developing experience of workforce planning, governance and operational management.
• Building evidence in line with CESR domains relating to leadership and professionalism.
· Portfolio Development
• Maintaining a CESR portfolio aligned to GMC requirements.
• Meeting regularly with educational supervisors.
• Collecting workplace-based assessments and supporting evidence.
  
  Our Trust is one of England's top-performing and safest trusts. We operate two main acute hospital sites-Chelsea and Westminster Hospital and West Middlesex University Hospital-along with award-winning clinics across North West London.
Our nearly 7,500 staff care for a diverse population of 1.5m, providing full clinical services including maternity, A&E and children's services, plus specialist HIV and sexual health care. The CQC rates us Good in safety, effectiveness, care and responsiveness, and Outstanding in leadership and resource use. We continually invest in our facilities, including a £30m expansion of critical care at Chelsea and an £80m Ambulatory Diagnostic Centre at West Mid. We are delivering sustainable healthcare through our Green Plan. In line with Greener NHS ambitions, we aim for net zero carbon emissions by 2045. Achieving this requires collective effort. We encourage staff to reduce their impact on carbon, waste and pollution wherever possible. Every action counts to create a healthier, more sustainable future.