Gender identity

Your gender identity describes the feeling and convictions you have about your gender. This can be very different to the sex you have been assigned at birth, which is either female if you have a vulva and male if you have a penis.

The idea that everyone is either a boy or a girl is known as ‘gender binary’.

‘Trans’ is an umbrella term that describes all the different ways of not belonging to the gender you were given at birth, so it can mean different things to different people.

‘Non-binary’ refers to people who have a gender identity that is not simply ‘male’ or ‘female’. There are lots of different ways of being non-binary. People who are non-binary can feel as though their gender identity involves being both a male and female, can move from one to the other, can be between the two or something else entirely.

How we can help

If you need support in this area of gender identity, we are here for you. We are GPs running a women’s health clinic which means that we welcome any person who identifies as a woman or any person who has a vulva or any person who feels that our clinic is the right place to address their concerns.

Furthermore, we also want to learn from you and develop our knowledge and skills around gender identity. We can refer you to a Gender Identity Clinic. Please note that the waiting time for a first appointment with a Gender Identity Clinic in London is currently a minimum of 3 years. Your GP can also refer you. We are happy to talk to you and give health advice as well as assisting with investigations, referral and repeat prescriptions.

Sex & relationships

Sometimes it’s hard to talk about sex. Discussing sexual problems can be even harder. Sexual problems might originate from several sources, some of which include:

• Negative or false messages that have been picked up about sex, either from previous relationships, past sexual trauma/ abuse, sexual images or scenes etc
• Depression, anxiety, low self-worth or lack of confidence
• Cultural, generational and religious influences

A therapist can help you with any of the following issues:

• Libido issues
• Performance anxiety
• No orgasms with self-and/or partner/s
• Body image and genital dissatisfaction
• Lack of pleasure in sex or life
• Inability to relax or switch off
• Inability to identify or communicate sexual needs
• Shame and guilt about fantasies or experiences
• Sex and intimacy issues following life events (e.g. childbirth, illness, menopause, ageing, etc.)
• Bereavement and loss of intimacy
• Communication
• Body image and self-love
• Affairs, separation & divorce

The list is not exhaustive, and our therapist will always take care of you with a holistic view of the problem in a safe and confidential way.

Abuse and the law

There are several forms of abuse against women, from domestic violence, sexual violence, tech abuse, Female Genital Mutilation, ‘honour’ based violence, forced marriage, human trafficking and slavery. All these acts are a criminal offense and need to be reported to the police.

Sadly, the fear of reporting or the coercion of the victim may prevent or delay intervention. A sexual assault is any sexual act that a person did not consent to, or is forced into against their will. It includes rape (an assault involving penetration of the vagina, or anus with any body part or object, or penetration of the mouth by a sex organ), or other sexual offences such as groping, forced kissing, child sexual abuse, or being forced to look at sexual material.

Sexual assault is a crime and can be reported to the police in the same way as other crimes. Most sexual assaults are carried out by a person known by the victim.

Domestic abuse is still one of the most common and yet unreported crimes in the UK; and 1 in 4 women is expected to experience some form of domestic abuse in their lifetime.

With more awareness of abuse and mental health generally we hope that figures will go down. As GPs, we speak to women reporting abuse which is often experienced in their own private household but can also outside the home.

Female genital mutilation

Female genital mutilation (FGM) or female genital cutting (FGC) is a harmful practice involving the full or partial removal of, or injury to any part of a girl’s external genitals. On average, girls are subjected to FGM/FGC before the ages of 0-15 years.

There is no medical reason for this to be done. Far from it, the practice can cause long-lasting physical and psychological damage for more than 200 million women and girls who are affected worldwide (which also includes the UK).

Immediate health risks include severe pain, heavy bleeding, infection, sepsis, difficulty passing urine and negative effects on psychological well-being.

Long-term health risks include problems with passing urine, period/menstrual problems, painful intercourse and poor-quality sex life, chronic pain, fertility problems, chronic infections, scarring, negative effects on psychological well-being e.g post-traumatic stress, anxiety, depression, fear of sexual intercourse and vaginismus.

It can also lead to complications in pregnancy, such as an increased likelihood of having a caesarean section, bleeding soon after delivery, perineal trauma, potentially longer hospital stay.

In some rare cases, FGM/FGC can lead to death. It is also a violation of the human rights of girls and women.

Myths and facts about FGM: