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- 1. What name do you prefer to be known by (when we meet you and/or in written reports)? Have you made an official name change? What pronouns do you use?
- 2. How old are you?
- 3. Have you used other gender services, private or NHS?
- 4. Are you living, day to day, as you'd like to live, gender-wise? Have you made a social transition? If not, what are the obstacles? What needs to change?
- 5. What do you do during the day (work, study, volunteering, social activity)?
- 6. Are those close to you (family, friends, partners, colleagues) aware of your gender circumstances? Do they support your plans?
- 7. Have you had any treatment for physical health conditions?
- 8. Have you had any treatment for mental health conditions? Have you ever harmed or tried to kill yourself?
- 9. Are you on any medication for physical or mental health conditions (including contraception)?
- 10. What is your objective in seeing me?
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