We recently raised concerns with the online pharmacy DoctorFox.co.uk after a trans patient reported that their sex assigned at birth was permanently displayed in their medical record, and that the company refused to remove it.
Their response?
They removed the flag. That’s a meaningful improvement for privacy and dignity – and I appreciate that the senior team met to discuss it and took the issue seriously.
But their reply also highlighted broader systemic problems that affect many trans people accessing healthcare – especially from online services.
Here’s why we still need to talk about it:
Providers say they need to know birth sex, and won’t prescribe certain medications like Finasteride, if you are ‘female at birth’ , even if those drugs are routinely used in gender-affirming care. This is because they follow “licensed indications,” and refer trans people back to their GPs instead.
But that reasoning doesn’t hold up.
✔️ Off-label prescribing is legal and common – especially in trans care.
✔️ The GMC and MHRA both permit it, as long as it’s clinically justified and discussed with the patient.
✔️ Finasteride, in particular, is widely used by both trans men (to reduce testosterone-related hair loss) and trans women (as an androgen blocker).
So why is birth sex being used? Especially when it can block care? For many trans people, being told to “just see your GP” isn’t safe or realistic.
➡️ Some GPs aren’t trained in trans healthcare.
➡️ Some actively refuse to help.
➡️ Some patients are still waiting years to be seen by a Gender Identity Clinic.
Online services often feel like the only option – but only if those services understand the realities of trans healthcare and the legal protections we’re entitled to.
Doctor Fox said they treat everyone with respect and that they provide equality training. That’s good.
But it is vital to fulfil duties under the Equality Act 2010, the UK GDPR, or GMC confidentiality guidance, which clearly states that gender history should only be shared when strictly necessary for care.
The intention may not be discriminatory – but the impact absolutely can be.
To Doctor Fox’s credit:
✅ They removed the visible “birth gender” field
✅ They engaged in dialogue
✅ They expressed willingness to improve
But if the entire prescribing model puts trans patients in a separate category and denies them safe, common medications based on outdated ideas about biology, or insists on recording data that could ‘out’ them, then the problem runs deeper.
We will continue to engage with them to challenge further, because this is how we effect real change, one small win at a time.
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