The co-founders of Anne Healthcare have said the clinic only exists in response to the NHS’ failures on trans healthcare.

The non-profit healthcare provider’s co-creators Lizzie Jordan and Susie Green told PinkNews that private clinics “shouldn’t need to exist” but are in increasingly high demand due to the state of gender-affirming care provision in the UK.

“What we provide should be available free at the point of access via the NHS. We would love nothing more than not needing to do what we’re doing, but until the NHS does a complete 180, and we’re not seeing that any time soon, that is why we’re here.”

The healthcare provider was thrust into the news last week after online star Jude Howarth, better known as F1NN5TER, revealed they had donated a sizeable sum of money to the organisation during its first few months.

The announcement sparked debate among many in the trans community over the nature of private healthcare clinics, with some arguing the industry is inherently “exploitative”.

Addressing the controversy, Jordan said she completely understood why the community was “angry and frustrated” at private healthcare providers, arguing many of the larger European providers are poor quality.

“The NHS is not going to provide them with medication and prescriptions and all of the evidence-based stuff that would actually enable them to thrive,” she said. “Unfortunately, that means trans people have the option of either DIYing [buying medication online with no medical oversight], which for many young people is not really an option because of the risks, or a service which is not actually going to provide them any kind of reliable healthcare.”

The current largest private trans healthcare provider in Europe, Gender GP, has routinely been criticised for its level of care, with many patients arguing it provides minimal oversight which fails to cater for trans people’s specific needs.

According to Gender GP’s services page, it currently uses an AI bot to check if patients are eligible to access its services using an “informed consent” model.

Anne Health faces criticism from trans community

While working in the charity sector, Jordan and Green respectively said they were shocked by the lack of human interaction in Gender GP’s care model.

“I don’t think you can compare [Anne] with services that are AI-driven with no blood tests and fees for every interaction, every appointment … our fees include all your appointments that you will need. All the hand-holding,” Jordan said.

Much of the criticism against Anne specifically takes issue with its membership fees. At the time of reporting, the clinic charges a one-off setup fee of £200 and a monthly fee that operates on a sliding scale depending on the length of time someone has accessed hormone therapy. Members pay £150 a month for their first year, £100 for their second, and £50 for their third year onwards.

Some have argued the costs are too expensive for many within the community, with one viral post going so far as to call its price model “predatory”.

Others argue that the private clinic’s services are opaque and confusing, with some saying it’s difficult to understand what it even provides.

Jordan said that, as much as she and the team “wish [Anne] was free”, the fees were necessary for the “level of clinical care” it provides.

“The safety, the insurance, all of those things need funding, and we are a living wage employer, so it’s really important that everyone who works with us is able to live a good life. All of those fees go towards that and the individual patient’s care.

“There are always people who want things cheaper, there will always be people who want things free, and while we totally agree that this should be available, free of charge and free to the point of access [on the NHS], it’s not going to happen anytime soon.”

Patients who have yet to start gender-affirming care pay approximately £3,200 for the first two years with Anne, minus prescription costs and other administrative fees.

Comparatively, Gender GP’s current membership model involves a £30 monthly access fee and a £195 set-up fee. The monthly fee does not include subsequent costs, such as the £20 AI Consent Check-In session, blood tests, or prescription costs.

Fellow competitor Gender Plus, the only independent hormone clinic in the UK rated ‘Outstanding‘ by the Care Quality Commission, currently charges an initial fee of £325 and a monthly fee of £90, totalling around £2,485 over two years. The provider charges one-off fees for services such as the initial consultation and surgery referrals.

Trans people forced to wait years, pay thousands, or DIY for trans care

Patients who instead choose to wait for a referral to an NHS gender clinic could be waiting anywhere from three years to a staggering two centuries for a first appointment, according to a report from QueerAF.

It’s for this reason that so many trans people choose to ‘DIY’ HRT by accessing hormones through online distributors or local stockpilers.

Jordan noted that, while Anne typically urges patients to consider alternative options than DIYing, the organisation remains committed to helping all trans people regardless of their methods of access.

“DIY is a totally valid route for many, but for some people it’s not appropriate at all, especially if they have pre-existing health conditions. We have a lot of people on our books who do DIY and actually want to have the additional support of knowing that somebody’s looking over their bloods and keeping an eye on them.”

Susie Green noted that, as well as supporting DIY patients by providing medical oversight, Anne is also open to shared care agreements with GPs.

“We will send a complete breakdown of the plan that somebody is on, the treatment protocols, what we are looking for in terms of levels, who they’ve seen, such as our endocrinologists or clinical prescribers,” she said. “We really want to [do shared care agreements], but we know there’s been a lot of pushback on private healthcare providers by the NHS.

“So many GPs are wary of getting involved, and obviously we’re also seeing this massive roll back in terms of GPs actually refusing trans related healthcare full stop for a lot of people.”

GPs in London, Sheffield, Nottingham, and many other cities have, over the past year, begun cancelling HRT prescriptions, citing a “lack of support” and “expertise.”

The growing attacks on trans healthcare has posed concerns over the longevity of organisations like Anne, with many saying private clinics aren’t worth it if they will be banned by the UK government.

Jordan said the organisation is “constantly surveying what the future looks like” and insisted the clinic was “set up in a way to ensure that we can be here” long term.

“Susie and I are both experienced in running organisations like this and so we are scaling and growing appropriately with the right resource plan that enables us to ensure we are here for a long time.

“We hope that in time we can just hand everything back to the NHS, and they will pick it up and run it, but we are going to be here constantly improving and constantly striving to do the best thing.”

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