TSS commonly known as Trans Support Services is a therapy service for trans people in the Liverpool, Cheshire, & Wirral area. It provides 4 sessions of therapy for free to patients 18+ to help people work through their gender related problems. More therapy sessions may be available under certain circumstances but this is dependant upon your personal circumstances and the capacity of the service.

You do not have to have a referral to a GIC in place to use these services, the TSS services are intended to help people work through their gender identity.

The TSS service is split into two different catchment areas, each catchment area is managed by a different organisation i.e. each have their own waiting lists, processes, & quirks. It is not possible to transfer between services. Service eligibility is also based on where you live.

Liverpool TSS

The Liverpool TSS service was started many years ago back in 2013. It was originally pioneered by In-Trust Merseyside but later handed over to Merseycare NHS Trust to manage. Some key features of the service:

  • They offer a type of listening therapy, they will guide you to talk about various things and help you talk things out aloud. They will write quite detailed therapy notes, which can be used as evidence for any GIC Appointments.
  • They can write the application form out for the GIC and refer you to them based upon their notes. It is also worth noting that when you do attend the GIC or CMagic, being able to state that you sought therapy can help tick one of the GIC's many boxes and help make getting HRT via the GIC a much simpler/easier process.
  • More than 4 sessions of therapy may be available, this is dependant upon how much ground is covered and your individual circumstances along with availability.


The LCH TSS can be located at: The Beat, Hanover Street/David Lewis Street, Liverpool L1 4AF

Bridging Hormones

They are capable of writing a supporting letter for bridging hormones to your GP if required which historically has allowed many trans women and trans men to access HRT prior to their first GIC appointment and to the creation of the CMagic pilot GIC in Merseyside.

Waiting Times

Please expect a wait time of at least 12 months for this service, it is a very popular service. We have a reported wait time of 3 years for this service for a referral made in 2017, the patient was seen in 2020. Although the wait time is long, it is still recommended to refer, as it is a free service. Do keep in mind the waiting times apply for both GP referrals and private. If you need urgent therapy or counselling contact one of the other services.

How to get in touch

You can self-refer to this service or have your gp write a referral to the service for you. Tel: 0151 247 6555. https://www.merseycare.nhs.uk/our-services/liverpool/sexual-health/trans-support-service-tss

Cheshire & Wirral

A free counselling service for transgender, non-binary and intersex people for both Cheshire residents and now Wirral residents who need support either before, during or after their social or medical journey. The service is provided by Cheshire Merseyside Adult Gender Identity Collaborative (CMAGIC) and commissioned by NHS Cheshire Clinical Commissioning Group (CCG) and NHS Wirral Clinical Commissioning Group.

The services provides access to experienced gender incongruence counsellors who patients can access 4 weekly one-hour appointments. The service is by self-referral and patients will be placed on a short waiting list before being introduced to a gender counsellor.

The Cheshire service went live on 1 July 2021 and the Wirral service went live in January 2022. Anyone wishing to access either service should visit www.cmagic.org.uk/counselling and answer some questions. A convenient appointment will then be made. Counselling appointments take place using Zoom technology.

Anthony Griffin, chair of CMAGIC, said: “We are eternally grateful to both Cheshire and Wirral CCG that they have recognised the need for specialist counselling services as trans, non-binary, intersex people begin or contemplate beginning the social and medical transition. This is often a tipping point for people especially young people as it can be that they become very isolated and for some it brings the loss of or reject by their families. We recognised from the number of people asking for help that we needed to establish a service that we know works well - and very often saves people from a deeper crisis - by simply having someone who is a trained therapist to support them. Thankfully, both NHS Cheshire CCG and Wirral CCG has understood the situation and enabled us to work in a partnership approach to launch this quality new service.”

The services build upon the community design that was created many years ago and called Transgender Support Service TSS and commissioned by Sefton and Liverpool CCG in 2013. That service is still in operation and is now managed by Merseycare NHS Foundation Trust.

The TSS service is totally separate to the CMagic pilot, there is no crossover of information between the two services. However they are both under the umbrella of the charity known as CMagic (not to be confused with the CMagic pilot GIC scheme). If you see a therapist as part of TSS, you will not see that therapist when attending an appointment with the CMagic initiative. Use of the TSS service has no impact on your CMagic/GIC application other what you personally disclose.

You may be offered more than 4 sessions, depending upon your needs and the capacity of the service if required.

Some key features of the service:

  • The service does not provide support with GIC referrals unlike the liverpool TSS service, however in practice most people seeking support from the TSS services, will most likely already have a GIC referral in place.
  • The service can provide recommendations to your GP to start bridging
  • You will see the same therapist for all of your sessions
  • The service is a full time service
  • Therapy is 121 counselling by registered BAC counsellors

Waiting Lists

We have a reported waiting time of 1 month. (2021). The official stance for this service is a short waiting time. In practice we believe this to be less than 3 months (April 2022) but this can obviously change.

How to get in touch


The Key differences between the two services

  • The Cheshire/Wirral service has significantly shorter waiting lists.
  • Cheshire/Wirral is managed by the CMagic charity, Liverpool is managed by MerseyCare (NHS) They are two completely seperate services although they do share the same name and are almost identical in operation.
  • The Cheshire/Wirral service does not at present provide support for referrals to the GIC, where as the Liverpool TSS service does. However in practice most people seeking support from the TSS services generally already have a GIC referal in place.
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