How Can I Access Sexual and Reproductive Healthcare in the UK?

ALL sexual⁠ (sexual: About or relating in some way to sex or sexuality.) and reproductive healthcare in the UK is free through the NHS.

The best ways to access sexual and reproductive health services are through a GUM (genitourinary medicine)/sexual health/family planning clinic or through your GP. You do not need an NHS number to attend a GUM clinic — these services are available to everyone. To find out⁠ (out: Short for ‘out of the closet’. When someone’s LGBTQ+ identity is known to other people.) which services are available near you, you can check out the Sexwise website.

A great thing about going to a GUM clinic is that you can get a comprehensive sexual health check up with a doctor or nurse who works in sexual health. It can be your one-stop shop for contraception⁠ (contraception: Devices, medications or behaviors used to intentionally aim to prevent pregnancy, including the condom, the cervical barrier, the implant, the patch, the pill, the rhythm method, the ring, the shot, the IUD, spermicide and withdrawal.) , sexually transmitted infection⁠ (infection: When harmful microbes, or germs, or harmful levels of microbes/germs, enter the body and multiply, causing illness. The common cold, flu viruses, sexually transmitted infections, chickenpox, impetigo, rabies and diphtheria are some kinds of infections.) ( STI⁠ (STI: Sexually transmitted infections: illness, infection and/or disease which is often or can be transmitted through sexual or other intimate contact, like HIV, Chlamydia or Herpes. Some people call STIs STDs.) ) screening and management of STI symptoms, pre-exposure prophylaxis ( PrEP⁠ (PrEP: Pre-exposure prophylaxis. A daily medication that is taken regularly (before and after exposure) to prevent HIV. It is meant to prevent HIV exposures that occur on an occasional to frequent basis.) ) for HIV⁠ (HIV: A virus that attacks cells of the immune system, weakening the body’s ability to fight infections and diseases.) and more.

If you need contraception

ALL contraception in the UK is free, including emergency contraception⁠ (emergency contraception: A method of contraception used to prevent pregnancy after sex or rape has already occurred, rather than used before or during, like most types of contraception. Includes emergency contraception pills and IUDs.) . There are many different methods of contraception available so you should be able to find something that suits you. These include contraceptive pills, the contraceptive patch, the vaginal ring, injectable contraceptives, implants, and intrauterine devices (IUDs). You can have a read about all the methods available in the UK on the Sexwise and Contraception Choices websites, or a range of contraceptive methods here at Scarleteen, so that you can come to your appointment with some information and any questions about the methods you're interested in.

Emergency contraception comes in two forms – an intrauterine device or emergency contraceptive pills. Both forms of emergency contraception are available for free at GUM clinics, some GP clinics and some A&Es. Emergency contraceptive pills can also be bought over the counter at some pharmacies.

If you want to get tested for STIs 

Free at-home STI testing kits are available to many people in the UK (depending on where you live) and can be ordered online. These kits are for if you want to test for STIs and also have no symptoms. If you do have symptoms, you should see a nurse or doctor at your GP clinic or a GUM clinic instead.

The free STI testing kits are sent to your house in an unmarked confidential package. The tests usually involve collecting a urine sample for those with a penis⁠ (penis: One of the two external reproductive organs of people often assigned male at birth.) and a vaginal swab for those with a vagina⁠ (vagina: The internal passage leading from the opening of the vulva to the cervix of the uterus.) ; these usually test for chlamydia⁠ (chlamydia: A very common bacterial infection/STI. It can infect the cervix, urethra, testicles, fallopian tubes, and/or ovaries. It can also infect the throat when acquired through oral sex. Chlamydia requires medical treatment.) and gonorrhea⁠ (gonorrhea: A bacterial infection/STI which can infect the cervix, uterus, fallopian tubes, urethra, mouth, throat or anus. It requires medical treatment.) . Taking a vaginal swab is similar to inserting a (very tiny, very thin) tampon⁠ (tampon: A firm, disposable roll of absorbent cotton or other fiber that goes inside the vagina to absorb menstrual blood.) . There is also a blood test, usually for syphilis⁠ (syphilis: A bacterial infection/STI, transmitted when someone touches a sore on a person who has syphilis. These sores are can be on the mouth, penis, vagina, anus or skin. It requires medical treatment.) and HIV; this involves pricking your finger and squeezing out blood into a small tube. You can then post the samples back to the lab for processing for free – just pop the kit in any post box.

If you’ve got STI symptoms

If you have any symptoms, like unusual discharge⁠ (discharge: In the context of sex and sexual health, any number of fluids which come from the genitals. Plenty of genital discharge is healthy, while some discharges can be symptoms of illness.) from your vagina or penis, pain passing⁠ (passing: Being perceived as a member of a non-marginalized group when you’re a member of a marginalized group.) urine, pain in your pelvis or lower tummy, pain with sex⁠ (sex: Different things people choose to do to actively express or enact sexuality and sexual feelings; often this involves genitals, but not always. ) , unusual vaginal bleeding (like during or after sex, or between periods), or rashes, lumps, bumps, or sores on or around your genitals⁠ (genitals: Body parts that are generally, culturally, scientifically or personally considered to be external sexual or reproductive organs.) , then you should be assessed by a healthcare professional at a GP clinic or GUM clinic.

If you need a cervical smear

A cervical (or Pap) smear is a test to help detect pre-cancerous changes in the cervix⁠ (cervix: The opening to the uterus, the bottom of which is at the back end of the vagina.) . All cisgender⁠ (cisgender: Describes people who have a gender identity which is traditionally thought to “match” their assigned sex. For instance, someone who was assigned male at birth who identifies as a man. Often used in relation to transgender.) women or other people with a cervix aged 25 to 64 should be invited by letter. You should have a cervical smear every 3 years from age 25 to 49. After this, the test becomes less frequent. Even if you have had HPV⁠ (HPV: Human papillomavirus, a very common sexually transmitted infection with more than 40 HPV types.) vaccinations, you still should have regular cervical smears.

If you have not already, register with a GP in the UK. You will get a letter in the post just before you turn 25 inviting you to book an appointment at your GP clinic for a cervical smear. If you do not receive a letter, or you think you need a cervical smear and haven’t received a letter, contact your GP.

If you need an abortion⁠ (abortion: A procedure to intentionally end a pregnancy before a birth. Miscarriage is also sometimes called "spontaneous abortion," even though it is usually not intended.)  

Abortions are available for free through the NHS. You can either ask a GUM clinic or GP to refer you, or you can contact one of the following abortion providers directly:

• The British Pregnancy Advisory Service (BPAS)
• Marie Stopes UK
• The National Unplanned Pregnancy Advisory Service (NUPAS)

Check out the NHS website for more information.

If you have been sexually assaulted

The UK has sexual assault⁠ (sexual assault: When someone is attacked, or attacks someone else, in a sexual way.) referral centres which are 24-hour one-stop specialist services where you can receive medical care and counselling. Find your closest centre on the NHS website. You can also go to a GUM clinic, an accident and emergency department, or your GP clinic.

Check out the Sexwise and NHS websites for more information on finding those services.

The last thing you may feel like doing after being sexually assaulted is going to the doctor. However, you should ideally do this as soon as possible because you may be at risk of pregnancy⁠ (pregnancy: The state of carrying a developing embryo or fetus within the uterus. Medically, someone is considered to be pregnant when an egg has been fertilized by sperm, cells divide, and the fertilized egg is implanted within the lining of the uterus.) or STIs. You can be given medications to reduce your risk of pregnancy and STIs after assault. You don’t have to report the assault to the police if you don’t want to: reporting isn’t required to get emergency contraception, medications to help prevent STIs or other kinds of care.

I’m a man who has sex with men. Where should I go?

You can visit your local GUM or GP clinic to discuss regular STI screening, relevant vaccinations that may be available to you for free (e.g. the HPV vaccine, hepatitis vaccines etc), pre-exposure prophylaxis for HIV, and more.

What to expect at your appointment

If you have symptoms, are having a cervical smear, or are having an IUD⁠ (IUD: Intra-uterine device. A long-term birth control method inserted into the uterus by a healthcare provider. Also called an IUS (Intrauterine system) or IUC (Intrauterine contraceptive).) inserted your nurse or doctor will likely need to examine you. Please don’t worry about pubic hair⁠ (pubic hair: The hair that grows around the genital and anal regions (often extending a ways up the front or back and onto the inner thighs) and usually first appears around puberty. It may vary in color, texture, length, and thickness.) : your healthcare provider⁠ (healthcare provider: A qualified person to provide sound physical and/or mental healthcare, such as a doctor, nurse, clinician, counselor, medical assistant, midwife or other healthcare professional.) couldn’t care in the slightest if you have or haven’t shaved or waxed. It also doesn’t matter if you are currently menstruating. If you are feeling anxious, remember that the doctor or nurse you are seeing examines many people every day and this is as mundane for them as brushing your teeth is for you.

What about during the coronavirus pandemic?

The NHS is still open. Don’t avoid seeking healthcare you usually would during this time. Call your local GUM or GP clinic and they will advise you on what you can do during this time. They may try and manage your needs remotely, like by posting you medications you may require.

During the lockdown is also a great time to order an STI testing kit to your home.

While routine services may running at reduced capacity right now, all emergency services are functioning. If you have been assaulted, if you need emergency contraception, if you are feeling unwell, or if you need an abortion, you will still be able to receive these services and more. For example, some clinics are now posting medical abortion pills to patients, and you can still get help from a sexual assault referral centre (SARC) during the coronavirus outbreak. You can contact your GP clinic, GUM clinic, or go to A&E if you need any sexual and reproductive healthcare.