This qualitative study examines the healthcare provision for gender dysphoria patients by the National Health Service (NHS) in England. The thesis takes as its starting point the experiences of those providing and receiving care following the A, D & G vs North West Lancashire Health Authority court decision in 1999. The aims of the research are threefold: To examine what trans narratives tell us about individual understandings of gender, to explore what practitioner narratives tell us about the understandings of gender utilised in NHS treatment, and to determine what issues are important to consider when providing gender services. It undertakes an empirical thematic analysis through a triangulation of data sources - a literature review, qualitative interviews with specialists and focus groups with trans patients. The research is underpinned by three central questions: Do differences exist between the ways in which trans people and their doctors understand gender identity? Can the ways in which trans people formulate and express their gender identity map onto the notions of gender that practitioners employ? What are the wider implications for healthcare policymaking? The research questions were intended to investigate how trans people formulate and express their gender, whether and how those understandings differ from those that practitioners employ, whether trans narratives can map onto medicalised notions, and the implications for healthcare policymaking.