A Regional Gender Identity Clinic was established in Yorkshire ten years ago. It is an entirely NHS-based service and is well used by the psychiatrists in the region. The Director of the clinic is a psychiatrist and there is a cohesive group consisting of a plastic surgeon, gynaecologist (who supervises medication) and a speech therapist. The clinic has won the recognition of the Leeds Community & Mental Health Services Teaching NHS Trust which supports its continuation. An audit of outcome of the first 12 male to female reassignment procedures was conducted by a independent assessor. The result gave the team clear indication that the work should continue. A plea is made for the establishment of more regional services.