Background: The Leeds Teaching Hospitals Northern Gender Identity Development Clinic is a supra regional centre for young people with a diagnosis of gender dysphoria. The service is jointly run with the Tavistock and Portman NHS Foundation Trust and University College London Hospital NHS Foundation Trust. We provide a highly specialised service for young people (up to 18 years of age) who are experiencing gender dysphoria and who have major concerns about their physical development through puberty. The young people are referred to the endocrine service following extensive assessments undertaken by the Tavistock Team. Since 2009 referral rates have increased 50% year on year with a 100% increase in 2016. Purpose: With increased referrals and waiting list pressures, we felt that the original model of practice did not meet the needs of the young people and their families. Furthermore, due to the physical interventions offered by the service it was felt a strong public health approach was required in order for the young people to be able to make informed decisions about their care. Methods: The original care pathway involved an initial 40-minute appointment with a paediatric endocrinologist followed by a two month nurse led telephone consultation prior to commencing any medical treatment. The aim was to change the model of practice in order to provide a better quality of care through a strategic public health approach. We aimed to implement and evaluate a new model where the clinical nurse specialists ran an education session alongside some clinical tests as the initial appointment. This was followed by a two-month review with a paediatric endocrinologist to discuss results and the young person's eligibility to commence hormone blocker treatment. Results: The new pathway of care is being positively evaluated by both the young person and the parent/caregiver. Post session questionnaires demonstrate that they feel more knowledgeable about the hormone blocker and also have a better understanding of the implications of any treatment on their fertility. Clinical Implications: From a clinical perspective it has reduced waiting lists, enabling the consultants to see the increasing number of review patients. From the clinical nurse specialist perspective it has allowed us to provide a more holistic model of care, utilising the highly specialised skills of the GID clinical nurse specialists. It is anticipated that the nurse led education session will support young people to make better informed decision about their ongoing care.