First reported 16 Feb 2022•Latest report 25 Jul 2024
Definition
What this concern includes
Includes failures in gender-affirming healthcare access and referral arrangements, including unclear national referral mechanisms, insufficient or poorly communicated service resources, delayed access, waiting-list barriers and failures to direct patients through the appropriate gender-service pathway.
Not included
Excludes clinical treatment quality or outcomes after gender-affirming healthcare has been accessed reliably.
Excludes generic mental-health, psychological-therapy or healthcare waiting-time concerns without a material gender-affirming healthcare access or referral connection.
Excludes failures concerning unrelated gender-based safeguarding or bullying processes.
Excludes neutral descriptions of gender services, referral pathways or available resources without an identified access, delay or reliability deficiency.
Reports
5
Distinct published reports
Individual concerns
8
A report can raise multiple concerns
Date range
2022–2024
First to latest report issue date
Stated actions
23
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
NHS England3
Cambridgeshire and Peterborough NHS Foundation Trust1
Cambridgeshire County Council1
Department of Health and Social Care1
London Adult Gender Identity Clinic1
National Referral Support Service1
North London NHS Foundation Trust1
Royal College of General Practitioners1
Surrey and Borders Partnership NHS Foundation Trust1
Executive non-departmental public body3
NHS trust3
Healthcare site2
English county council1
Health professional body1
Ministerial department1
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
North London
Concerns raised1
Excessively long waiting lists for first appointments at Gender Dysphoria clinics
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
Action
Work with NHS England and other providers to develop ways to reduce GIC waiting lists and support patients while waiting.
Stated by North London NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 29 July 2025.
Action
Conduct a review of adult Gender Dysphoria Clinic operations, service models, quality concerns and improvement actions.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 29 July 2025.
Action
Publish the adult Gender Dysphoria Clinic review report and its findings and recommendations.
Stated by Department of Health and Social CareStated plannedThe respondent said that this action was planned when they made their response on 29 July 2025.
Action
Develop a new service specification for adult Gender Dysphoria Clinics through public consultation.
Stated by Department of Health and Social CareStated plannedThe respondent said that this action was planned when they made their response on 29 July 2025.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Position
NHS England, as commissioner of specialised gender dysphoria services, is responsible for commissioning sufficient service capacity.
Stated by North London NHS Foundation TrustRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
Insufficient specialist clinical staff and increasing demand have prevented NHS England from commissioning enough capacity to meet waiting-time expectations.
Stated by North London NHS Foundation TrustUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Position
New clinical capacity cannot be built quickly because specialist staff require training and experience.
Stated by Department of Health and Social CareUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
East Sussex
Concerns raised4
Lack of clarity about national gender-service referral mechanisms and available resources
Long waits for access to gender services
Failure to refer young people awaiting gender services for specialist psychiatric support from CAMHS
Delays in access to specialist gender dysphoria treatment while on the GIDS waiting list
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.5
Action
Decide whether to require all Children and Young People’s Gender Service referrals to come through NHS secondary care after public consultation.
Stated by NHS EnglandStated plannedThe respondent said that this action was planned when they made their response on 9 May 2024.
Action
Establish new regional Children and Young People’s Gender Incongruence Services under an interim service specification.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 9 May 2024.
Action
Develop a substantive service specification strengthening infrastructure and regional links between specialist centres and local services.
Stated by NHS EnglandStated in progressThe respondent said that this action was in progress when they made their response on 9 May 2024.
Action
Send referral information for consenting patients to their local children and young people’s mental-health providers.
Stated by NHS Arden and Greater East Midlands Commissioning Support Unit (AGEM CSUStated plannedThe respondent said that this action was planned when they made their response on 9 May 2024.
Action
Decide whether to strengthen pre-referral relationships between gender services and local secondary-care services after public consultation.
Stated by NHS EnglandStated plannedThe respondent said that this action was planned when they made their response on 9 May 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Position
Clinical support for waiting-list patients is to be provided by their GPs or other local clinicians, not the administrative referral service.
Stated by NHS Arden and Greater East Midlands Commissioning Support Unit (AGEM CSURedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
NHS Arden and Greater East Midlands Commissioning Support Unit will respond separately to concerns within its commissioned waiting-list management role.
Stated by NHS EnglandRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
Expanding clinical capacity is constrained by shortages of suitable workforce potential in children’s and adult gender services, rather than funding.
Stated by NHS EnglandUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
East London
Concerns raised1
Very long waiting lists for Gender Identity Clinics
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.6
Action
Develop five pilot gender dysphoria services to expand clinical capacity and reduce established-clinic waiting lists.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 18 December 2023.
Action
Move the London and Greater Manchester pilot services to substantive seven-year contracts following positive evaluations.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 18 December 2023.
Action
Conduct the procurement process for a substantive Cheshire and Merseyside gender dysphoria service contract.
Stated by NHS EnglandStated in progressThe respondent said that this action was in progress when they made their response on 18 December 2023.
Action
Establish and fund the UK’s first accredited gender identity healthcare training programme.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 18 December 2023.
Action
Deploy £2.2 million of additional investment to established clinics for clinical-capacity expansion or direct patient support.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 18 December 2023.
Action
Refresh adult gender dysphoria service specifications, including consideration of service inefficiencies and further clinical-capacity expansion.
Stated by NHS EnglandStated plannedThe respondent said that this action was planned when they made their response on 18 December 2023.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Sufficient gender dysphoria clinic capacity cannot be commissioned because specialist clinical staff are unavailable amid increasing demand.
Stated by NHS EnglandUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
West Sussex, Brighton and Hove
Concerns raised1
Delays in access to gender-affirming healthcare
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.8
Action
Participate in the current review led by a former Royal College of Paediatrics and Child Health president.
Stated by Royal College of General PractitionersStated completedThe respondent said that this action was complete when they made their response on 11 December 2023.
Action
Develop innovative waiting-list reduction and patient-support measures, including nurse-led triage and peer-support worker roles.
Stated by North London NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 11 December 2023.
Action
Commission and deliver an accredited postgraduate training programme in gender identity healthcare.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 11 December 2023.
Action
Develop and fund five pilot services to expand gender dysphoria clinical capacity and reduce established-clinic waiting lists.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 11 December 2023.
Action
Move the London and Greater Manchester pilot services to substantive seven-year NHS England contracts.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 11 December 2023.
Action
Run the tender for a substantive Cheshire and Merseyside gender service contract.
Stated by NHS EnglandStated in progressThe respondent said that this action was in progress when they made their response on 11 December 2023.
Action
Refresh adult gender dysphoria service specifications, including consideration of inefficiencies, further clinical-capacity expansion, and learning from pilot services.
Stated by NHS EnglandStated plannedThe respondent said that this action was planned when they made their response on 11 December 2023.
Action
Reconfigure children’s and young people’s specialised gender services, including closing the Tavistock service and establishing around seven regional services.
Stated by NHS EnglandStated plannedThe respondent said that this action was planned when they made their response on 11 December 2023.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
Decisions on specific therapy, including medication, are specialist responsibilities outside general practitioners’ scope of practice.
Stated by Royal College of General PractitionersOutside remitThe respondent said that this matter was outside its role or authority.
Position
Sufficient gender dysphoria service capacity could not be commissioned because specialist clinical staff were unavailable amid substantially increasing demand.
Stated by NHS EnglandUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Cambridgeshire and Peterborough
Concerns raised1
Delays in obtaining Gender Identity Clinic appointments
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Pin
Get email alerts
Request correction
Includes failures in gender-affirming healthcare access and referral arrangements, including unclear national referral mechanisms, insufficient or poorly communicated service resources, delayed access, waiting-list barriers and failures to direct patients through the appropriate gender-service pathway.
