A recent review of the NHS’s gender services for children, conducted by consultant paediatrician Hilary Cass, proposes a dramatic shift in the type of treatment offered to children and young people with gender dysphoria. Here are the key findings:
Holistic Assessment: Instead of primarily focusing on medical treatment, young people referred to NHS gender services should now “receive a holistic assessment of their needs to inform an individualized care plan.” This means that questions of gender identity should be considered alongside other possible mental health concerns. The review emphasizes the importance of addressing wider mental health and psychosocial challenges, including screening for neurodevelopmental conditions like autism spectrum disorder1.
Beyond Medical Pathways: The report suggests that a medical pathway (such as puberty blockers) may not always be the best option for children with gender dysphoria. It should not be provided “without also addressing wider mental health and/or psychosocially challenging problems.” This approach aims to consider the overall well-being of the individual1.
Positive Reception: Medical experts, including Dr. Lade Smith (President of the Royal College of Psychiatrists), have welcomed the idea of holistic assessments. Dr. Smith emphasizes that children questioning their gender often experience mental illness, and timely access to services that respond to individual needs is crucial.
However, implementing these changes will have significant implications for wider children’s mental health services, which are already overstretched. The waiting lists for gender-affirming care on the NHS are alarmingly long. As of August 2022, approximately 26,234 adults and 7,600 children were waiting for their first appointment with gender dysphoria clinics, with many waiting more than 18 weeks. Urgent improvements are needed to address this backlog and provide timely support for those seeking gender-affirming care.
For more details, you can refer to the full report by Hilary Cass. The NHS is also planning a review into adult gender services to further guide and shape gender-affirming care in England.
As of April 2024, the waiting times for gender-affirming care in the UK can be quite lengthy due to high demand. Here’s an overview of the waiting times for various gender services:
Belfast: Approximately 75 months to be seen.
Belfast KOI: Around 24 months.
Cardiff: Waiting time is approximately 15 months for the first appointment, and less than 12 months to get hormones.
Edinburgh: Approximately 23 months.
Exeter: Awaiting time is 88 months for the first appointment and 12 months to receive hormones.
Glasgow: About 65 months.
Glasgow Youth: Waiting time is approximately 58 months.
Grampian: Around 24 months for the first appointment and 12 months for hormones.
Inverness: Approximately 29 months1.
Leeds: Waiting time is approximately 58 months, with a 10-month wait for hormones.
London Gender Identity Clinic (GIC): Approximately 61 months for the first appointment and 10 months for hormones.
London Gender Identity Development Service (GIDS): Not currently accepting new patients1.
London TransPlus: Details not specified.
Newcastle: Not currently accepting new patients.
Northants: Approximately 53 months for the first appointment and 9 months for hormones1.
Nottingham: Waiting time is approximately 27 months for the first appointment and 11 months for hormones.
Sheffield: Approximately 65 months for the first appointment and 16 months for hormones1.
The Northern Hub: Opening in 2024.
The Southern Hub: Also opening in 2024.
For youth services, the wait times as of October 2023 are as follows:
Belfast KOI: Around 24 months.
Cardiff: Waiting time is approximately 15 months for the first appointment, and less than 12 months to get hormones.
Edinburgh: Approximately 23 months.
Exeter: Awaiting time is 88 months for the first appointment and 12 months to receive hormones.
Glasgow: About 65 months.
Glasgow Youth: Waiting time is approximately 58 months.
Grampian: Around 24 months for the first appointment and 12 months for hormones.
Inverness: Approximately 29 months1.
Leeds: Waiting time is approximately 58 months, with a 10-month wait for hormones.
London Gender Identity Clinic (GIC): Approximately 61 months for the first appointment and 10 months for hormones.
London Gender Identity Development Service (GIDS): Not currently accepting new patients1.
London TransPlus: Details not specified.
Newcastle: Not currently accepting new patients.
Northants: Approximately 53 months for the first appointment and 9 months for hormones1.
Nottingham: Waiting time is approximately 27 months for the first appointment and 11 months for hormones.
Sheffield: Approximately 65 months for the first appointment and 16 months for hormones1.
The Northern Hub: Opening in 2024.
The Southern Hub: Also opening in 2024.
For youth services, the wait times as of October 2023 are as follows:
England & Wales: Up to 5 years for the first appointments, with a queue length of 7902+.
Scotland: Approximately 4.5 years.
Northern Ireland: Around 2 years, with a queue length of 451.
It’s important to note that these waiting times are subject to change, and demand continues to increase over time. While waiting, consider seeking mental health support, and explore free UK-based services through your GP referral.
Scotland: Approximately 4.5 years.
Northern Ireland: Around 2 years, with a queue length of 451.
It’s important to note that these waiting times are subject to change, and demand continues to increase over time. While waiting, consider seeking mental health support, and explore free UK-based services through your GP referral.