An official review of NHS adult gender dysphoria clinics in England has found that waiting times for a first appointment could reach 15 years without improvements. The review, led by Dr David Levy, an NHS medical director and cancer specialist, also revealed a critical lack of outcomes data, making it impossible to judge the safety or effectiveness of treatments.
The report, commissioned after last year's Cass review on gender care for children, examined nine clinics. It found that patients currently wait an average of five years and seven months for a first assessment, with demand rising significantly. The absence of systematic outcome recording was described as 'unacceptable', as it prevents clinicians and patients from understanding which treatments work best.
Long waiting lists have driven some patients to self-source hormones from high-risk online providers abroad. Staff reported that by the time patients are seen, they may have relied on inaccurate online information. The review also noted that only 31.5% of patients were discharged after completing treatment, raising concerns about why others disengage.
The patient profile has shifted, with 57% of referrals now aged 18-25, and a higher proportion of neurodevelopmental conditions such as autism. The review called for robust research and national audits to address data gaps and improve care quality.
