Wales' First Minister Rhun ap Iorwerth has said a review into the Welsh Gender Service needs to be carried out "swiftly" following the pause of gender-affirming surgeries. He was asked if he supported the decision to pause all surgery commissioned by the service.
Background to the pause
On August 28, Cardiff and Vale University Health Board was asked by the NHS Wales Joint Commissioning Committee (NWJCC) to pause referrals for gender-affirming surgery and scheduled surgeries through the Welsh Gender Service while an independent clinical review is undertaken.
That came after a meeting on August 24 where the service was escalated to Level 3, a formal NHS process indicating that concerns have been identified which require increased oversight, monitoring and improvement action. It followed concerns indicating "significantly higher" rates of referral for gender-affirming surgery from the Welsh Gender Service compared with English gender services. Additional concerns were raised regarding aspects of referral and assessment processes.
Impact on patients
As a result, new referrals for gender-affirming surgery were paused, and surgical assessments and scheduled surgery relating to the Welsh Gender Service pathway were paused. An independent clinical review was ordered. Those awaiting surgery with appointments scheduled were told to attend meetings as planned and that psychological support would be available. Some have reported being due to arrive in hospital for surgeries only to be told they could not have long-awaited operations or were told planned surgeries were being paused while they were in hospital.
Political reactions
Plaid Cymru posted on Instagram that it would "press for answers". The post read: "Trans rights are human rights. The decision by the NHS Wales Joint Commissioning Committee to temporarily pause referrals for gender-affirming surgeries from the Welsh Gender Service has understandably caused deep distress and uncertainty for many in the trans community - particularly those awaiting surgery, and their families and loved ones. Plaid Cymru will continue to listen, press for answers from the NWJCC and ensure any review is undertaken swiftly and effectively - and always stand with Wales' trans community."
Backbench Plaid MS Matthew Jones, who represents Sir Fynwy Torfaen, posted a statement saying: "So what if Welsh gender affirming care referrals are higher than the rest of the UK? All this says to me is that Wales has been the last bastion of dignity and compassion against the snowballing transphobic rhetoric from the right wing media and unqualified commentators. Let's not forget the most important fact here: referrals are made by trained clinicians with relevant medical expertise. These doctors take time to listen to patients, assess their needs and understand their lifelong experiences before making a referral after lots of counselling and support."
Sara Rees, who represents Pen-y-bont Bro Morgannwg, shared a post saying: "Trans rights are human rights" and saying she was holding a meeting and she would share information gathered with the health minister Mabon ab Gwynfor.
First Minister's response
At a press conference on September 2, the First Minister said: "This is a decision—very important to understand—that has been taken by the Joint Commissioning Committee, not by Welsh Government. You referred to calls for resolutions. That is precisely what we in government want to see happening now. It will be based, and has to be based, on clinical considerations. That is all that can matter from a government point of view. What I absolutely sympathise with and am concerned for is those people—a small but significant number of people—who are very, very concerned and distressed now about the pace with which this pause in services came about. What we need to see, of course... there's not a pause in the psychological support and so on. It's really important that those individuals who are concerned today are given the support that they need but as a government, as pressing absolutely for resolutions now and getting a review, of course, swiftly—which is very, very important—we now wait and see what the clinical response is, because that is absolutely what we will follow, but with an enormous amount of sympathy and empathy for those people."
He said he had "no doubt" that the decision by the JCC was made "for the right reasons". "It was their decision to take. I'm not questioning their reasons why they took that decision and the quality of ground. What we need is to now go through that review swiftly so that we can find out what is happening. As a government—and I know many backbenchers are, too—we want to see that resolution being found quickly, because there are a number of very concerned individuals involved here."
He added: "We need to understand from a clinical point of view what has been going on here. Concerns were raised with the JCC. I am not questioning that at all. What we need to do now is find the results of the review that is being taken place to understand exactly what is behind the concerns that have arisen. We will focus on that clinical side of things; at the same time, we need to make sure that those people, with whom I absolutely sympathise, are given the support that they need at this very difficult time."
