Waiting list for gender care for children has increased after opening of new specialist centres

The national waiting list for gender services for children in England and Wales has increased following the opening of two new specialist centres, with more than 5,700 children under the age of 18 waiting an average of 100 weeks for a first appointment.

The two services, run by Great Ormond Street Hospital in London (Gosh) and Alder Hey Children’s Hospital in Liverpool, opened in April following the closure of the Gender Identity Development (Gids) service, run by the Tavistock and Portman NHS Foundation Trust.

In total, the new centres have admitted 236 Gids patients, but thousands of children are still waiting for an appointment, according to data from PA Media.

Experts have described the figures as “worrying” and “deeply depressing” as they highlight the importance of “timely access to the professional care and support that children and young people need”.

NHS England acknowledged the concerns and stress that long waits can cause, but said plans being drawn up soon will help transform gender care services.

When Gids closed at the end of March, the number of children on the national waiting list was 5,560.

By the end of May, this number had risen to 5,769. The youngest person on the waiting list at that time was under five years old, as appears from the PA’s requests under the Government Information (Public Access) Act (Wob).

The exact age was not disclosed because it concerns personal data from third parties, NHS England said.

Of the 127 patients transferred from Gids to the Gosh gender service, all had a first appointment at the end of May.

Alder Hey said all 109 patients transferred from Gids to the gender service would be given a first appointment between the opening and June 30.

The two new centres, which currently serve patients across England and Wales, employ around 40 full-time equivalent (FTE) staff, figures show.

When it opened, the Alder Hey branch had 7.8 full-time employees. This number has now risen to 15.7 on May 31.

At opening, the Gosh hub had 14.63 full-time employees, which had risen to 24.23 by the end of June.

The figures do not relate to the number of employed persons, but to the number of full-time equivalents. This allows the staff of both clinics to be compared.

In its response to the Cass inquiry in April, NHS England acknowledged that the “transformation and expansion” of its gender care service “will take time to fully realise, and the pace of progress will continue to be affected by staffing issues”.

NHS England has previously said it hopes the two centres will be the first of up to eight specialist centres to form part of the northern and southern hubs over the next two years.

It is reported that the Joint Commissioning Committee of NHS Wales hopes to work with NHS England in the future to open a regional centre in Wales.

In her final report, Dr Hilary Cass said the length of the waiting list for access to gender services was having “significant consequences” for children and their families.

She recommended a model of care that was “holistic and personalized” and potentially included a wide range of interventions and services, including pediatric and mental health care.

The NHS plan for implementing the Cass recommendations is expected to be published shortly.

Dr Roman Raczka, President of the British Psychological Society, said: “These latest figures make for worrying reading. It is vital that children and young people have access to the professional care and support they need in a timely manner.

“We must not forget that behind the numbers, the headlines and the often toxic public debate are children and young people who need care.

“Too often, the issue of gender care playing out in the open has been detrimental to the children, young people and families desperate for help. This must change.”

Ashley Grossman, an endocrinologist who has practiced for more than 40 years and has treated adult transgender patients, described the waitlist numbers for children as “very depressing” but said they “probably reflect the huge gap overall between the needs for mental health care for children and the resources available.”

The emeritus professor of endocrinology at the University of Oxford said: “There seems to be a big increase in demand for these services, particularly since the isolation and loss of schooling during the pandemic, so I suspect this is a much wider issue than just for children with gender dysphoria.”

An NHS spokesperson said: “We know that children, young people and their families are concerned and distressed about the time it can take to access treatment and support from gender services.

“NHS England is making good progress in implementing the recommendations of the Cass review – expanding services with two new specialist centres that opened in April, with more to follow. We will soon be setting out more detailed plans for how all the recommendations of the Cass review will be implemented to transform the delivery of gender services.”

A Department of Health and Social Care spokesperson said: “For too long, children and young people who are questioning their gender identity have struggled to get the support they need.

“We are working with NHS England to transform gender identity services to tackle waiting times and ensure everyone receives holistic care, guided by clinical experts, paediatricians and psychologists.”