Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, in light of the finding of the Levy Review that adult Gender Dysphoria Clinics collect no systematic data on benefits, harms, regret, or detransition, what assessment they have made of the treatment offered by those clinics.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The information requested in HL3448, HL3450, and HL3451 is not centrally held by the Department.
With regard to HL3449, patients can complain directly to the provider that treated them or to NHS England, as the commissioner of adult gender services. They can also raise concerns with the Care Quality Commission or Healthwatch. If they remain unhappy after completing the National Health Service complaints process, they can ask the Parliamentary and Health Service Ombudsman to investigate. Information regarding the number of complaints received is not held centrally.
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what complaint mechanisms exist for patients who consider themselves harmed by treatment received at an adult Gender Dysphoria Clinic to raise concerns; and whether any such complaints have been received in the last three years.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The information requested in HL3448, HL3450, and HL3451 is not centrally held by the Department.
With regard to HL3449, patients can complain directly to the provider that treated them or to NHS England, as the commissioner of adult gender services. They can also raise concerns with the Care Quality Commission or Healthwatch. If they remain unhappy after completing the National Health Service complaints process, they can ask the Parliamentary and Health Service Ombudsman to investigate. Information regarding the number of complaints received is not held centrally.
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps NHS England takes to establish the clinical status and outcomes of patients who cease to attend an adult Gender Dysphoria Clinic before treatment is recorded as complete.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The information requested in HL3448, HL3450, and HL3451 is not centrally held by the Department.
With regard to HL3449, patients can complain directly to the provider that treated them or to NHS England, as the commissioner of adult gender services. They can also raise concerns with the Care Quality Commission or Healthwatch. If they remain unhappy after completing the National Health Service complaints process, they can ask the Parliamentary and Health Service Ombudsman to investigate. Information regarding the number of complaints received is not held centrally.
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimate they have made of the number of patients who have discontinued treatment, expressed regret, or detransitioned following care at an adult Gender Dysphoria Clinic in the NHS.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The information requested in HL3448, HL3450, and HL3451 is not centrally held by the Department.
With regard to HL3449, patients can complain directly to the provider that treated them or to NHS England, as the commissioner of adult gender services. They can also raise concerns with the Care Quality Commission or Healthwatch. If they remain unhappy after completing the National Health Service complaints process, they can ask the Parliamentary and Health Service Ombudsman to investigate. Information regarding the number of complaints received is not held centrally.
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the reliance of the NHS adult gender service specification on the World Professional Association for Transgender Health's standards of care; and whether they consider that reliance remains appropriate.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has committed to implement the Cass Review's recommendation for a dedicated detransition service, and will hold a public consultation on a proposed service specification in the autumn of 2027, for adoption in 2027/28.
The NHS service specification for adult gender services was published in 2019, following an extensive public consultation in 2017, respondents to which included United Kingdom professional medical bodies and health regulators. A similar process of public consultation on a proposed new service specification will be held later in 2027/28 building on the findings and recommendations of the report of the National Operational and Delivery Review of Adult Gender Services published in December 2025.
The arrangements for referral for surgery, and the funding of that surgery, are consistent with those for other specialised services. Upon a confirmed diagnosis of gender dysphoria, an NHS-commissioned specialist multi-disciplinary Adult Gender Service may make a referral to a specialist surgical team who will assess the patient's suitability for surgery and communicate that decision to the Adult Gender Service. Processes are in place to ensure that patients are fully informed of potential risks and benefits in order to give informed consent both to the initial referral for surgery and to the surgical intervention.
The following table shows the number of NHS referrals for chest reconstructive surgery which were made in each of the last three years, broken down by age group. Please note that the number of referrals that were assessed as suitable for surgery will be lower and that these numbers include patients from England, Northern Ireland, Wales, and Scotland:
Age at date of referral | 2023/24 | 2024/25 | 2025/26 |
<18 | 0 | 0 | 0 |
18 - 20 | 207 | 205 | 171 |
21 - 24 | 506 | 448 | 426 |
25 - 29 | 300 | 302 | 322 |
30 - 39 | 167 | 157 | 169 |
40 - 49 | 34 | 31 | 40 |
>49 | 25 | 16 | 16 |
The following table shows the number of NHS referrals for genital surgery which were made in each of the last three years, broken down by age group:
Age at date of referral | 2023/24 | 2024/25 | 2025/26 |
<18 | 0 | 0 | 0 |
18 - 20 | 48 | 35 | 45 |
21 - 24 | 281 | 233 | 232 |
25 - 29 | 365 | 375 | 371 |
30 - 39 | 361 | 323 | 301 |
40 - 49 | 137 | 129 | 117 |
>49 | 172 | 159 | 129 |
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether providers of gender surgery receive funding from a national budget separate from standard commissioning arrangements; and what assessment they have made of any financial incentives this creates.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has committed to implement the Cass Review's recommendation for a dedicated detransition service, and will hold a public consultation on a proposed service specification in the autumn of 2027, for adoption in 2027/28.
The NHS service specification for adult gender services was published in 2019, following an extensive public consultation in 2017, respondents to which included United Kingdom professional medical bodies and health regulators. A similar process of public consultation on a proposed new service specification will be held later in 2027/28 building on the findings and recommendations of the report of the National Operational and Delivery Review of Adult Gender Services published in December 2025.
The arrangements for referral for surgery, and the funding of that surgery, are consistent with those for other specialised services. Upon a confirmed diagnosis of gender dysphoria, an NHS-commissioned specialist multi-disciplinary Adult Gender Service may make a referral to a specialist surgical team who will assess the patient's suitability for surgery and communicate that decision to the Adult Gender Service. Processes are in place to ensure that patients are fully informed of potential risks and benefits in order to give informed consent both to the initial referral for surgery and to the surgical intervention.
The following table shows the number of NHS referrals for chest reconstructive surgery which were made in each of the last three years, broken down by age group. Please note that the number of referrals that were assessed as suitable for surgery will be lower and that these numbers include patients from England, Northern Ireland, Wales, and Scotland:
Age at date of referral | 2023/24 | 2024/25 | 2025/26 |
<18 | 0 | 0 | 0 |
18 - 20 | 207 | 205 | 171 |
21 - 24 | 506 | 448 | 426 |
25 - 29 | 300 | 302 | 322 |
30 - 39 | 167 | 157 | 169 |
40 - 49 | 34 | 31 | 40 |
>49 | 25 | 16 | 16 |
The following table shows the number of NHS referrals for genital surgery which were made in each of the last three years, broken down by age group:
Age at date of referral | 2023/24 | 2024/25 | 2025/26 |
<18 | 0 | 0 | 0 |
18 - 20 | 48 | 35 | 45 |
21 - 24 | 281 | 233 | 232 |
25 - 29 | 365 | 375 | 371 |
30 - 39 | 361 | 323 | 301 |
40 - 49 | 137 | 129 | 117 |
>49 | 172 | 159 | 129 |
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the practice of referrals for irreversible surgery being made by non-surgical clinicians in gender services; and in what other areas of NHS medicine this practice occurs.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has committed to implement the Cass Review's recommendation for a dedicated detransition service, and will hold a public consultation on a proposed service specification in the autumn of 2027, for adoption in 2027/28.
The NHS service specification for adult gender services was published in 2019, following an extensive public consultation in 2017, respondents to which included United Kingdom professional medical bodies and health regulators. A similar process of public consultation on a proposed new service specification will be held later in 2027/28 building on the findings and recommendations of the report of the National Operational and Delivery Review of Adult Gender Services published in December 2025.
The arrangements for referral for surgery, and the funding of that surgery, are consistent with those for other specialised services. Upon a confirmed diagnosis of gender dysphoria, an NHS-commissioned specialist multi-disciplinary Adult Gender Service may make a referral to a specialist surgical team who will assess the patient's suitability for surgery and communicate that decision to the Adult Gender Service. Processes are in place to ensure that patients are fully informed of potential risks and benefits in order to give informed consent both to the initial referral for surgery and to the surgical intervention.
The following table shows the number of NHS referrals for chest reconstructive surgery which were made in each of the last three years, broken down by age group. Please note that the number of referrals that were assessed as suitable for surgery will be lower and that these numbers include patients from England, Northern Ireland, Wales, and Scotland:
Age at date of referral | 2023/24 | 2024/25 | 2025/26 |
<18 | 0 | 0 | 0 |
18 - 20 | 207 | 205 | 171 |
21 - 24 | 506 | 448 | 426 |
25 - 29 | 300 | 302 | 322 |
30 - 39 | 167 | 157 | 169 |
40 - 49 | 34 | 31 | 40 |
>49 | 25 | 16 | 16 |
The following table shows the number of NHS referrals for genital surgery which were made in each of the last three years, broken down by age group:
Age at date of referral | 2023/24 | 2024/25 | 2025/26 |
<18 | 0 | 0 | 0 |
18 - 20 | 48 | 35 | 45 |
21 - 24 | 281 | 233 | 232 |
25 - 29 | 365 | 375 | 371 |
30 - 39 | 361 | 323 | 301 |
40 - 49 | 137 | 129 | 117 |
>49 | 172 | 159 | 129 |
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many NHS referrals for (1) mastectomy, and (2) genital surgery as treatment for gender dysphoria, were made in each of the last three years, broken down by age group.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has committed to implement the Cass Review's recommendation for a dedicated detransition service, and will hold a public consultation on a proposed service specification in the autumn of 2027, for adoption in 2027/28.
The NHS service specification for adult gender services was published in 2019, following an extensive public consultation in 2017, respondents to which included United Kingdom professional medical bodies and health regulators. A similar process of public consultation on a proposed new service specification will be held later in 2027/28 building on the findings and recommendations of the report of the National Operational and Delivery Review of Adult Gender Services published in December 2025.
The arrangements for referral for surgery, and the funding of that surgery, are consistent with those for other specialised services. Upon a confirmed diagnosis of gender dysphoria, an NHS-commissioned specialist multi-disciplinary Adult Gender Service may make a referral to a specialist surgical team who will assess the patient's suitability for surgery and communicate that decision to the Adult Gender Service. Processes are in place to ensure that patients are fully informed of potential risks and benefits in order to give informed consent both to the initial referral for surgery and to the surgical intervention.
The following table shows the number of NHS referrals for chest reconstructive surgery which were made in each of the last three years, broken down by age group. Please note that the number of referrals that were assessed as suitable for surgery will be lower and that these numbers include patients from England, Northern Ireland, Wales, and Scotland:
Age at date of referral | 2023/24 | 2024/25 | 2025/26 |
<18 | 0 | 0 | 0 |
18 - 20 | 207 | 205 | 171 |
21 - 24 | 506 | 448 | 426 |
25 - 29 | 300 | 302 | 322 |
30 - 39 | 167 | 157 | 169 |
40 - 49 | 34 | 31 | 40 |
>49 | 25 | 16 | 16 |
The following table shows the number of NHS referrals for genital surgery which were made in each of the last three years, broken down by age group:
Age at date of referral | 2023/24 | 2024/25 | 2025/26 |
<18 | 0 | 0 | 0 |
18 - 20 | 48 | 35 | 45 |
21 - 24 | 281 | 233 | 232 |
25 - 29 | 365 | 375 | 371 |
30 - 39 | 361 | 323 | 301 |
40 - 49 | 137 | 129 | 117 |
>49 | 172 | 159 | 129 |
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government when NHS England will decide whether to commission a dedicated service for patients who detransition; and what criteria will inform that decision.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has committed to implement the Cass Review's recommendation for a dedicated detransition service, and will hold a public consultation on a proposed service specification in the autumn of 2027, for adoption in 2027/28.
The NHS service specification for adult gender services was published in 2019, following an extensive public consultation in 2017, respondents to which included United Kingdom professional medical bodies and health regulators. A similar process of public consultation on a proposed new service specification will be held later in 2027/28 building on the findings and recommendations of the report of the National Operational and Delivery Review of Adult Gender Services published in December 2025.
The arrangements for referral for surgery, and the funding of that surgery, are consistent with those for other specialised services. Upon a confirmed diagnosis of gender dysphoria, an NHS-commissioned specialist multi-disciplinary Adult Gender Service may make a referral to a specialist surgical team who will assess the patient's suitability for surgery and communicate that decision to the Adult Gender Service. Processes are in place to ensure that patients are fully informed of potential risks and benefits in order to give informed consent both to the initial referral for surgery and to the surgical intervention.
The following table shows the number of NHS referrals for chest reconstructive surgery which were made in each of the last three years, broken down by age group. Please note that the number of referrals that were assessed as suitable for surgery will be lower and that these numbers include patients from England, Northern Ireland, Wales, and Scotland:
Age at date of referral | 2023/24 | 2024/25 | 2025/26 |
<18 | 0 | 0 | 0 |
18 - 20 | 207 | 205 | 171 |
21 - 24 | 506 | 448 | 426 |
25 - 29 | 300 | 302 | 322 |
30 - 39 | 167 | 157 | 169 |
40 - 49 | 34 | 31 | 40 |
>49 | 25 | 16 | 16 |
The following table shows the number of NHS referrals for genital surgery which were made in each of the last three years, broken down by age group:
Age at date of referral | 2023/24 | 2024/25 | 2025/26 |
<18 | 0 | 0 | 0 |
18 - 20 | 48 | 35 | 45 |
21 - 24 | 281 | 233 | 232 |
25 - 29 | 365 | 375 | 371 |
30 - 39 | 361 | 323 | 301 |
40 - 49 | 137 | 129 | 117 |
>49 | 172 | 159 | 129 |
Asked by: Baroness Maclean of Redditch (Conservative - Life peer)
Question to the Department for Work and Pensions:
To ask His Majesty's Government, further to the Written Answers by Baroness Sherlock on 30 June (HL116 and HL117), whether the training programmes for case managers and healthcare professionals include the identification of false letters sent to PIP assessors.
Answered by Baroness Sherlock - Minister of State (Department for Work and Pensions)
"Relevant partners" refers to charities and organisations with expertise in disability benefits, welfare rights and claimant support, such as Citizens Advice.
As part of keeping this area under review, the Department will continue to consider evidence about the activity of commercial providers and any poor practice, including where this may affect the quality or reliability of evidence submitted in support of Personal Independence Payment (PIP) claims.
Healthcare Professionals (HPs) and Case Managers are required to undertake a detailed review of all available evidence as part of the assessment and decision-making process and to assess the consistency, relevance and sufficiency of the information provided in support of a claim.
The PIP Assessment Guide requires HPs to consider any inconsistencies in the evidence available, determine whether further supporting evidence is required, and record the rationale for the conclusions reached. Where appropriate, HPs may seek additional evidence from professionals involved in the claimant’s care, including GPs, hospital clinicians and other relevant practitioners, to help inform their advice to DWP.
DWP is focussed on preventing fraud and error from entering the system and has robust detect and correct capabilities in place to address inaccurate payments at the earliest opportunity.