Transgender People: Provision of Healthcare

Nadia Whittome Excerpts

Tuesday 16th December 2025 Westminster Hall

[Nadia Whittome (Nottingham East) (Lab)]

It is a pleasure to serve under your chairship, Mr Turner. I thank my hon. Friend the Member for North Warwickshire and Bedworth (Rachel Taylor) for securing this important debate and for all her work to champion trans rights in this place.

First, I want to speak about the delivery of general medical care to trans people and the discrimination they experience. Constituents have told me how unrelated health problems have been attributed to them being trans. One person described this as “exhausting and frightening”, stating that it discourages them from seeking help. Meanwhile, 14% of respondents to a survey by TransActual reported that they had been refused GP care on account of being trans. One trans man told the Nottingham Pastel Project that he had been turned away for a cervical smear and treatment for a urinary tract infection.

The second issue I want to raise is the difficulty of accessing gender-affirming care. Trans people will be the first to say that the delivery of gender-affirming care in this country is deeply flawed and in need of serious reform. Instead of taking their experiences as the starting point, discussions about trans healthcare have been rooted in transphobia, misinformation and moral panic. Meanwhile, waiting times for gender-affirming care stretch into years. One Nottingham resident said that they waited seven years for a diagnosis. Another has been waiting for an appointment with a gender identity clinic for five and a half years. Someone who joined the waiting list two years ago has been told to expect to wait a further four years.

Faced with an eight-year wait for gender-affirming surgery on the NHS, one trans person in my city worked two full-time jobs, sold their car and held fundraising events to cobble together £20,000 so they could have that surgery abroad. They are emphatic that it saved their life, but they should never have been forced to go through that ordeal just to access healthcare.

Reports of GPs denying gender-affirming care have increased dramatically. One constituent told me they had huge problems finding a private gender clinic with which their GP would do shared care, and that delayed their treatment by six months. Another Nottingham resident who was on testosterone for more than a decade has not received a single dose in 16 months because their GP has refused to prescribe it. I could go on and on with examples just from my city, and I have not even spoken about the appalling situation that trans people under 18 face.

It is clear that the Government must act, from increasing funding for gender-affirming healthcare to improving training for GPs, modernising assessment and treatment pathways and ensuring co-production of services with trans patients, because this is an emergency. Inadequate healthcare is ruining trans people’s physical health, their mental health and their lives. It cannot be allowed to continue.

--- Later in debate ---

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Mr Turner. I thank and congratulate my hon. Friend the Member for North Warwickshire and Bedworth (Rachel Taylor) on securing this important debate. Without giving away any state secrets, we are roughly the same age; I am not gay, but I also marched and campaigned against section 28—I remember those days from very early on.

I want to say from the outset that this Government stand for the important principle in our healthcare system—which has been echoed this afternoon by many Members—that everyone in our country deserves access to first-class healthcare. I will not rehearse here the mess that we inherited from the last Government; we do not have time. However, we are determined to ensure that what I have set out happens. If we are to make good on that principle, we must take account of the diverse needs of our society. That of course includes trans people and the wider lesbian, gay and bisexual community.

Colleagues are right to say that transgender people experience significant and specific health inequalities throughout their lives. As we have been reminded again this afternoon and should always bear in mind when we have debates in this place, these are real people’s lives. Many people are with us today in the Public Gallery, and I am sure that many others are watching online. That is why this Government have commissioned NHS England to undertake a health evidence review, led by Dr Michael Brady, the national adviser on LGBT health, whom I met in advance of this debate. He has held the position of adviser since 2019 and works as a sexual health and HIV consultant at King’s College hospital. I am pleased that he is doing that review. The work is considering how we can better understand lesbian, gay, bisexual and transgender healthcare needs and will provide a clearer picture of what the problems are—the data, the evidence—and how we need to address them.

That is particularly important in relation to preventive healthcare and the inequalities space. The Government have been very clear about our commitment to reversing the shocking health inequalities in this country. My hon. Friend the Member for Walthamstow (Ms Creasy) highlighted where there is good practice across the country. In addition, it is important to highlight the fact that despite the umbrella term of LGBT, needs are different in this group, and equality terms are covered by different aspects of the Equality Act 2010. All of this needs to be clearly evidenced and brought forward in the work to which I am referring. Lots of people asked this question: we anticipate that the findings of the evidence review will be finalised in the new year. We will then be considering those very carefully.

We have talked this afternoon about the fact that trans people—they are the subject of this debate—have unique health needs and specialist services to support them. This Government are improving specialist gender services for children, young people and adults in England. I recognise that those wishing to access gender services are waiting far too long for a first appointment. We are determined to change that, which is why NHS England has increased the number of adult gender dysphoria clinics in England from seven to 12, with the roll-out of five new pilot clinics since July 2020. These clinics are helping to tackle long waits, but we know that waiting times for these services can be distressing and are having a real impact on people’s wellbeing. To support those facing long waits, the Department of Health and Social Care has tendered for a new Waiting Well pilot. That will run for 12 months and provide those on the waiting list for the gender dysphoria clinic in the south-west region with access to support and information before appointments. The aim is for the pilot to launch in early 2026 and to inform plans for a national offer, subject to effective evaluation.

It is vital that transgender people are able to access the high-quality healthcare that they deserve. As we have heard, NHS England has asked Dr David Levy to carry out a review of adult gender services, because that was a specific recommendation from the Cass review of children and young people’s gender services. As an independent chair, Dr Levy will examine the model of care and operating procedures of each service, and is carefully considering feedback and outcomes from clinicians and patients. To respond to a number of questions this afternoon, that includes issues relating to shared care prescribing and monitoring of hormone medication. Dr Levy has been supported in his review by independent senior clinicians and professional bodies. I expect the review to be published shortly, and I know that my right hon. Friend the Secretary of State will inform the House as soon as that has happened, but let me assure Members here, and people listening to or reading about this debate, that we will use the review as a basis to improve NHS adult gender services.

Issues relating to children have been raised this afternoon. I know that children and young people’s gender services are a sensitive topic that elicits strong opinions, some of which we have heard today. Let me be very clear: we will take an evidence-based approach when it comes to the health and wellbeing of all children and young people. Their safety is our primary concern. We are committed to implementing the recommendations of the Cass review, to ensure that children who access these services receive the same high-quality care as any other child or young person accessing NHS services. We believe that the Cass review remains an excellent, evidence-based report. I urge all hon. Members to use it as their guide when making assertions, including in their understanding of gender dysphoria. We welcome that report and accept its work; it is our guidance for navigating healthcare for transgender young people.

It is still my understanding that the report is not supported by the Green party, and not properly supported by the Liberal Democrats, so when we talk about evidence, colleagues perhaps need to check and go back to the source report, because we are determined to follow the evidence and great work done by Hilary Cass.

NHS England has opened three new services in the north-west, London and the south-west, as we have heard. Those services operate under a fundamentally different and new clinical model, in which children and young people get the tailored and holistic care they need from multidisciplinary teams of experts in paediatrics, neurodiversity and mental health. A fourth service in the east of England is expected to open early in the new year. NHS England aims to open service provision in every region of England by 2026–27. That will help to further reduce waiting times and bring these services much closer to the homes of the children and young people who need them.

On puberty blockers and the pathways trial, the Cass review was clear that better quality evidence is critical to understanding the effects of puberty-suppressing hormones. That is why the NHS has removed them from children’s gender services, and why the Government have indefinitely banned them in private supply.

Dr Cass also recommended a clinical trial to understand the effects of these hormones, which is why the pathways trial has been established. In this controlled study, puberty suppression will be offered solely within the context of the comprehensive assessment and psychosocial support now offered by the NHS. The trial has undergone comprehensive review, has received independent scientific, ethical and regulatory approvals, and will soon open to recruitment.

I know that many hon. Members have strongly held views about this research. However, I want to be really clear that safeguarding the children and young people participating in this trial is our absolute priority. In response to the hon. Member for South West Devon (Rebecca Smith) on detransitioning, I will add that NHS England has called for evidence from people with lived experience and from professionals; I understand that the consultation closes on 28 December.

[Nadia Whittome]

Will the Minister give way?

[Karin Smyth]

I will finish.

I met Dr Sullivan recently to understand her report and how it impacts on the Department of Health and NHS England. My understanding is that each Department is looking at the recommendations of her review, and that it is important to have accurate data. I will ensure that the hon. Member for Sleaford and North Hykeham (Dr Johnson) gets an answer on whether there will be a formal Government response.

This Government were elected on a manifesto to bring down inequality. We are doing so through a number of different measures—on the soft drinks industry, free school meals, the generational ban on smoking and Awaab’s law. In her Budget, the Chancellor lifted half a million children out of poverty at the stroke of a pen.

We are determined to ensure that no one falls through the cracks of our health system, and we will give transgender people the care they deserve. I hope the actions I have set out today demonstrate our commitment to that goal and our focus on improving healthcare provision for transgender people, across all ages, based on good clinical scientific evidence. We will cut waiting lists for gender services, along with all other waiting lists, and ensure that healthcare is always evidence-based, improving health outcomes for trans people and the wider community.

Baby Loss

Nadia Whittome Excerpts

Monday 13th October 2025 Commons Chamber

[Nadia Whittome (Nottingham East) (Lab)]

I start by thanking Members for bringing this important debate and thanking those who have spoken so bravely about their own experiences of loss and harm. No matter how a baby dies or a wanted pregnancy ends, it is always deeply painful and traumatic for bereaved families, but their suffering is particularly exacerbated when the loss of a baby could have been prevented. I have constituents who tragically know that only too well.

Our city is at the centre of the largest maternity inquiry in NHS history and a corporate manslaughter investigation due to failings by Nottingham University Hospitals that have led to hundreds of baby deaths and injuries—hundreds of preventable tragedies. Many families are still waiting for answers. Many have faced contemptuous treatment, not just at the time of the loss or injury of their baby, but in the aftermath. These families have been institutionally gaslit, lied to and robbed of so much, and they are still having to fight for their children. Some have also faced abhorrent racism.

I pay tribute to the Nottingham affected families group for their unwavering determination to secure accountability and change. It is because of their tenacity that the review is happening at all. It has been a privilege to work with them, and I have been deeply moved by their strength and selflessness in fighting not only for their own families, but for others, in the face of such appalling institutional failures and systematic neglect. I also thank Donna Ockenden for agreeing to lead the review and for all her work so far—I am so grateful that families in Nottingham have such a champion fighting their corner.

Above all, there must be accountability for this scandal, and lessons must be learned so that no family has to go through such an avoidable tragedy again. While standards of care at NUH under new leadership have improved, they are still falling short, and further action must be taken to ensure that parents and babies receive the care that they deserve.

I welcome the Government’s launch of a national maternity investigation to examine maternity and neonatal services across England. This rapid review will consolidate previous inquiries’ findings and recommendations, with the aim of improving the quality and safety of maternity care. However, I am concerned that families in Nottingham do not feel that they were included in the meaningful way they were promised, and the Government must not simply wait for the outcome of this investigation before taking action. I am certain that the Secretary of State will act on that, and I thank him for his ongoing genuine commitment to this.

The Nottingham affected families group has been calling for the 22 national recommendations from the Shrewsbury and Telford Ockenden review to be implemented without delay. The families also want the role of oversight bodies, which are meant to hold trusts and healthcare professionals to account, to be scrutinised. The CQC must become a more visible organisation and it must be able to bring prosecutions more than three years after the offence occurred; the current limit is far too short, and it is denying people even a semblance of justice.

There is so much more to say, but in the last few seconds I want to pay tribute to charities in Nottingham founded by bereaved parents, particularly Zephyr’s and Forever Stars. These organisations are already doing the work of supporting grieving families, but they are operating on shoestring budgets and generally do not receive statutory funding. We need to see that change. We need to see statutory funding increase and for those allocating it to recognise that these charities are best placed to provide those services, as they have already built relationships of trust within our communities.

Oral Answers to Questions

Nadia Whittome Excerpts

Tuesday 25th March 2025 Commons Chamber

[Karin Smyth]

I thank the right hon. Gentleman for that question and for the work he has supported on behalf of his wife to raise awareness. Screening access and uptake are shockingly low across the country right now, and looking at that is a key part of what we need to do to ensure that women come forward for the screening test. The AI work will support the faster response time so that we can get women treated more quickly, and will absolutely form part of what we need to do in the coming years.

[Nadia Whittome (Nottingham East) (Lab)]

I want to put on the record my thanks to the Health Secretary for coming to Nottingham last week and meeting some of the families who have been harmed by extremely serious failings in maternity services at Nottingham University Hospitals NHS trust, and for his sincere commitment to them. It was clear just how moved he was by their stories. One of their asks is that the Government implement the 22 recommendations from the Shrewsbury and Telford Ockenden review, so I ask the Minister today to commit to doing that.

[Karin Smyth]

I know that my hon. Friend and other Members representing that area have supported the trust and particularly the families who have been affected. As she highlights, my right hon. Friend the Health Secretary visited last week and was deeply moved by those stories, and has committed to visiting again. The Government are working through those recommendations and will update the House shortly.

Health and Adult Social Care Reform

Nadia Whittome Excerpts

Monday 6th January 2025 Commons Chamber

[Wes Streeting]

Once again, the arsonist is complaining that the fire brigade is not doing a quick enough job. We are a bit sick of it on the Government Benches, but we are at least rolling up our sleeves, getting on with the job and making improvements, and we will continue to do that. I heard the same complaints about Darzi: “What can Darzi tell us that we did not already know?” Quite a lot, actually. The Conservatives should hang their heads in shame for it.

[Nadia Whittome (Nottingham East) (Lab)]

I thank the Secretary of State for his clear commitment to action. There are 131,000 vacancies in the social care sector, and low wages are the prime culprit. Last year, Unison found that three quarters of care staff who do home visits continue not to be paid for journey times between appointments. Will my right hon. Friend commit to ensuring both a £15-an-hour minimum wage in the social care sector, and paid travel time as a contractual requirement?

[Wes Streeting]

I thank my hon. Friend for that question. I am a proud member of Unison, and I am proud of its work to stand up for its workforce in the social care sector. She and Unison are absolutely right to argue that fair pay is essential to recruitment and retention. That is why I am delighted that the Deputy Prime Minister included fair pay agreements in the Employment Rights Bill in the first 100 days. I am looking forward to working with Unison, GMB and others to negotiate the first ever fair pay agreements for care professionals in this country.

Puberty-suppressing Hormones

Nadia Whittome Excerpts

Wednesday 11th December 2024 Commons Chamber

[Wes Streeting]

I do not agree with the hon. Member’s characterisation. A whole range of medicines are prescribed for a whole range of uses among a whole range of patient cohorts that may well be unsafe, inappropriate or ineffective for use by other patients with other conditions. That is a basic fact of medicine and, if I may say so, the hon. Member’s intervention is why we should listen to clinicians, not politicians.

[Nadia Whittome (Nottingham East) (Lab)]

I share the deep disappointment that many young trans people and their families will feel about the Health Secretary’s decision today. I know that many will be devastated by this news, and I know that they have communicated to the Health Secretary and his Department the huge concerns that they have about their wellbeing in the face of these restrictions. Too many young trans people are already in, or at high risk of, mental health crisis. What consideration has he given to the impact of this decision on their mental health?

[Wes Streeting]

Very heavy consideration—of all the considerations, it is the one that has weighed most heavily. As I said in my statement, trans people too often find themselves at the wrong end of the statistics on mental ill health, self-harm and suicide. I take those issues very seriously indeed.

What I would say to my hon. Friend, Members of this House, and campaigners—particularly online actors—is that a number of claims have been made about the data that are not borne out by the facts. In fact, I asked Professor Louis Appleby, the Government’s suicide prevention adviser, to examine the evidence for some of the claims made that there has been a large rise in suicide. His paper, published on 19 July, concluded as follows:

“The data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock.

The way that this issue has been discussed on social media has been insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide.

The claims that have been placed in the public domain do not meet basic standards for statistical evidence.

There is a need to move away from the perception that puberty-blocking drugs are the main marker of non-judgemental acceptance in this area of health care.

We need to ensure high quality data in which everyone has confidence, as the basis of improved safety”.

I would add that it is important that we make sure that these children and young people have access to good-quality mental health support, and I am working with NHS England to make sure that this is the case. This area is one in which all Members should tread carefully when engaging in debate.