Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure young people on waiting lists for gender affirming care are transitioned to adult waiting lists when they turn 18.

NHS England published a new service specification in August 2024 for the referral pathway of Children and Young People’s Gender Services. The service specification sets out that young people are removed from the waiting list for Children and Young People’s Gender Services once they reach the age of 17 years and nine months.

NHS England has determined that it is not clinically appropriate to directly transfer a young person onto the waiting list of an adult service. This is because, as a commissioner of health services rather than a provider, it has no direct knowledge of the aims and intentions of the individual young person in regard to their gender identity and how these may have changed while they were on the national waiting list.

Those who are removed from the national waiting list are advised to seek advice from their general practitioner, who is best placed to support the young person in considering the appropriateness of a referral to an adult Gender Dysphoria Clinic. Should a referral be made to the adult service, the original referral date to the children's service will be honoured for this purpose. As NHS Children and Young People’s Gender Services expand, this approach will be regularly reviewed.

In August, NHS England published an implementation plan detailing how it intends to implement recommendations from Dr Cass’s report. This includes establishing a follow through service for people aged between 17 and 25 years old. NHS England has started to explore with potential partner organisations the feasibility of establishing this service. The planning assumption is that this follow-through service will become operational no sooner than April 2025. Further development of the design of this part of care will be informed by NHS England’s systemic review of adult gender services.