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Case update 16 November 2022

Our challenge to trans healthcare delays: what you need to know

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We’ll be in court at the end of the month to challenge NHS England over long-standing, lengthy and unlawful delays to meeting the trans community’s healthcare needs.

On November 29 and 30, we and our co-claimants will be arguing that these waiting times – and other failures in trans healthcare services – are discriminatory and unlawful.

Here’s what you need to know about the case.

What’s the issue?

NHS England has a legal duty to see 92% of children and young people who are referred to the Gender Identity Development Service (GIDS), and adults referred to the Gender Dysphoria Clinics (GDCs, previously GICs) within 18 weeks.

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Despite this, the average waiting time for young people is nearly three years, with some waiting significantly longer. Similarly, many adults have faced wait times of four years or more.

This means thousands of people are being denied the specialist healthcare they need, which can have serious consequences for their mental health. Eva Echo, one of the claimants in this case, explained: “I would describe being on the waiting list as torture, and there were times when I felt that I may not even be alive long enough to receive my first appointment. Being on the waiting list was no comfort; I desperately needed help.”

These delays also mean teenagers are missing the short window of time in which they can secure puberty blockers, if they need them. With such a long wait for safe treatment, some feel they have no choice but to self-medicate with drugs purchased on the dark web.

This situation predates the pandemic by a long margin.

Why is this happening?

In England, it is almost impossible for trans people to get timely access to healthcare they are entitled to. One reason for this is the sheer lack of specialist centres.

There is just one service for trans young people in the whole of England, though the closure of this service and its replacement with a “localised approach” has been announced for Spring 2023. There are only a handful of services for adults.

The UK is an international outlier when it comes to the lack of trans healthcare, particularly for young people.

What are we doing about it?

We’re bringing a claim against NHS England alongside two adult claimants, Eva and Alex, two child claimants, and trans-led grassroots charity Gendered Intelligence, arguing that it is failing to fulfil its legal duty of offering a first appointment within 18 weeks.

We are also arguing that these waiting times are discriminatory, as the delays faced by trans people are far longer than those faced by other people waiting for treatment.

This is about individuals getting important and, in some cases, life saving care.

What are we hoping to achieve?

We are asking the court for a declaration that NHS England has been acting unlawfully in relation to its provision of healthcare to trans children and adults.

While we recognise the strain NHS England is under, it must fulfil its legal duty of offering a first appointment within 18 weeks.

The Government must start listening to trans people, their families and medical experts about the care they need and commission more services so people are not deprived of the healthcare and support that is readily available in other countries.

If you are in a position to support the fight for trans healthcare rights, you can donate here. We are grateful for your support.

You can read witness evidence from Gendered Intelligence, Eva Echo, Alex Harvey and Jo Maugham. Read our main grounds here.

You can also read the expert witness statement from academic specialist Dr Michael Toze, which provides important background to the case.