Improving access to gender reassignment surgery: The story so far

Recent figures show that as more referrals are being made to gender identity clinics and resources are stretched, some people are experiencing extensive waiting times for appointments.

We first heard about this issue in 2014 when local Healthwatch told us that people were experiencing long delays for gender reassignment surgery. We wrote to NHS England to highlight this problem, and to recommend a number of changes to help improve access to these services. Meanwhile, local Healthwatch have been working within their communities to understand people’s experiences and help improve access to services for transgender and non-binary people.

Whilst there is still a long way to go, some positive progress has been made to help ensure that people get the support they need, when they need it. Here we explore what has happened so far, and what needs to happen next.

Progress so far

The NHS has announced £6.5m of increased funding for gender identity services next year. This year services have already benefited from a £4.4m allocation, as well as additional funding to help bring waiting times down. In addition, Health Education England and NHS England are exploring ways to address recruitment gaps, staff retention issues, and training needs amongst teams delivering gender identity treatment.

NHS England has recognized the importance of listening to patients’ views in order to improve services and its intention to keep working with local Healthwatch to do so.

What are local Healthwatch doing?

Local Healthwatch have been working to help improve access to gender reassignment surgery for people across the country. Here are four examples of how they are working on the ground:

1. In Hampshire, Healthwatch have worked in partnership with Chrysalis, a charity supporting transitioning adults, to understand local people’s experiences. They have also worked together to raise awareness amongst Clinical Commissioning Groups and GPs of people’s needs whilst on the transgender journey.

2. Healthwatch Hertfordshire's work has led to the appointment of six local Transgender Champions, who raise awareness of the needs and experiences of the transgender community. GPs and local health care professionals in the area are also being given updated guidance on how to support transgender and non-binary people.

3. Healthwatch Devon published a report based on the experiences of 149 local people who spoke to them about their experiences of accessing support and treatment. It identified a number of areas for improvement, including waiting times, quality of information, and understanding about transgender issues.

4. Healthwatch Telford and Wrekin raised concerns with NHS England about delays to the development of the new Gender Identity protocol. This aims to create greater consistency in the way that gender identity services are created and is now likely to be introduced in September 2016.

What happens next?

Whilst strong progress has been made, there is still a long way to go to ensure that people get the treatment they need in a timely fashion. It is vital that the conversation continues between those with the power to improve access to gender identity services, and the transgender and non-binary community. Local Healthwatch will continue to listen to people’s concerns and to work with NHS England to scrutinise local systems and call for change.