**Sharp Rise in Children Awaiting Gender Care: Waiting List Figures Up 12% Across England and Wales**
The backlog of children hoping to access gender-related care through NHS services in England and Wales has grown notably over the past year, with the number of young people on waiting lists rising by 12% according to newly released data. The latest figures, covering the period up to the end of March, reveal that a total of 6,225 children are now waiting to be seen—a significant increase from the 5,560 registered during the same period in the preceding year.
An area of particular concern is the number of very young children waiting for support. Of those currently on the waiting lists, 157 are aged under 10. While the majority are older children and teenagers, NHS England has confirmed that fewer than 10 of those waiting are under the age of five, although exact figures are withheld to protect patient confidentiality.
The average wait time for a first appointment at a specialist NHS gender care clinic for children has also worsened, now standing at more than two years. The latest data shows families can expect to wait an average of 116 weeks before their child is assessed for the first time. Twelve months earlier, that figure was just under 100 weeks, reflecting growing pressure on existing services and a rise in demand that currently outpaces available appointments.
Healthcare professionals and advocacy groups have expressed concern about the impact of these delays. The British Psychological Society described the situation as troubling, highlighting how it is “essential that children, young people, and their families can access professional care and support before they reach crisis point”. The organisation strongly believes that increased resources are needed to keep pace with the rising demand.
NHS England is currently in the midst of a major restructuring in response to both growing demand and recommendations from last year’s high-profile Cass Review. Two new regional “gender hubs” for children, operated by London’s Great Ormond Street Hospital and Liverpool’s Alder Hey Children’s Hospital, opened their doors in April 2024. A third clinic has since launched in Bristol, with further clinics planned, including one in the East of England later this spring. The long-term ambition is to establish up to eight specialist clinics covering all NHS regions across England.
The national waiting list encompasses children in Wales as well, as there is currently no dedicated children’s gender clinic in that nation. Reports indicate that of the 6,225 children waiting for care, a portion are Welsh residents accessing England-based services.
Recent changes to the referral pathway, prompted by the findings of the Cass Review, stipulate that all new referrals must first be seen by a GP, mental health specialist or paediatrician. This approach is intended to ensure that children are given holistic care tailored to their needs, rather than a purely medical model, and to provide relevant mental health support while they wait for specialist appointments. Professor James Palmer, NHS medical director for specialised services, emphasised the importance of these reforms, stating that families can now access referral-specific mental health support as an interim measure.
Another significant development has been the permanent NHS ban on prescribing puberty blockers for the treatment of gender dysphoria in children. This agreement, made last December and endorsed across the devolved UK governments, means such medication will not be available outside clinical trials. Plans for such a trial remain active, although no participants have been recruited to date as ethical and regulatory processes are still underway.
A spokesperson for the Department of Health and Social Care underlined that the government is pressing ahead with reforms in line with the Cass Review’s recommendations. The establishment of regional centres is expected to not only expand clinical capacity but also ease some of the strain on waiting times, ultimately allowing children to be seen sooner and in a location closer to their home.
As the NHS continues its service expansion, the situation remains dynamic, with all eyes on how rapidly new capacity can be brought online to meet the needs of these vulnerable young patients and their families. Discussions continue over how best to balance immediate support with long-term clinical developments, as professionals, patients, and policymakers grapple with the realities of an overstretched system.