The review by Dr David Levy of all nine NHS adult gender dysphoria clinics (GDCs) in England was commissioned by NHSE in June 2024 in response to a recommendation in the Cass Review Final Report.

Dr Levy said care provision ‘does not meet the service specification, nor does it meet the needs of the current patient cohort' due to ‘failings within the services themselves, as well as in part from the long-term effects of demand far outstripping supply and a lack of joined-up care across the wider healthcare system'.

Health and social care secretary Wes Streeting pledged the Government would prioritise a key set of the review's recommendations by:

• creating a new single, national waiting list for adult gender services to be implemented in April 2026
• raising the referral threshold to 18 years to align with the age of discharge from the NHS Children and Young People's Service
• bringing an end to self-referrals into the service and, in parallel, providing advice and guidance for those finding it difficult to secure a referral
• establishing challenging but achievable productivity goals for every service which can then guide and inform the commissioning of additional services, underpinned by a clear understanding of the regional demand through the national waiting list.

Streeting said: ‘This Government has always made clear that anyone accessing gender services deserves the highest quality of care and support, and to be treated with dignity and respect. The publication of this review marks a significant step forward in our commitment to ensuring safe, effective, and evidence-based care for anyone accessing gender dysphoria services across the NHS.'