Thousands waiting years to access gender services despite 12-week target

Thousands of people are waiting years to receive gender identity care in Scotland – despite the national target for wait times being just 12 weeks.

Data released by Public Health Scotland (PHS) shows 4,209 (75%) of the 5,640 people who are currently waiting for treatment have been doing so for up to three years.

The remaining 1,431 patients have been waiting more than three years, including 184 who have not been seen in more than five years.

The vast majority of those who have been waiting more than three years (98%) are waiting for an appointment at an NHS Greater Glasgow and Clyde adult or young person clinic.

The Scottish Government confirmed in April that wait times for gender identity services would fall under national targets.

This includes the target of 95% of outpatients waiting no longer than 12 weeks from referral to being seen.

The PHS data also shows the number of people attempting to access gender identity services is on the rise.

As of March, 5,640 people were waiting on a first outpatient appointment, a 7% increase from last year. That includes 4,643 adults and 997 young people.

At least 1,680 referrals were made over the last year, although PHS says that may be an undercount as people are transferred between clinics.

In 2023/24, 596 patients had an initial outpatient appointment at a gender identity service.

Nearly two-thirds (64%) of these were at NHS Lothian, while 23% were at the NHS Greater Glasgow and Clyde adult service, 7% were at NHS Grampian and 5% were at NHS Highland.

Less than 2% took place at the NHS Greater Glasgow and Clyde GIC for young people.

Vic Valentine, manager of Scottish Trans, described the wait times as “unbearable”.

They said: “It’s really important to remember that this data is talking about real people’s lives.

“It’s almost impossible to imagine how distressing it must be for someone who has already been waiting five years for an appointment and may still not have a date in sight.

“We know that people waiting for an appointment often struggle with their mental health and self-esteem, and feel like they are “stuck”. Waiting this long will make all that worse.

“Things have to be done differently if there is any hope of tackling these unbearable waits.”

They called for a different approach to trans healthcare in Scotland, saying: “The clinics that have made the biggest improvements are the ones that have recognised that not all gender identity healthcare needs to be delivered by psychologists and psychiatrists.

“This outdated approach is due to services being designed at a time when being trans was thought of as a mental illness – rather than trans people being a normal part of a diverse society.

“We hope that health boards across the country will take the publication of today’s data on waiting times really seriously. While only four health boards host gender identity clinics, trans and non-binary people live the length and breadth of Scotland. We need everyone to work together on improving gender identity services to give trans people a decent chance to live happy, healthy lives.”

Public health minister Jenni Minto said: “It is clear that performance is not yet at the level we all wish to see, and more needs to be done.

“This is, however, not unique to Scotland. This nationally collated data will be an important tool for driving service improvement.

“Whilst the dataset highlights regional variation and areas for improvement, it also highlights progress some health boards have made during the reporting period. We continue to support health boards to reduce long waits.

“I remain determined that people using these services are our priority and should be at the heart of all our discussions about how this care is provided.”

At the Scottish Parliament on Wednesday, the Green co-leader Lorna Slater asked when referrals for gender-affirming surgery for 18 to 24-year-olds would be reinstated at the Chalmers Gender Identity Clinic in Edinburgh.

Ms Slater said the clinic appeared to be waiting for work on national work on gender identity healthcare provision to be completed.

Ms Minto said a working group in NHS Lothian is “progressing work at pace” and a report is expected early in the new year.