The Impact of Long NHS Wait List for Transgender People

Written by on 19th April 2024

An average person has to wait over five years for their initial Gender-affirming appointment with the NHS in the United Kingdom; the effect of this causes many people to seek private care.

NHS badge. Credit: RawPixel

NHS badge. Credit: RawPixel

Transgender individuals face unique and somewhat sad challenges when they seek healthcare assistance in the United Kingdom and one of the significant issues they normally face is the long waiting list within the National Health Service (NHS).

Different people have sought care with private Gender Clinics which take less time to set up an appointment organisations like Gender GP are completely online and you can get appointments set up in the comfort of your home and have your medications delivered to your doorstep.

In 2022, Alice Litman took her own life after waiting almost three years for her initial assessment with the NHS. Alice was referred in 2019 and wasn’t able to get any Gender-affirming healthcare until she passed away when she was 20 years old.

The impact of long waits can cause emotional, mental, and physical consequences on the lives of people.

NHS wait lists can cause some individuals to consider private healthcare as another means of getting care. The struggle and negative impact of waiting for essential gender-affirming care can push people to look into other options.

Private healthcare providers often offer shorter wait times, allowing individuals to access the necessary treatments and procedures faster. The only important thing to note is that private healthcare may not be financially accessible for many people, as it can be expensive and not covered by insurance. The decision to switch to private Gender-affirming healthcare is a personal one, which is oftentimes influenced by factors such as financial means, the need to get treatment done quickly, and individual circumstances and predicaments.

Many other individuals have suffered and struggled with mental health issues like identity crises. According to the NHS, there were over 4000 referrals to Gender-affirming clinics in the year 2016.

As much as going with private care providers sounds appealing, it’s costlier compared to the free service NHS provides.

Many people have resulted in setting up a GoFundMe account to raise money for their transitions or use personal funds.

Ru, a 23-year-old Trans Man in the North East was first referred to the NHS waiting list in 2017 after coming out to his friends family, and ‘inner circle’ at age 16. After seeing the Doctors who then referred him, he waited 2 years before he was given an appointment in 2019 where he was just asked some ‘pretty invasive but necessary questions’.


pc: Marvelous Adenekan


He said “I was told I had to wait the same amount of time it took me to get my first appointment but I still haven’t heard a word from them up till now.

“I felt like I was downing and stuck in limbo and didn’t have any idea when the NHS was going to get back to me and I didn’t have the funds to go private as well. As all these went on, I was reaching out to my friends and talking about how I was feeling and they supported me.”

Like many other people, Ru didn’t see the need to source funds externally after his friends brought up the idea of starting a GoFundMe because he didn’t feel ‘worthy enough for someone to donate to his funding’.

He said, “It took a lot of convincing before I let my friends start the GoFundMe on my behalf and  I later took over the management after a while and everyone has been so supper supportive.”

Waiting for such a long time can have different impacts on different people and also the funds to stay on private care can be overwhelming. Ru is currently with private provider GenderGP and said: “he is happy to stay private and can switch back to the NHS if they perhaps contact him and they can pick up from where GenderGp progress, but hopefully they contact me.”

Khaleel who was previously on the wait list for the London Gender-affirming clinic said: “After a couple of years on the wait list, I was weirdly contacted by the East Gender-affirming clinic who stated that they will be taking over his care. I was very sceptical but they said they were an NHS new clinic that had just opened up in the East. I went to the NHS website and confirmed that it was legit and they took over my care but this was after I’ve spent over a thousand pounds on private health care providers.


pc: Khazeel

The East clinic was quicker because I was contacted on a Tuesday and I got an appointment where they asked all the questions on Friday. After 6 months, I was officially off the waiting list and this meant I could leave my private care providers which was where I’ve only had 4 appointments.

Delayed access to gender-affirming care can prolong feelings of dysphoria, which is the distress or discomfort experienced due to a disconnect between one’s gender identity and assigned sex at birth. This can negatively impact mental health and overall well-being, delays can contribute to increased rates of anxiety, depression, and other mental health issues. It can be emotionally challenging for individuals to navigate daily life while waiting for the care they need, it can hinder an individual’s ability to fully transition socially, which may impact their sense of identity and integration within their desired gender.

The lack of timely gender-affirming care can strain relationships with friends, family, and partners. It can be difficult for loved ones to understand and support a person’s gender identity without the visible changes that come with appropriate care.

Some gender-affirming procedures, such as chest or genital surgeries, can have long waiting lists. Delayed access to these procedures may lead to physical discomfort, increased risk of complications, and potential limitations in physical activities. There is also a risk of higher healthcare costs in the long run. Without timely interventions, individuals may require additional treatments or interventions to address the effects of prolonged dysphoria or physical discomfort.

It’s important to advocate for timely access to Gender-affirming care to reduce potential consequences and support the overall wellbeing of individuals.

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