Introduction: a growing concern for transgender adults
Patients seeking gender-affirming care in adult clinics are experiencing long and unpredictable waits, according to a new review highlighting systemic delays. The findings indicate that many individuals facing gender dysphoria are left waiting months for initial assessments, diagnosis, and treatment decisions. As health systems struggle to balance safety, accessibility, and timely care, the report underscores the urgent need for policy changes and increased capacity in adult gender clinics.
What the report reveals about wait times
The analysis shows an average wait time that stretches well beyond what patients and clinicians consider acceptable. Some individuals report waiting for multiple appointments before a pathway toward treatment can be agreed, while others face delays in receiving essential letters, referrals, or referrals to surgical teams. The picture across regions reveals uneven access, with rural areas often facing longer journeys to care and higher personal costs to maintain continuity of treatment.
Impact on patient wellbeing
Delays in care can exacerbate distress and worsen mental health conditions already at play for many seeking gender-affirming support. The report notes increased anxiety, deteriorating quality of life, and a higher burden of self-advocacy where patients feel compelled to navigate complex systems without clear timelines. For some, protracted waiting periods may also delay crucial interventions, including assessments related to puberty blockers or hormone therapies when clinically appropriate for adults.
Systemic factors behind the delays
Experts point to several contributing factors. Demand for gender-affirming care has grown, but capacity at clinics has not kept pace. Staffing shortages, lengthy multidisciplinary assessments, and backlogs in diagnostic processes all combine to prolong waiting times. Additionally, some regions rely on centralized hubs rather than local services, increasing travel time and logistical barriers for patients who are already managing significant emotional and practical challenges.
What the report recommends
The review advocates a multi-pronged approach to shorten waits and improve patient experience:
- Increase staffing and allocate dedicated lines of clinical capacity for adult gender clinics.
- Streamline referral and assessment pathways with clear timelines and transparent communications for patients.
- Expand regional access to services to reduce travel burdens, including telehealth options where appropriate.
- Improve data collection to monitor wait times, patient outcomes, and service quality in real time.
- Engage with trans communities to co-design services that better meet diverse needs and reduce unnecessary delays.
What patients can expect next
Advocacy groups and health authorities are calling for urgent action, with commitments to reduce average waiting times and to set enforceable targets. Patients waiting for care should receive regular, proactive communication about expected timelines and the steps being taken to expedite their assessment. Where possible, interim support services and peer navigation can help address distress and provide information between appointments.
A note on future improvements
While changes may take time to implement, the report signals a clear shift toward more responsive and patient-centered care. By prioritizing capacity, simplifying pathways, and enhancing regional access, health systems can begin to meet the needs of adults seeking gender-affirming care in a timely and respectful manner.
