Children waiting two years for critical gender care as numbers trapped on waiting lists soar
Children aged under five are among a soaring number of young people waiting for gender care treatment as the NHS grapples to clear a backlog of patients.
The number of children waiting for treatment in England and Wales has risen by 12 per cent in a year, with 6,225 children now on the national waiting list, up from 5,560 a year earlier.
A total of 157 of those are aged under 10, with up to 10 aged under five. Average waiting times have also grown to more than two years for a child to get a first appointment at a specialist clinic.
One expert warned children need help 'before they reach crisis point', with numbers showing that 'demand is outpacing supply'.
Responding to the latest figures, the NHS medical director for specialised services, Professor James Palmer, said he understands it 'can be really difficult' for children and their families waiting to be seen.
TransActual, a charity supporting trans people, said the waiting list figures were 'unacceptably high'.
Two new gender care services led by London's Great Ormond Street Hospital (Gosh) and Alder Hey Children's Hospital in Liverpool opened in April 2024 following the closure in March 2024 of the UK's dedicated gender identity clinic, run by the Tavistock & Portman NHS Foundation Trust.
A third service has since opened in Bristol while another is planned for the East of England 'later this spring', according to the Department of Health and Social Care (DHSC). The aim is for there to eventually be up to eight specialist children's gender clinics covering the seven NHS regions in England.
Last year, health secretary Wes Streeting branded waiting times 'unacceptable', acknowledging the 'enormous distress' they can cause.
Waiting times for a first appointment have also risen, to an average of 116 weeks at the end of March from an average of 100 weeks at the end of May last year, according to a Freedom of Information request by the Press Association.
There is no minimum age requirement for gender care and the NHS previously said it wanted to ensure parents of very young children are given support where necessary, with some aged under five seeking help.
Dr Roman Raczka, president of the British Psychological Society, said: 'It is essential that children, young people and their families can access the professional care and support they need, before they reach crisis point.
'Demand is currently outpacing supply. This contributes to a range of broader challenges which face children and young people's services that require further investment.'
Chay Brown, operations director for TransActual UK: ' Trans and gender questioning children and young people are having to wait years to access support from the NHS.
'The majority of people leaving the waiting list at that time will have aged out. Sadly, some will have died whilst waiting – waiting times for NHS gender services have been cited in several prevention of future deaths reports.'
Following last year's Cass Review, which concluded children had been let down by a lack of research and evidence on medical interventions in gender care, NHS England announced a new plan which requires new referrals to the clinics to have been seen by a GP and mental health specialist or paediatrician first.
Some 250 patients transferred from the Gender Identity Development Service have been seen by new services, and it is understood that each of the new clinics is designed to see 25 patients a month.
Guidance expected to be published later this month will see the health service move away from a 'medical model' in favour of a 'holistic' approach to children's gender care, as per recommendations from the Cass Review.
According to leaked plans reported last month, children who have gender dysphoria will now be tested for neurodevelopmental conditions, including autism and attention deficit hyperactivity disorder (ADHD).
Prof Palmer said: 'We know it can be really difficult for children and young people and their families who are waiting to be seen by our new holistic gender services, and that's why it has been so important that we put a new system in place to ensure that, while they're waiting, they can access mental health support if they need it.
'The NHS is now almost halfway through its planned expansion of regional services, and we are seeing significantly fewer referrals as children are first assessed by paediatric or mental health experts and provided with care in NHS services that are more appropriate to their needs.'
Puberty blockers are not prescribed on the NHS to children for the treatment of gender dysphoria, after a ban last year was made permanent in December.
Plans remain in place to set up a clinical trial into their use this year, although no patients have yet been recruited and ethical and regulatory approval is being sought.
A DHSC spokesperson said: 'We are working with NHS England to reform children's gender services in line with the recommendations from the Cass review, to provide children with timely, holistic support.
'We've opened three new children and young people's gender services, with a fourth anticipated to open later this spring. These new services will increase clinical capacity and reduce waiting times, so patients can be seen sooner and closer to home.'
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BBC News
an hour ago
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Nutrition: Apple really dey good for your health?
Dem dey tell us say one apple a day dey keep di doctor away, but dis fruit really get dat kain positive effect on our health? Di world love apple. Every year, na almost 100 million tonnes of apples dem dey produce globally. Dis fruits dey come in different colours and for long, don get reputation say e dey help us stay healthy. Di popular saying "an apple a day dey keep di doctor away" originate from one Welsh proverb wey dem write for 1866: "Eat an apple wen you dey go to bed and you go keep di doctor from earning im bread." But any truth dey dis longstanding saying? And shey apples dey especially healthy compared with oda fruits? First, make we tink about di nutrients wey apples contain. For one tin, dem be rich source of phytochemicals, including flavanols. Dis compounds don dey linked to plenti health benefits, like maintaining healthy weight and to lower your heart disease risk. Why apples dey so healthy Apples also contain various polyphenols, including anthocyanins, wey dey help give some apple peel im red colour and dey associated wit improved heart health. Anoda polyphenol wey you go find in apples na phloridzin. Dem find say e dey help control blood glucose. Lots of fibres also dey inside apples, mostly pectin, wey dey reduce di amount of low-density lipoproteins (LDLs) – di unhealthy form of cholesterol – in our blood. Pectin also dey lower di amount of sugar and fat wey dey absorb from food, help to stabilise our blood sugar levels. Dis nutrients wey dey inside apples be like dem dey offer health benefits. One 2017 review of five studies bin report say to dey eat apples dey associated wit 18% reduction in di risk of developing type 2 diabetes. Anoda review from 2022, wey analyse 18 studies, find say to dey eat more apples, or apple-derived foods like apple juice, fit reduce cholesterol, if you sustain di habit for more dan one week. To get healthy diet in general fit lower your risk of cancer by up to 40%, mostly thanks to bioactive compounds, phytochemicals, wey dey common in apples. Some studies don even link apple consumption to get lower risk of developing some certain cancers. To dey eat apples regularly dey associated wit plenti health benefits – and we know say dem dey full wit healthy compounds. But apples, dey specifically, any more effective dan oda plant-based foods for keeping di doctor away? "Apples no get much vitamin C, and dem no get no iron or calcium, but dem get so many oda ingredients wey dey promote health and do wonderful tins for di body," Janet Colson, professor of nutrition and food science for Middle Tennessee State University in di US tok. "Some researchers say apples get di 'second highest level of antioxidant power among all fruits" Apples contain compounds wey dey common to many fruits and vegetables, including those helpful polyphenols, Flavia Guzzo, associate professor of plant biology for University of Verona in Italy tok. Polyphenols be strong antioxidant molecules. Dem dey help to balance di ratio of antioxidants to free radicals in our bodies – free radicals dey highly reactive, potentially cell-damaging oxygen molecules. By keeping free radicals in check, we dey reduce our risk of developing diseases including cancer and heart disease through long-term inflammation. "Some researchers say apples get di 'second highest level of antioxidant power among all fruits" Apples contain compounds wey dey common to many fruits and vegetables, including those helpful polyphenols, Flavia Guzzo, associate professor of plant biology for di University of Verona in Italy tok. Some researchers say apples get di "second highest level of antioxidant power among all fruits". Apples also contain di polyphenol phloridzin, wey dey much less common within di oda fruits in your fruit bowl. Like pectin, phloridzin appears to lessen di amount of sugar wey dey absorb into our blood from food. Apples also be good source of phenolic compounds, wey be anoda form of phytochemical. E get one study wey find say pipo wey dey live in di US get around one fifth of dia total phenolic intake from apples. Research suggests say apple phenolic compounds dey associated wit lower risk of heart attack, cancer, asthma, diabetes and obesity. But no be just di powerful polyphenols and antioxidant punch wey dey make some scientists to recommend apples over oda fruit. In some papers, scientists dey recommend regular apple-eating sake of say di fruits dey simply so widely available. Wey mean say, to dey eat dem regularly na sometin wey dey relatively achievable for many pipo. E dey clear say apples get di potential to improve our health. But na quite a big claim to say to dey eat one every day go make us no go to see doctor. One 2015 study bin chook eye for dis exact question. Researchers bin analyse one survey of nearly 9,000 pipo, wey di participants tok wetin dem eat during one 24-hour period, wey dem tok say dey indicative of dia typical daily diet. Dey find say apple-eaters dey more likely dan apple-avoiders to keep di doctor away, however, dis result no dey statistically significant wen we wan take into account say apple-eaters dey more likely to be more educated and dey less likely to smoke. "Di main finding, no say much of di association between pipo wey dey regularly consume one apple a day and di likelihood to visit physician, na sake of say e dey complex," lead researcher Matthew Davis, adjunct associate professor of epidemiology for Dartmouth Geisel School of Medicine in New Hampshire, US tok. "Pipo wey dey consume apples, based on our analyses, dey healthier in general." But dem also find say daily apple-eaters dey less likely to dey reliant on prescription medication – and dis na still one significant finding wen pesin adjust di socioeconomic differences between participants wey dey eat one apple per day and those wey no dey eat am. Therefore, di paper conclude say, one more key saying fit be say: "One apple a day go keep di pharmacist away." But Davis get issues wit di apple-a-day tok, and say anoda reason fit dey why im and im colleagues no find connection between daily apple consumption and to dey go see doctor. "Di underlying assumption na say you dey only visit di doctor wen you dey sick, but pipo dey visit di doctor for annual check-ups and oda prevention-type tins," e tok. Dis na why Davis also analyse di data around di likelihood of using prescription medication, too. "E mean say apples dey reduce di likelihood to get chronic illness," e tok. But ultimately, e say, apples alone no dey enough to stop your visit di GP, and say di most impactful tin na to get healthy diet overall. "Wey, really, be wetin di saying dey reason," e tok. Colson agree say di apple-a-day agree to regularly eating plant-based foods. Apples na good example sake of say dem dey so readily available, affordable and get long shelf-life. "Before fridges, you fit put apples for cellar and dem go last long time, and dem no dey attract mould," she tok. Oda studies don find health benefits wey relate to daily apple-eating – but only wen pipo dey consume more dan one per day. "Anoda study find say to dey eat three apples daily dey stimulate statistically significant weight loss" Inside one study wey dey publish for 2020, researchers bin split 40 participants (wey all get small elevated cholesterol levels) into two groups. One of those groups bin eat two apples per day while di oda get one apple drink wit similar calories. Di experiment bin last eight weeks and, apart from di apple products, di participants no make any oda changes to dia diets. Di researchers bin find say di apple-eaters get clinically significant lower level of cholesterol, at di end of di study. However, one weakness of dis study na im small size; 40 participants na relatively low sample size from which to draw any big conclusions. Anoda study bin find say to dey eat three apples daily dey stimulate statistically significant weight loss and improved blood glucose levels (wey bin no dey statistically significant wen e dey followed up) in 40 overweight women. As for how best to eat apples to get di greatest benefit from dem, Guzzo advise against removing di skin first. "We suppose dey eat di peel of apples, as dis na wia you go find most of di apple polyphenols," she tok. And ancient varieties dey preferable to new varieties of apple, Guzzo tok. For 2021, she and colleagues bin publish one paper wey dey look at di nutritional value of di Pom Prussian apple, one ancient apple from northern Italy, wey she find say dey richer in polyphenols dan more modern apple varieties. "Wen breeders select new varieties, dem dey look oda traits, including size and taste and robustness of di trees," she tok. "And wen dem select dis traits, rather dan polyphenol content, di variety become poorer [from a health point of view]." She tok say some polyphenols fit produce a bitter taste, and say sweeter varieties probably contain a lower proportion of dis compounds. As for colour, Guzzo tok say e no matter so much. Both di polyphenols wey dey cause apple skin to dey red or green dey both good for us. Ultimately, while to dey eat one apple a day fit no mean say you go visit di doctor less often, e fit impact your overall health or your reliance on long-term medication. But, as e always be di case, di bigger picture dey complicated. To dey eat one apple a day dey great, Guzzo tok – but only if dat na part of a diet wey dey rich in various oda plant-based foods, since dat na di key driver of good health.
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