Waiting list/waiting times

We know a lot of people are concerned about the waiting times for the Northern Region Gender Dysphoria Service (NRGDS), and we hope this page will give you some useful information.

We will update this page regularly when we have new information to share about waiting times and the work we are doing to make them shorter.

How long can I expect to wait to be seen?

As of June 2024 the person at the top of the waiting list for their initial assessment has waited 72 months (6 years) for an appointment and is currently still awaiting appointment allocation.

As of June 2024 the person at the top of the waiting list for their second assessment with our Medical team (for diagnosis and to agree treatment plans) has waited 54 months (4 years and 6 months) to be seen since their initial assessment appointment (and a total of 78 months (6 years and 6 months) from their referral) and is currently still awaiting appointment allocation.

We cannot accurately predict whether waiting times will go up or down in the future, because it depends on several things including:

  • How many people are referred to us
  • How many staff are working in the service
  • What needs people have once in the service (some people need more regular contact with us than others)
  • The rate that people pass through the service (people need to go at a pace that is right for them)
  • How long people have to wait for surgeries (please see below)

You might have seen people and organisations quoting potential waiting times of 40+ years for initial assessment if we were to carry on seeing people on our waiting list at our current rate.

We want to reassure you that this is not an accurate reflection of how long people will wait to be seen by the NRGDS.

This 40+ year figure is based on data gathered using Freedom of Information Requests (FOIs) about our average numbers of appointments per month and the numbers currently on our waiting list. It assumes that nothing about the service or the way we work will change to improve the number of people we can see each month. But this is not the case. We are working closely with NHS England, who commission us to provide the NRGDS, to make changes that will enable to us to see and support more people. This has included recruiting more staff, including peer supporters who help people while they are on the waiting list. In August 2023 we took the difficult decision to pause referrals to our service, to enable us to do this work. You can read more about the pause in referrals here.

We sincerely apologise for these lengthy waiting times, and for the distress this may cause. We have put together a webpage listing mental health services and helplines, and a leaflet of local, national and online support for transgender and non-binary people.

How transfers of care from children’s gender identity services have affected our waiting times, and how we are working to improve this

People can come onto the NRGDS waiting list in two ways.

When someone is aged 17 or over (given that they are not offered an appointment with NRGDS until they turn 18), they can self-refer, or be referred by a professional, to our service.

However, people can also ask to be transferred onto our waiting list if they have turned 18 while being assessed or treated by a children and young peoples’ gender identity service, as these services only treat under-18s. People who are transferred to our waiting list from a children and young peoples’ gender identity service join the NRGDS waiting list at a level which reflects the treatment they received in children’s services. This can lead to transfers from children’s services being prioritised when offering assessment appointments. Prior to the service’s temporary suspension, people were able to transfer to NRGDS from a children’s service as a Transfer of Wait, meaning the time they spent in the children’s service was taken into account during their transfer and they were placed accordingly onto our waiting list (They are likely to be near the top of our waiting list if they were already in assessment and will be prioritised if they are in treatment in a children’s service.).

Many people have already been on a children’s service waiting list for several years when they were transferred to us, we recognised the importance of young people receiving assessment, support, and treatment for gender dysphoria as soon as possible.

However, prioritising transfers in this way meant that the waiting times for people aged 18+ being referred to our service sometimes remained the same for many months, or even got longer, as they could not ‘move up the queue’.

For example, in one month we might be able to offer five appointments for an assessment. If five people who have been transferred to our waiting list from a children’s gender identity service are prioritised and given these five appointments, this leaves no more appointments to offer to other people on the waiting list that month. This means that waiting times for people who were referred at 18+ would not ‘move forward’ at all that month.

When we temporarily paused referrals and transfers to NRGDS, we had lots of discussions with NHS England about different ways of working which would help us to work through our waiting list and see people for assessments faster.

One of the things we have now agreed with NHS England – to enable us to re-open referrals to NRGDS – is a more equitable way of working through our new referrals and transfers from children’s services.

From February 2024, we will alternate offering assessment appointments to people transferred from children’s services and people who have been referred to our service in the ‘routine’ way. So, a person transferred from children’s services will receive an appointment, then someone who referred into our service in the ‘routine’ way, then another from children’s services, and so on.

We hope that this will strike a balance between continuing to offer people coming from children’s gender identity services quicker access to treatment, while also enabling us to make more progress offering assessments to people who have been referred to our service in the ‘routine’ way who have also been waiting a long time.

Impact on NRGDS of waiting times for surgery

Some of the people who the NRGDS supports are waiting for surgery. This surgery is not provided by CNTW and is also experiencing significant waiting lists. We see these people every six months, to review their care and treatment. This is necessary to do, but it does impact on the capacity in the service and therefore the number of initial assessments we can offer.

While referrals are paused,  we hope many of these people will go on to receive their surgery and be discharged from the service. This means there will be more capacity in the service to offer initial assessments.

Please do not contact the service asking for further information on waiting times. We cannot provide any more information than what is on this page, and this takes up valuable administration time.

We will update this page regularly when we have new information to share about waiting times and the work we are doing to make them shorter.

We do encourage you to contact our Peer Support Service, who can provide support and advice while you are waiting to be seen.

Let us know if you cannot attend your appointment

It is important that you let us know as soon as possible, at least 24 hours in advance, if you cannot attend your appointment. This is so that we can offer that appointment to someone else. Unused appointments add to waiting time for other people wishing to use the service.

Unfortunately, some people do not attend their appointments without letting us know in advance. From April 2023 to March 2024, 327 appointments were not attended. That is 12.7% of all the appointments we offered.

If you need to cancel an appointment for any reason, please contact us on 0191 287 6130 or email us at [email protected]

Due to the high demand for our service, if you are repeatedly unable to attend your appointments (or do not attend for three appointments in a row) and we do not hear from you in advance to cancel them, we will have to discharge you from our service. It is important to know that failure to attend your appointments, and being discharged from the service, may affect your treatment pathway, including any surgery we have referred you for.

If you are not able to attend on several occasions, even if you let us know in advance, we may contact you to talk about whether this is the right time for you to use the service.