Exploring people’s experience of being on the gender identity clinic waiting list

Healthwatch Essex launch a new report and photo zine exploring Essex residents’ experiences of being on the waiting list for services provided by gender identity clinics.

In the UK, adults seeking medical services to affirm their gender are supported by a set of specialist centres, often known as gender identity clinics (GICs). These clinics offer medical services like hormone medications and surgeries as well as psychological support. People face extremely long waiting lists to access these services. According to data provided by the Tavistock and Portman NHS Foundation Trust in August 2024, there is currently a wait of up to 6 years at London’s GIC – the closest clinic for Essex residents. This is despite the NHS Constitution stating that patients have a legal right to start treatment within 18 weeks of a GP referral.

These extended waits prevent many trans and nonbinary people from accessing the support that they need. This has a significant impact on their lives, and can cause severe emotional, psychological and physical distress. Our in-depth research project, led by former Research Associate Sarah Krauze, aimed to understand the impact of these waiting times on people who live in Essex. We also wanted to gain insight into people’s experience of being referred to the GIC and support mechanisms that people had accessed whilst they waited.

We aimed to use a range of methods to ensure that people had a choice in how they shared their experiences so that they felt comfortable doing so. Our research generated a survey with 29 individuals and in-depth interviews with 3 participants. One participant also took part in a photovoice activity, which involved sharing photographs that expressed who they are and how they feel in their day-to-day lives.

Through sharing their lived experiences, participants detailed their complex journeys of self-discovery in relation to their gender identity. Survey respondents detailed how it felt to initially request a referral to the GIC from their GP. Several indicated the lack of support that they received during these conversations:

It was daunting, and it felt like they didn’t really want to take the time to understand. I felt rushed and like I just had to wait and see what would happen. I felt dismissed, and that I had to exaggerate to be taken seriously.

This lack of support included using the incorrect pronouns and having limited knowledge about the GIC referral process. It was apparent that GPs were more likely to be supportive and understanding if they had previously supported trans and nonbinary patients.

Our participants also emphasised that the wait for medical care was just one facet of their transition. Other services including beauty salons, and friends’ acceptance of their name change also constituted gender-affirming care. Participant Alex explained the importance of being able to access advice and support on how to wear wigs to support her style:

There’s a really good wigs supplier…obviously they’d seen lots of trans clients, and I was so pleased they helped me to choose wigs that fitted with my sort of neutral to feminine presentation.

Participants discussed the range of support that they drew on whilst waiting for GIC support. This support ranged from online forums to community groups, as highlighted by participant Mac:

A support group for trans people locally…that’s been a really good way for me to cope and like, meet people that are going through similar experiences and just yeah, learn from them. Just be with be with people that understand. That’s community.

You can find a list of valuable organisations and resources at the end of this article.

Drawing on their experiences, participants highlighted multiple recommendations for services, including mandatory trans awareness training for GPs and effective communication from GICs. These recommendations, along with our findings, are detailed in a research report which you can read here. We have also created a photo zine showcasing the images our participant who took part in the photovoice kindly shared with us. You can read a digital copy of the zine here. If you would like to view the zine as a digital flipbook click here.

Healthwatch Essex’s Research Manager Dr Kate Mahoney said:

‘It is unfathomable that people are waiting up to 6 years to access vital gender affirming care. This research provides valuable insights into people’s everyday lives during this wait, highlighting the importance of adopting a holistic approach to gender affirming care that extends beyond the clinical. Our participants championed the value of access to information on beauty, hairstyling, and dress, online forums, community groups, and friendships as vital components of gender affirmation. This research therefore contributes to wider calls for accessible and personalised gender affirming care for all who need it’.

We would like to thank all our participants for so generously sharing their experiences, and to our Research Ambassadors Madhusree Dasgupta, Arti Rai, Teresa Wagstaff, Sarah Walsh, and Gemma Wood, who volunteered to support our research analysis.

You can find our report here and the photo zine here. For more information about this research project, please contact Dr Kate Mahoney at [email protected].

The following organisations can be contacted if you would like support:

Gendered Intelligence is a trans-led charity that works to raise awareness of gender diversity and improve the lives of trans people. genderedintelligence.co.uk/
[email protected]
0800 640 8046/07592 650 496 (WhatsApp)

LGBT Foundation is a national charity supporting LGBTQ+ health and wellbeing.
lgbt.foundation/
[email protected]
0345 3 30 30 30

Mermaids supports trans, non-binary and gender diverse children, young people and their families.
mermaidsuk.org.uk/
[email protected]
0808 801 0400

SNEE THINCC: Trans* Health Inclusion Network for Care is a group of people who want to improve health and care in Suffolk and north east Essex for transgender and non-binary people and those exploring their gender identity.
www.letstalksnee.co.uk/tg-nb-gq-network
0800 448 8234

Switchboard is the national LGBTQIA+ support line.
switchboard.lgbt/
[email protected]
0800 0119 100

The Outhouse provide safe, supportive spaces for all LGBTQ+ individuals.
theouthouse.org.uk
[email protected]
19 East Hill, Colchester, Essex, CO1 2QX
01206 871394

TransActual UK are a national, trans-led organisation that aim to improve health care and legal protections for trans adults.
[email protected]

TransLucent advocates for the trans and gender-diverse community, campaigning for visibility, acceptance, legal recognition and healthcare.
translucent.org.uk/

Transpire is Southend’s trans and LGBTQI+ network, working with the local community to help support transgender persons, their friends and family.
www.facebook.com/transpiresouthend/
[email protected]

 

Cover image – An image provided by one of our participants, who felt that it highlighted how ‘all of our journeys are like completely individual and unique and beautiful in their own way.’