The Welsh NHS has paused new referrals and scheduled surgeries for gender-affirming procedures while an independent clinical review examines the Welsh Gender Service’s assessment and referral processes.
Cardiff and Vale University Health Board, which runs the service, said the NHS Wales Joint Commissioning Committee ordered the pause with immediate effect.
The move affects the surgical pathway only. Hormone therapy support, endocrine reviews, psychological support and speech and language therapy will continue.
What Has Been Paused?
Three parts of the surgical pathway are currently on hold: new referrals for gender-affirming surgery, surgical assessments and surgeries that had already been scheduled through the Welsh Gender Service.
Patients who already have appointments with the service are being told to continue attending. Those appointments can still be used to discuss next steps and access support while the review is under way.
Gender-affirming surgeries for Welsh patients are generally carried out at specialist centres in England after referral from the Welsh Gender Service.
Why Is The Review Happening?
The decision followed 2025–26 data showing that the Welsh Gender Service had significantly higher rates of referral for gender-affirming surgery than gender services in England.
Concerns were also raised about aspects of the service’s referral and assessment processes.
However, the higher referral rate does not itself prove that patients were referred inappropriately.
The independent clinical review is intended to examine the service’s assessment, referral and governance arrangements and determine whether any changes are needed.
NHS Wales Says Other Care Will Continue
The Welsh Gender Service was established in 2019 and provides specialist care to adults experiencing gender incongruence.
While surgical pathways are paused, patients can continue accessing other parts of the service.
Cardiff and Vale University Health Board said it recognised that the uncertainty could be distressing for trans patients, their whānau and those waiting for surgery.
It has promised to keep affected patients informed as the review progresses.
Trans Patients Face New Uncertainty
For people already waiting for surgery, the pause means further uncertainty around treatment timelines.
The NHS has not yet said how long the review will take or when referrals and surgeries may resume.
Until the independent review is completed, it is important not to assume that the higher referral rate reflects inappropriate care.
What the review finds — and how quickly patients can return to the surgical pathway — will now be closely watched by trans communities and healthcare advocates across Wales.
