Crisis-hit gender service cancelled 60 surgeries this year, Welsh health minister says

About 60 surgeries via the Welsh Gender Service (WGS) were cancelled for this year after NHS officials paused referrals in August, Wales' health minister has revealed.

It is the first time figures have been given for the number of people affected by the decision to pause referrals over concerns that patients who identify as transgender had been "appropriately assessed".

In a Senedd debate, Welsh Green leader Anthony Slaughter said patients were facing "unbearable limbo". Reform's Cristiana Emsley said it would be unacceptable to continue when "serious concerns exist".

Health Minister Mabon ap Gwynfor said he wanted "to bring certainty" as quickly as possible.

The body that took the decision, the NHS Wales Joint Commissioning Committee (NWJCC), has commissioned a review that is examining the referrals to see if any of the cancelled surgeries can proceed before the end of the year.

BBC Wales revealed in August that some patients found out about the cancellations while they were in hospital.

Earlier this month, the NWJCC said in some cases patients did not meet "the basic requirements for surgery".

Having an unsuitable body mass index (BMI) - a value derived from an adult's height and weight - was a factor.

It also said the proportion of Welsh patients progressing from referral for some types of surgery was "significantly lower" than across the border, while the rate of surgery referrals was "significantly higher".

The WGS provides referrals for adult patients living in Wales, but all NHS surgeries are carried out in England.

The surgery includes both masculinising and feminising procedures. They are not reversible.

Ap Gwynfor said the NWJCC had appointed a clinical review panel, and it was expected its work would commence "imminently".

"This review will prioritise those individuals who are further along the pathway to allow appropriate referrals to proceed as soon as possible," he said.

"The JCC has identified that approximately 60 patients were due surgery between the pausing of surgery in August and the end of December.

"Our priority is to bring certainty to these people as quickly as possible and the JCC are confident that all 60 of these cases can be reviewed before the end of December."

A wider independent review into the service is also taking place, with findings expected later this year.

Ap Gwynfor added: "I have met with the JCC and been clear that the urgent clinical review needs to be swift to minimise the disruption and distress for individuals on the waiting list.

"I have also been clear that I expect all patients impacted by this pause to have access to the necessary support whilst the review is undertaken."

Wales Greens leader Slaughter led the debate and told Members of the Senedd (MSs) that an "unbearable limbo" was being faced by patients.

He said some of whom had been left feeling "abandoned, alone and confused, having had the rug pulled from under them".

"They had jumped through every hoop asked of them, had arranged and rearranged their lives around this day," he said.

Slaughter urged ministers to review what he called "the failure of governance that led to both patients and the government being blindsided" and said "robust measures" should be put into place so that the JCC could be held to account.

Slaughter was supported by Plaid Cymru MS for Sir Fynwy Torfaen, Matthew Jones, who accused the committee of "not publicly or adequately" explaining its concerns.

But Conservative health spokesperson Natasha Asghar said: "The title of this short debate suggests that pausing sex change operations is unacceptable but that couldn't be further from the truth.

"There is nothing unacceptable about pausing irreversible surgery at the Welsh Gender Service while serious concerns are investigated."

Cristiana Emsley, Reform MS for Fflint Wrecsam, said she believed the halt was merited, saying: "Whatever our political differences, truth and patient safety must unite us.

"I accept that the pause might cause distress and patients must be supported, but what would be unacceptable is continuing irreversible referrals when serious concerns exist about referral appropriateness, clinical governance and patient safeguards".

The NWJCC said in an update on Wednesday that it would begin its review looking at patients whose surgery would be due to take place between August and December 2026.

"Reviews will start with those whose planned surgery dates were earliest and will continue in date order," it said.

"NWJCC has sought confirmation from the NHS England surgical providers that patients who are able to proceed with surgery will be prioritised."

It promised that this stage of the review would be completed by the end of December, and says "experienced gender clinicians" will undertake the work.

"Patients who are waiting for surgery in 2027, and those who are waiting for a surgical assessment, will also have their referral reviewed to confirm that the requirements for surgery have been met."

The NWJCC said it had not identified any patients who had come to harm, but said concerns were raised through "complaints, correspondence and other information".