Welsh Gender Service Update – 05 October 2026 

Cardiff and Vale University Health Board and the Welsh Gender Service continue to work closely with the NHS Wales Joint Commissioning Committee (NWJCC) and partner organisations in relation to the temporary pause to referrals for gender-affirming surgery, surgical assessments and scheduled surgery through the Welsh Gender Service. We remain committed to providing high-quality, evidence-based and compassionate gender affirming care for people in Wales. 

We recognise that many patients, families and stakeholders continue to seek information about what happens next and what the review may mean for individual care. We remain committed to providing clear, factual and timely updates while supporting those affected by the pause. 

Since our last update, the scope of the Independent Clinical Review has been established, providing additional clinical assurance in relation to the gender-affirming surgery pathway. The Terms of Reference for the Independent Clinical Review, led by the NWJCC are now available on our website. 

Independent Clinical Review 

The Independent Clinical Review will be carried out in phases, with patients reviewed in order of where they are within the surgical pathway.  

The review will initially focus on patients whose surgery was due to take place between 26 August 2026 and 31 December 2026. It will then consider patients who have already had a surgical assessment and are awaiting surgery, followed by patients who have been referred for surgery and are waiting for a surgical assessment. 

Independent gender clinicians will review relevant clinical records and meet with patients as part of the review process and will consider a range of factors relevant to an individual's care. Where appropriate, surgery will be reinstated as soon as an individual’s review is complete. 

Patients will be contacted directly regarding any review relating to their individual care and will receive information about any outcomes, next steps or further actions required. The Welsh Gender Service will continue to oversee each patient's ongoing care throughout the process and remain the main point of contact for support. 

Alongside individual patient reviews, the independent gender clinicians will identify any common themes, examples of good practice and opportunities for learning. These findings will help inform recommendations for future improvements to the service and its governance arrangements. 

What happens next?  

Over the coming weeks, Cardiff and Vale University Health Board will continue to work closely with the NHS Wales Joint Commissioning Committee, independent gender clinicians and partners across Wales to support the implementation of the Independent Clinical Review. 

We recognise that patients, families and stakeholders will wish to remain informed as this work progresses. We will continue to provide updates as further information becomes available and when key stages of the review are reached. 

Frequently asked questions 

In response to feedback and questions received from patients, families and stakeholders, we have published a set of frequently asked questions, developed in partnership with Welsh Gender Service colleagues and the NHS Wales Joint Commissioning Committee. These FAQs will continue to be updated as further information becomes available.  

Patients and stakeholders are encouraged to review the FAQs before contacting us, as they may provide answers to many common questions.  

Read the frequently asked questions on the Cardiff and Vale UHB website 

Questions, concerns and support  

We understand that some patients may require additional information, reassurance or emotional support during this period.   

To help provide additional support, the Concerns team continues to act as a single point of contact for enquiries.   

If you have questions about the current pause, require clarification about your individual circumstances, or would like to request psychological support, please contact: Cav.Concerns@wales.nhs.uk   

While we may not yet be able to answer every question about the outcome or timeline of the Independent Clinical Review, we will continue to respond as openly as possible and provide updates when new information is confirmed.    

Patients who need urgent mental health support can also access services through:   

• NHS 111 Wales, Press 2: If you need urgent mental health support, call 111 and press option 2. The service is available across Wales, 24 hours a day, seven days a week, and calls are free from a landline or mobile.    
• Samaritans: Call 116 123 free of charge at any time if you need someone to talk to.     
• Switchboard: Free LGBTQIA+ Support Line.     
• CALL (Mental Health Helpline for Wales): Offers emotional support and information on mental health related matters to the people of Wales.    

If someone’s life is at immediate risk, call 999 or attend the nearest Emergency Department.    

Other support and advocacy information can also be found on the Welsh Gender Service web pages.   

Thank you 

We would like to thank colleagues across the Welsh Gender Service and Cardiff and Vale University Health Board for their continued professionalism, compassion and commitment during this period.  

We are also grateful for the support provided by colleagues across the NHS, partner organisations, advocacy groups and third-sector services across Wales. The continued commitment to supporting patients, families and loved ones remains greatly valued.