Welsh Gender Service update – 11 September 2026

Cardiff and Vale University Health Board continues to work closely with the NHS Wales Joint Commissioning Committee (NWJCC) following the decision to pause referrals for gender affirming surgery, surgical assessments and scheduled surgery through the Welsh Gender Service while further assurance work is undertaken.

Since our previous updates on 28 August and 3 September, we have continued to hear from patients, families, clinicians, partner organisations and community groups across Wales. We recognise that this period of uncertainty remains difficult and distressing for many people, and we remain committed to providing clear, accurate and timely information as it becomes available.

As outlined previously, the pause applies specifically to the gender affirming surgery pathway. The pause does not affect patients who have already had surgery and require follow-up care, those who are midway through a series of surgical procedures, treatment for complications, or other clinically necessary aftercare.

Other services provided through the Welsh Gender Service continue, including hormone therapy support, endocrine review, psychological support, speech and language therapy, and fertility preservation and treatment services.

Patients with scheduled appointments should continue to attend unless they are contacted directly and advised otherwise.

Independent Clinical Review

We are continuing to work closely with the NHS Wales Joint Commissioning Committee in anticipation of the Independent Clinical Review and are in regular contact regarding the next steps.

While the review has not yet commenced, we are ensuring that the Health Board is ready to engage fully and constructively with the process when it begins. The review will provide an important opportunity to further strengthen assurance around the service and help inform future decisions.

As soon as we receive confirmed information about the scope, timescales or progress of the review, we will communicate this directly with patients and stakeholders and update our published information accordingly.

It is important to highlight that the Independent Clinical Review is a separate piece of work to the Welsh Gender Service Review, which is an assessment of the service as a whole and has been planned since 2024. This review assesses the service against its current specification, relevant professional standards, emerging evidence, and national developments. Initial findings from the Welsh Gender Service Review are expected by the end of 2026.

Contacting affected patients

Since the pause was announced, work has been undertaken to identify patients who may be affected.

We identified 451 patients across the gender affirming care surgery pathway in Wales who may be impacted by the pause, and letters have been issued to all those individuals. Some patients will have already received these and others will be due to receive them imminently.

We recognise that every patient's circumstances are different and understand that some people may still have questions about what this means for their care. If you have not received a letter but have questions about your individual care, please contact us via the concerns team at cav.concerns@wales.nhs.uk. The concerns team will appropriately direct your enquiry to address your individual questions.

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 the service, 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.

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 reiterate our sincere thanks to colleagues within the Welsh Gender Service for the professionalism, compassion and commitment they continue to demonstrate while supporting patients during this challenging period.

We are equally grateful to colleagues across the NHS, Third Sector organisations, advocacy groups and the wider community who continue to provide practical and emotional support to patients, families and loved ones across Wales. Your partnership, understanding and commitment are greatly valued.

What happens next?

Our priorities remain unchanged:

supporting patients and families affected by the pause
engaging fully with the NHS Wales Joint Commissioning Committee and the independent clinical review process
providing the necessary clinical and governance assurances
supporting Welsh Gender Service colleagues
communicating openly and transparently with patients and stakeholders
updating affected individuals promptly when new information becomes available

We are committed to providing high-quality, evidence-based and compassionate gender affirming care and will continue to share factual updates as work progresses.