Welsh Gender Service update – 28 August 2026

28 August 2026

Cardiff and Vale University Health Board has been asked by the NHS Wales Joint Commissioning Committee (NWJCC) to pause referrals for gender affirming surgery and scheduled surgeries through the Welsh Gender Service while an independent clinical review is undertaken.

The Welsh Gender Service provides specialist NHS support and assessment for adults experiencing gender incongruence, including psychological support, hormone therapy care, endocrine review, and referral into appropriate treatment pathways including surgery.

We recognise that this announcement may be concerning for patients, their families, staff and the wider community. We are committed to providing clear, factual and timely information about what this means and the support available.

What has happened?

The NHS Wales Joint Commissioning Committee (NWJCC) has asked Cardiff and Vale University Health Board to immediately pause referrals from the Welsh Gender Service for gender affirming surgery and existing scheduled surgeries while further independent clinical review work is carried out.

The decision was made following a meeting of the NWJCC Quality, Safety and Outcomes Committee on 24 August 2026, where the service was escalated to Level 3. Level 3 escalation is a formal NHS improvement and assurance process, indicating that concerns have been identified which require increased oversight, monitoring and improvement action.

Concerns have arisen from referral data from 2025-26 indicating significantly higher rates of referral for gender affirming surgery from the Welsh Gender Service compared with English gender services. In addition, concerns were raised regarding aspects of referral and assessment processes.

As a result:

New referrals for gender affirming surgery have been paused.
Surgical assessments and scheduled surgery relating to the Welsh Gender Service pathway have been paused.
An independent clinical review will be undertaken to provide assurance about assessment, referral and governance arrangements and identify any actions needed to strengthen the service.

What is the NHS Wales Joint Commissioning Committee?

The NHS Wales Joint Commissioning Committee (NWJCC) is the NHS organisation responsible for planning, commissioning and overseeing a range of specialised health services on behalf of the population of Wales. Its role includes ensuring that services are safe, effective and provide high-quality care.

The decision to pause referrals has been taken by the NWJCC as part of its responsibility for overseeing commissioned services and ensuring that any concerns regarding quality, safety or governance are fully reviewed.

What does this mean for patients?

At this stage, the pause applies specifically to the surgical pathway within the Welsh Gender Service. Other parts of the service continue to operate, including:

Hormone therapy support
Endocrine review services
Psychological support services
Speech and language therapy

These services are not affected by the current pause.

We recognise that patients who are currently waiting for surgery, assessment for surgery, or further information about their care may have concerns and questions about what this means for them personally.

Patients who have scheduled appointments with the Welsh Gender Service should continue to attend for discussions around next steps and psychological support.

Our commitment

The Welsh Gender Service supports people at important stages in their lives and we understand that uncertainty about treatment can be distressing. Our priority is to ensure patients are treated with dignity and compassion throughout this process.

We are committed to:

Keeping patients informed as further information becomes available.
Providing clear and honest updates.
Ensuring communication is factual, evidence-based and sensitive to the impact on those affected.
Working closely with the NHS Wales Joint Commissioning Committee to ensure appropriate patient support arrangements are in place.

We also recognise that gender affirming care is a topic that attracts strong and differing views across society. It is important that public and political discussion remains grounded in accurate information and that harmful speculation is avoided.

What happens next?

Cardiff and Vale University Health Board is working closely with the NHS Wales Joint Commissioning Committee as part of the review process and to determine the next steps.

We will continue to provide updates as more information becomes available and will contact affected patients directly if there are developments that impact their individual care.

Support available

We recognise that this update may be upsetting, frustrating or create uncertainty for some patients, their families and those supporting them.

If you would like additional support, there are organisations that provide information, advice, advocacy and emotional support for transgender and LGBTQ+ people, including:

Umbrella Cymru – umbrellacymru.co.uk (Gender and sexual diversity support specialists) 
Switchboard – switchboard.lgbt (Free LGBTQIA+ support line) 
Samaritans – Samaritans.org (24/7 helpline if you need to talk)

These organisations operate independently from NHS Wales and may be able to provide additional advice, information and peer support.

Questions, concerns and support

We understand that many patients may have questions about what this announcement means for their care. If you have questions or concerns, or need some support, please contact us via email: Cav.Concerns@wales.nhs.uk

Please note that we may not be able to answer all questions immediately while the independent clinical review is underway. However, we are committed to keeping patients informed and providing updates as further information becomes available.

We recognise correspondence to patients may take time to be received directly. Patients can also view the letter correspondence on our website by clicking on: Welsh Gender Service - Patient Correspondence.

All media enquiries must be directed to the Cardiff and Vale University Health Board communications team.