Welsh Gender Service update – 3 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 independent clinical assurance work is undertaken.

Since the announcement on 28 August, we have heard from patients, families, clinicians and partner organisations who are seeking greater clarity about what the pause means, how long it may last and what it means for ongoing care. We understand this period of uncertainty is worrying for many people.

We are working with the NWJCC to address the issues identified, provide the necessary assurances and support the de-escalation of the service as quickly and safely as possible.

Our commitment to providing high-quality, evidence-based and compassionate gender affirming care for people across Wales remains unchanged.

What did our previous update say?

In our update on 28 August 2026, we explained that the NWJCC had asked the Health Board to pause referrals for gender affirming surgery, surgical assessments and scheduled surgery through the Welsh Gender Service while further independent clinical review work is carried out.

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

The pause applies specifically to the surgical pathway. Other care provided through the Welsh Gender Service continues, including:

hormone therapy support
endocrine review
psychological support
speech and language therapy
Fertility preservation and treatment via fertility services

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

You can read the Welsh Gender Service update published on 28 August 2026 for the full background.

We understand that patients and stakeholders across Wales want clarity about how long the pause will last. We are seeking to provide that clarity as quickly as possible, but we do not want to create further uncertainty by giving a timescale before the assurance work has progressed sufficiently.

We will continue to provide updates and will contact affected patients directly if there are developments that affect their individual care.

Our commitment to gender affirming care

Cardiff and Vale University Health Board remains committed to providing high-quality, evidence-based and person-centred gender affirming care for people across Wales.

The current escalation and review do not change that commitment. The purpose of the assurance process is to ensure that the service has robust quality, safety and clinical governance arrangements and can continue to provide patients with safe and effective care. It is also an opportunity to identify any improvements needed to strengthen the service and patients' experience of care.

We recognise that gender affirming healthcare is discussed in an increasingly polarised public environment. Our approach will remain grounded in clinical evidence, accurate information and respect for the dignity of patients, families and staff.

We encourage people to seek information from trusted sources and to recognise the real impact that uncertainty can have on patients, families and colleagues.

New frequently asked questions

The questions we have received since the announcement have highlighted the areas where people most want further information and reassurance.

We have listened to those questions and used them to develop a set of frequently asked questions, in partnership with Welsh Gender Service colleagues and the NHS Wales Joint Commissioning Committee.

Read the FAQs here. The FAQs will be updated as further information becomes available.

Questions, concerns and requests for support

We understand that individual patients and families will have different circumstances and may need information or support that is specific to them.

If you have a question or concern about the announcement, or would like to request support, please email Cav.Concerns@wales.nhs.uk.

We may not yet be able to answer every question about the outcome or timescale of the independent clinical review. However, we will respond as openly as we can and will continue to update the FAQs as new information is confirmed.

Support available

We recognise the significance of the current uncertainty and the impact this may have. Patients, family members and loved ones do not have to manage these feelings alone.

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 to colleagues and partner organisations

We want to thank colleagues in the Welsh Gender Service for the compassion, professionalism and commitment they continue to show.

Members of the team work closely with patients and understand how difficult and distressing this period of uncertainty can be. We recognise that the current situation also has a significant impact on colleagues who have developed trusted relationships with service users and who are supporting people through deeply personal and important stages of their lives.

We are equally grateful to colleagues across the broader health service and the Third Sector organisations who have been speaking with and supporting patients, families and communities. Their insight, advocacy and practical support are extremely valuable, particularly for people who are worried about what the pause may mean for their care.

What happens next?

Our immediate priorities are to:

support patients and families affected by the pause
work with the NWJCC to provide the required clinical and governance assurances
support Welsh Gender Service colleagues through the review process
update patients promptly when there is confirmed information about their care
support the safe de-escalation of the service as quickly as possible
continue to engage with patients and stakeholders across Wales with the latest information

We will continue to provide clear and factual updates as the work progresses. Where there is information that affects an individual patient’s care, we will contact patients directly.

Media information

All media enquiries about the Welsh Gender Service and patient care should be directed to the Cardiff and Vale University Health Board Communications and Engagement Team at news@wales.nhs.uk.

Media enquiries about the review and the process should be directed to the NHS Wales Joint Commissioning Committee Communications and Engagement Team at NWJCC.Communications@wales.nhs.uk.