Welsh Gender Service
As of 1st November 2023 the current waiting time for a first gender appointment is 15 months; we are currently booking patients who were referred to us in August/September 2022.
The Welsh Gender Service (WGS) was established in 2019. The WGS operates as part of a network involving local clinicians to ensure that care is offered closer to home, via your Local Health Board.
The WGS is based in St David’s Hospital in Cardiff. Appointments can take place at the WGS itself, or online, or at our North Wales satellite clinic in Holywell. There are plans for further satellite clinics to be set up by the end of 2024.
Referral to the Welsh Gender Service
You can access the Welsh Gender Service if you are over 18 and are registered with a Welsh GP. You should ask your GP to make an electronic referral. If they are not sure how to do this they can contact us and we’ll help them with the process.
We can accept referrals from GPs for patients who are aged 17 and over; but you and your GP should understand that you will not become a patient of the WGS until you have turned 18, and responsibility will remain with your GP until that point.
Patients who are under 17 who wish to access gender services should ask their GP for a referral to Child and Adult Mental Health Services (CAMHS) in the first instance. Once a young person reaches 17, their file should be transferred to the WGS automatically.
What happens after referral?
You will join the WGS waiting list; when you move towards the top you’ll receive a phone call to arrange an appointment; following this you’ll receive a letter to confirm the details. If you have opted in, you will also receive text reminders about your appointment.
If we can’t get in touch with you by phone, we’ll send a letter asking you to contact us and it is really important that you do this within two weeks of receiving the letter. If we don’t hear from you we will assume you no longer require an appointment.
Unfortunately, a high number of patients do not attend for their appointments at the Welsh Gender Service, and this means longer wait times for everyone on our list. If you know you will not be able to attend your appointment in advance, please call us on 029 2183 6619 so that we can reschedule and offer someone else the cancelled slot. More details on our policy for non-attenders can be found here. (link).
Appointments and patient journey
Following your first appointment there are various stages to the patient journey, delivered by various providers. The table below provides an explainer of what your pathway may include.
Pathway step |
What to expect |
Provider |
|
Initial assessment & diagnostic appointments
|
These appointments are usually 60-90 minutes long, and will allow the clinician to understand your history and experiences and decide with you next steps. |
Welsh Gender Service |
|
Follow up appointments |
To review progress along the pathway and consider further steps, if appropriate. |
Welsh Gender Service |
|
Endocrine review
|
To support an appropriate treatment plan for patients with a more complex medical history. |
Welsh Gender Service |
|
Psychological therapy
|
Psychological therapy or support may be appropriate for some patients; a range of interventions are available. This service is in high demand so there may be a wait before you are offered an appointment. |
Welsh Gender Service |
|
Hormone therapy
|
The majority of patients will access gender-affirming hormone therapy (GAHT) as part of their treatment pathway. The WGS will make a recommendation then refer you to your Local Gender Team (LGT) to coordinate your treatment. The WGS doesn’t hold information about waiting times for LGTs so you will need to contact them direct should you have any queries. |
Local Health Board – via Local Gender Team (LGT) initially; then GP |
|
Surgical referral
|
Gender-affirming chest and genital surgeries are carried out at a number of centres across England and you will be asked for your preference; this will be included in your referral. For access to a genital surgery pathway, you will need to see an independent clinician for review after you see the WGS clinician; we will organise this for you. Referrals are sent to the NHS Gender Dysphoria Gender Dysphoria National Referral Support Service (GDNRSS) – also known as the Surgical Hub. You will be notified once your referral has been processed. The WGS doesn’t hold information about waiting times for surgeries, so you will need to contact the Hub direct should you have any queries. |
NHS England surgical network |
|
Fertility preservation
|
If you require fertility preservation there are two options. Mid and South Wales patients will be referred directly by WGS to the WFI. Referrals for North Wales patients will be arranged by the Local Gender Team after initial tests have been concluded. |
Wales Fertility Institute or The Hewitt Centre |
|
|
If this is recommended, either the WGS or your GP can refer you. In some health board areas, patients can self-refer. |
Local Health Board (via GP referral) |
|
Peer Support
|
We partner with Umbrella Cymru to offer peer support for patients who may benefit from this. You can also self-refer at any time – contact details below |
Umbrella Cymru |
Contact Details
Welsh Gender Service |
|
|
General enquiries |
029 2183 6612 or cav.wgs_enquiries@wales.nhs.uk |
|
Appointment enquiries |
029 2183 6619 or cav.wgs_enquiries@wales.nhs.uk |
Surgical Hub (GNDRSS) |
|
|
General Enquiries |
01522 857799 or agen.gdnrss@nhs.net |
|
Please note that the Welsh Gender Service do not have access to any information about your surgical referral once it has been passed to the Hub. |
|
Local Gender Teams |
|
|
Betsi Cadwaladr |
03000 85 66 88 |
|
Cardiff and Vale |
localgenderservice.team.cav@wales.nhs.uk or 07912 471661 |
|
Cwm Taf |
|
|
Hywel Dda |
|
|
Powys |
01654 702224 |
|
Swansea Bay |
SBU.LocalGenderService@wales.nhs.uk 01792 285005 |
|
Please be aware that Local Gender Teams do not operate full time, so there may be a delay in responding to your message. The Welsh Gender Service do not have access to any information about Local Gender Team appointments, waiting times, or blood test results. |
|
Umbrella Cymru |
|
|
Website |
https://www.umbrellacymru.co.uk/ |
|
Voicemail |
0300 302 3670 |
|
Text |
07520645700 |
Policy for non-attenders
If you miss an appointment without having informed us, we will offer one further appointment. If you do not attend this appointment, you will be removed from our waiting list and will need to return to your GP and request a new referral to the Welsh Gender Service.