Review process set out for patients affected by gender surgery pause

Health officials have set out how patients affected by the pause in gender-affirming surgery in Wales will have their care reviewed.

Cardiff and Vale University Health Board said patients whose operations were scheduled between 26 August and 31 December would be considered first.

Surgery may be reinstated where appropriate after an individual review, but no date has been given for the first operations to resume or for the review to be completed.

The update follows the suspension of referrals for gender-affirming surgery, surgical assessments and scheduled operations through the Welsh Gender Service in August.

The NHS Wales Joint Commissioning Committee (NWJCC), which ordered the pause, is leading the Independent Clinical Review. Its scope has now been established and the terms of reference published.

Independent gender clinicians will examine relevant medical records and meet patients to consider their individual care.

The health board said: “Where appropriate, surgery will be reinstated as soon as an individual’s review is complete.”

After reviewing those whose operations were scheduled between August and December, clinicians will consider patients who have already undergone a surgical assessment and are waiting for surgery.

The final phase will cover those referred for surgery who are still awaiting an assessment.

Patients will be contacted directly about their reviews and told what the findings mean for their treatment.

The Welsh Gender Service will continue to oversee patients’ care throughout.

Clinicians will also recommend improvements to the service and its oversight, drawing on their reviews of individual cases.

The health board said: “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.”

It has also published frequently asked questions, developed with the Welsh Gender Service and NWJCC, which it says will be updated as more information becomes available.

The pause affected around 60 patients whose surgery was scheduled between its introduction and the end of December.

The suspension followed concerns about surgical referral rates and whether patients were being appropriately assessed before surgery.

Criticism

The decision has prompted criticism from patients, campaigners and politicians. A Senedd petition calling for operations to resume had attracted close to 18,000 signatures by late September.

Twenty-six Plaid Cymru backbench Members of the Senedd also wrote to the commissioning committee expressing concern about the impact on patients.

More recently, Green Party activist Tessa Marshall called for Health Minister Mabon ap Gwynfor and Deputy First Minister Sioned Williams to resign over the decision.

Mr ap Gwynfor has previously said he wants the clinical review carried out quickly to minimise disruption and distress.

The review of individual patients is separate from a wider review of the Welsh Gender Service planned since 2024.

The pause applies to the surgical pathway. Other services, including hormone therapy support, psychological support and speech and language therapy, have continued.

Patients with questions about the pause or their circumstances, or who wish to request psychological support, can contact [email protected].