Welsh gender surgeries paused amid concerns over referral rates
Cardiff and Vale University Health Board, which oversees the service, said it was asked to "immediately pause referrals from the Welsh Gender Service
The Welsh Gender Service made the decision to pause both scheduled and new referrals for gender-affirming surgeries.
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The decision comes after Cardiff and Vale University Health Board, which oversees the service, raised "concerns" about the high number of referrals being made for the operations.
Data from 2025-26 indicated "significantly higher rates of referral for gender affirming surgery... compared with English gender services", according to the university health board.
The NHS Wales Joint Commissioning Committee (NWJCC), which commissions national specialist services, said its "processes are designed to ensure appropriate scrutiny and oversight where further discussion or investigation is required".
The NWJCC has also requested an independent clinical review after identifying "matters" through routine "assurance processes".
Cardiff and Vale University Health Board (CAVUHB), which runs the service, said it was asked 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".
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"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, it said:
- New referrals for gender affirming surgery have been paused
- Surgical assessments and scheduled surgery have been paused
- An independent clinical review will be undertaken to provide assurance about assessment, referral and governance arrangements
Although the decision has been made by the health board, patients have been advised to continue attending their scheduled appointments, with other parts of the service continuing to operate.
This includes hormone therapy support, psychological support, and speech and language therapy.
The Welsh Gender Service is an NHS gender identity clinic established in 2019, providing specialist care and support for adults in Wales. The service refers patients to England for surgery.
On average, 13 people per 100,000 were referred for gender surgery in Wales in 2025, according to figures obtained through a freedom of information request.
In England, the average was three people per 100,000, while in Scotland it was up to four people per 100,000, based on analysis of the data.