On 18 December 2025, NHS England published Dr David Levy’s independent operational review of the nine commissioned adult gender dysphoria clinics in England. This is about adult services. It is not the Cass Review of youth care, and it is not a youth medical ban.
The review says waiting times for a first assessment are long, and that the waiting list is still growing. Annual referrals have doubled since 2022/23. Clinics hold their own lists, so duplication is hard to see.
It also says limited and inconsistent quality data, plus little clinical audit, make it impossible to understand patient outcomes and the safety of these services properly. That puts the clinics outside usual NHS quality-assurance expectations. Care, the chair writes, does not meet the current service specification or the needs of today’s patient group.
NHS England’s initial response the same day accepts the findings and commits to an implementation plan, including a national board, quality-improvement work, and a single national waiting list.
Official sources
- Review, 18 December 2025: Operational and delivery review of NHS adult gender dysphoria clinics in England
- NHS England initial response, 18 December 2025: NHS England’s initial response to Dr Levy’s report