Exclusive | TL;DR: QueerAF and What The Trans!? can reveal the NHS has cancelled gender-affirming surgeries for patients of the Welsh Gender Service. This comes after calls from the Welsh Tories for an independent review of the service over “concerns” it is referring trans patients for surgeries ‘at a faster rate’ than the UK gender clinic average. Some trans patients received the news that their surgeries had been cancelled days or even hours before they were due to undergo procedures this week. By Ludovic Parsons.
The NHS has cancelled every gender-affirming surgery for patients of the Welsh Gender Service with immediate effect, QueerAF and What The Trans!? can exclusively reveal.
This includes pre-operative assessments and scheduled surgeries. Some trans patients received the news just days or even hours before they were due to undergo procedures, according to NHS correspondence sent to patients and seen by QueerAF.
While we don’t have exact data for the number of Welsh Gender Service (WGS) patients scheduled to undergo gender-affirming surgery, hundreds of people will be immediately affected. Last year, nearly 1,500 people were waiting for a first appointment at the WGS.
The pause on surgeries comes after calls earlier this year from Welsh Tories for a review into the WGS – apparently prompted by claims in a blog article by an independent journalist, which were subsequently repeated in The Times last weekend - Nation Cymru
Trans healthcare in Wales is provided by NHS Wales through the WGS, based at St David’s Hospital in Cardiff. The WGS carries out first appointments and then patients are seen by a network of clinicians forming local gender hubs - Welsh Gender Service
As of March 2025, 1,439 people were waiting for a first appointment at the WGS. As we reported in the Gender Clinic Files last year, the waiting time for a first appointment with the WGS is two years.
The cancellation of gender-affirming surgeries comes after Natasha Asghar, the Welsh Conservatives’ health spokesperson at the Senedd, wrote in June to Mabon ap Gwynfor, the Cabinet Secretary for Health and Social Care, asking for an independent review into the WGS.
Asghar told Gwynfor she had read an “extremely concerning news article” about the WGS.
“These revelations are incredibly concerning and, in my view, warrant a closer inspection. To that end, will you commit to launching a full independent review into the service’s practices and leadership as a matter of urgency?” Asghar wrote - Nation Cymru
The news article Asghar was referring to was apparently a blog post by gender-critical freelance journalist Nick Wallis, published on 23 May.
Based on responses to Freedom of Information requests, Wallis raised concerns alleging a lack of data collected on the number of patients being prescribed hormone replacement therapy. The blog also examined data showing the WGS refer people for “irreversible gender surgeries” at a rate he claims is three to four times higher than the UK average, and that the WGS was referred for an independent review in 2024 that has not yet begun.
On 20 August, Nation Cymru reported that a meeting of the Quality, Safety and Outcomes Sub-Committee at NHS Wales on 24 August would discuss the WGS, which was described in the meeting agenda as “currently under consideration as a potential Service of Concern”.
The agenda says that concerns “include higher rates of surgical referral than seen in comparable services” and “concerns regarding referral appropriateness”.
“Given the significance of the emerging concerns, enhanced governance and oversight
arrangements are being considered ahead of completion of the independent
review of adult gender services in Wales,” the meeting agenda notes - NHS Wales
Then, on 22 August, Wallis wrote an article for The Times that was headlined, “Another Tavistock scandal is brewing in Wales” - The Times
Five days later, trans patients began receiving phone calls telling them that their surgeries were cancelled.
In a statement to QueerAF, David Fluck, Executive Medical Director at Cardiff and Vale University Health Board, confirmed the pause of referrals for gender affirming surgery and scheduled surgeries "while an independent clinical review is undertaken.
"The pause applies specifically to referrals for gender affirming surgery, surgical assessments and surgery. Other elements of care provided by the Welsh Gender Service, including hormone therapy support, endocrine review and psychological support services, continue to operate and are not affected by this decision."
NHS England declined to comment. QueerAF has approached the NHS Gender Dysphoria National Referral Support Services for comment.
Analysis: Climate of fear about gender-affirming care moves onto adults
This week’s strong reaction by the NHS to “concerns” about an effective healthcare model sit neatly within the current climate of fear about trans existence. It’s also yet another example of the power of relentless right-wing media attacks on Trans+ healthcare – though this is ordinarily directed at healthcare for Trans+ children and young people.
When QueerAF and What The Trans?! published the Gender Clinic Files in 2025, we made all the data behind the investigation open source. Still, neither the government nor NHS England deigned to respond.
This was despite our investigation revealing that the national average wait time for a first appointment at an NHS gender clinic in the UK is a staggering 25 years. In Scotland, the worst place in the UK to try to access Trans+ healthcare, the wait time for an NHS gender clinic appointment was 224 years. In Wales, we found that the wait time was just two years.
The Welsh Gender Service opened in 2019, replacing a system under which Welsh trans people had to travel to English gender clinics for healthcare. The WGS operates a slightly different model to traditional gender clinics: patients are first assessed by the national hub, in Cardiff, and then seen by clinicians in local gender teams who have the power to prescribe hormones.
This model gets patients healthcare more quickly – as seen in the drastically shorter wait time for appointments. The Welsh Gender Service also doesn’t suffer from the vast backlogs that many English and Scottish gender clinics are weighed down by after decades of inefficient healthcare provision.
What’s notable is that this week, perhaps for the first time, we’re seeing the well-established backlash to healthcare shift from a focus on Trans+ children to directly impacting Trans+ adults. Adults who have seen their care withdrawn on the basis of claims from a single gender-critical journalist’s blog.
This bears repeating.
Our investigation into the UK's gender clinic system was backed by dozens of FOIs, excruciatingly fact-checked, published while abiding by our strict independent press regulation rules about accuracy and seen by more than a million of you - and that's before we count the reach of the many outlets that carried the story.
The investigation provided a far more accurate picture of the system than the then health secretary, Wes Streeting, had.
It was referenced in Parliament, in the Scottish election campaign and by international figures.
No change was made, and neither the Government nor the NHS responded.
One blog, self-published by a gender-critical freelance journalist - cited by one Tory member of the Senned in Wales - has led to the withdrawal of care for potentially hundreds of Trans+ adults.
It speaks volumes of how much the systems are stacked against our community. That's why we need a long term plan to change the media, and the country.
We are here every week while that work continues, filling the gap left by the mainstream media - reporting on LGBTQIA+ news with justice. But we're more than just a publisher.
Our core mission is to stop misinformation and the popularising of anti-LGBTQIA+ agendas at their most prominent source - the media. We're doing that by training up a new generation of queer creatives with journalism and strategic communication tools - so they can work in the media, to change it.
Help us fight back against the powerful and well-funded anti-trans movement by tooling up Trans+ journalists - to tackle hate at its source with a QueerAF membership, from just £4 a month.
