Following the publication of the final Cass Review, the NHS has committed to implementing its recommendations. Despite this commitment, waiting times continue to grow, with some young people having waited more than 6 years for a first appointment. This is unacceptable.
We know there have been many reports and announcements in recent weeks about the future of gender-affirming healthcare for young people so we have provided a short update to help you understand.
What’s happening with the opening of new NHS Youth Gender services?
The NHS has committed to opening up to 8 young people’s gender services, with 3 currently operational in London, Manchester and Bristol. A service for the East of England is set to open in Cambridge.
It is vital that the NHS speeds up the pace of opening these new services and takes more young people off the waiting lists, given the significant waiting times.
What is the situation with prescriptions and shared care for trans youth?
In December, we strongly condemned the Government’s decision to continue the criminal ban on puberty blockers for trans young people.
In April 2025, NHS England issued guidance to GPs that they should refuse to support the private prescribing or supply of puberty blockers for trans young people, including with hormone monitoring blood tests. This included that they should refuse to support providers who are not CQC regulated in prescribing gender affirming hormones for under 18s.
We also understand that some NHS GP clinics prescribing gender affirming hormones have been instructed to take no new patients under the age of 18.
We are deeply concerned that the Government and NHS are continuing to increase the difficulty of accessing gender affirming care, including through regulated routes which have enabled young people to safely access the healthcare they need.
What’s happening with the clinical trial on puberty blockers for trans youth?
In February 2025, the National Institute for Health and Care Research published initial details of its “PATHWAYS” research programme into the use of puberty blockers for trans youth.
This research, which has no trans people in the lead investigator team, has received more than £10 million in funding to undertake research until 2031.
Right now, we don’t have enough details to fully understand how the trial will work. However, we remain opposed to the unethical mandatory participation in research as a condition of accessing treatment. Ethics researchers have already identified significant concerns around this kind of coercive approach, and that there is a risk that NHS England could violate the human rights of those invited to partake in research.
What’s happening with the new service specification for NHS youth gender services?
At the start of April, Mermaids and other LGBT+ organisations were approached to respond to a stakeholder consultation on how the new youth gender clinics will provide care to young people. This new service specification will replace the interim service specification that was published in June 2023, following the recommendations of the Cass Review.
We expressed significant concerns to NHS England, particularly regarding the mandatory screening of all young people for neurodevelopmental conditions such as ADHD or autism. In our experience, children and young people have a strong inherent understanding of their gender and of their neurodiversity. Whether a young person is neurodivergent should not impact their ability to access care, nor should they be compelled for an assessment as a condition of treatment.
How you can take action today
The NHS have informed us they are likely to run a full public consultation on this specification, following their stakeholder engagement and we hope to update you on how you can take action on this. Become an email supporter to be the first to hear about future actions and campaigns.
In the meantime, please write to your MP to demand demand a future for trans young people where they can access the healthcare they need, without having to wait for years or fear their experiences will be dismissed. It’s time for the Government to start listening to trans youth.
We know that these developments are complex and the ongoing lack of youth gender healthcare options is causing substantial harm to trans youth. We continue to engage with NHS England and the UK Government to demand they listen to trans young people, and deliver timely, supportive and holistic healthcare, including gender affirming hormones and puberty blockers, to everyone who needs them.
We’re here to support you
If you are feeling impacted by the developments to NHS youth gender healthcare and need someone to talk to, we are here to listen. Mermaids’ Support line is open Monday-Friday, 1pm-8:30pm. Freephone: 0808 801 0400. You can access webchat via our website. For crisis support, text ‘Mermaids’ to 85258 (open 24/7).