What the Levy Review Means for Young Trans Adults Seeking NHS Care
The recent publication of the Levy Review (19.12.25) into NHS adult gender dysphoria clinics reveals the scale of challenges facing young adults seeking gender-affirming care in the UK.
The Current Reality for Young People
The review findings are stark: over 40,000 people are waiting for their first NHS appointment, with average wait times approaching six years. Several major clinics project this could extend to 15 years without significant intervention.
While NHS pathways for under-18s exist on paper, the reality is that young people referred before turning 18 face waiting times so extensive that they will reach adulthood before receiving their first assessment. In effect, there is currently no functioning pathway for young trans people to access specialist NHS care during their adolescence. This means young gender questioning people have to navigate critical developmental years without specialist support.
What the Review Identified as Essential
The Levy Review emphasises several critical elements for effective gender dysphoria services:
Comprehensive biopsychosocial assessment frameworks
Recognition and support for co-occurring conditions, particularly neurodevelopmental differences such as autism and ADHD
Multidisciplinary teams with expertise across mental health, physical health, and psychosocial support
Trauma-informed care approaches
Holistic, individualised formulations for each patient
The review confirms that the patient population increasingly presents with additional neurodevelopmental considerations and complex biopsychosocial needs - including mental health conditions and histories of childhood trauma or abuse.
Our Approach
These findings align closely with the model of care we've developed at Gender Plus and the Gender Plus Hormone Clinic, having worked for decades with trans people.
Our psychosocial team's experience has long informed our understanding that effective gender-affirming care requires:
Holistic assessment that considers the full range of a person's needs, including their gender within their broader life context
Multidisciplinary expertise spanning individual, family and couples therapy, autism assessments, and medical support
Integration of mental and physical health services
Recognition that gender dysphoria exists within the broader context of each person's life and wellbeing
Our integrated model means that when a person presents with both gender incongruence and, for example, undiagnosed autism, both needs can be identified and addressed concurrently rather than sequentially, reducing delays and improving outcomes.
Looking Forward
The Levy Review calls for a whole-system response involving NHS England, Integrated Care Boards, primary care, and specialist services. The recommendations emphasise quality improvement, standardisation of best practices, and collaboration across services, principles that have guided our model of care and should guide the development of any future pathways for young people.
As the only independent, CQC-registered Outstanding clinic supporting young people and their families, we welcome the opportunity to contribute our expertise to this broader effort to ensure trans people receive the support they need.
