What did the Levy Review actually find after ten years?

It found real progress in some regions, shorter waits, better care, but glaring gaps elsewhere. Some parts of the NHS have moved forward; others are still using frameworks that fail people. The picture is uneven, and that inconsistency matters. Are you in a place where the NHS is still catching up, or have you seen some of that progress yourself?

Does this review change anything for me right now?

It depends on where you are and what you need. The review makes recommendations, but change takes time to filter through. Some clinics are already adapting; others may take longer. If you are navigating NHS care now, knowing what the review says can help you ask better questions and know what you should reasonably expect. What part of the system are you trying to access at the moment?

The 2025 Levy Review: what has actually changed for trans people?

Substack 2 January 2026

The 2025 Levy Review: Progress and Persistent Gaps

A decade after the NHS was identified as fundamentally failing trans people, the 2025 Levy Review gives us a chance to take stock. Some things have genuinely improved. Others have not, and the gaps that remain are not minor oversights: they are places where real people are still being let down in ways that cause lasting harm.

In 2015, the House of Commons Health Committee concluded that the NHS was fundamentally failing trans people. Ten years on, the 2025 Levy Review offers us an opportunity to assess what has shifted in that time and where the gaps remain most acute.

The review's findings are sobering in places and encouraging in others. What emerges is a picture of inconsistency: some regions have made meaningful progress in affirming care and reducing waiting times, whilst others continue to operate within outdated frameworks that fail to meet people's needs with compassion or clinical competence.

Read the full analysis to understand what the review identifies, how it builds on earlier critiques, and what the recommendations mean for trans people accessing NHS care today.

In response to: Ten Years Ago the NHS Was Found to be Failing Trans People (Substack)