Around 42,000 people in England and Wales are currently waiting for their first NHS Gender Identity Clinic appointment. The average wait is about five years. Five years. That is roughly 14 times longer than the maximum waiting period the NHS Constitution sets out as acceptable. Some people are waiting closer to a decade. And 71% of people on those lists say their health got worse while they waited.
So when LGBT Foundation and Gendered Intelligence announce a new service called Waiting Well, my first reaction is genuine warmth for the people behind it, and my second is a quiet, honest recognition of what it represents. A support service for people on a waiting list is not the same as care. Its existence is, in the kindest possible framing, an admission that the system is failing tens of thousands of people at scale.
Both of those things can be true at once.
What Waiting Well actually offers
The service is launching as a pilot in South West England, where waiting times are among the longest in the country. It is open to people aged 18 and over who are registered with Exeter's Gender Identity Clinic, known as The Laurels, and people can self-refer directly online or by calling the dedicated phone line.
What the programme offers is peer support groups, gender-affirming voice workshops, and webinars to help people understand and prepare for gender identity healthcare. It has been shaped by trans and non-binary people themselves, developed alongside healthcare professionals, and brings together LGBT Foundation's five decades of LGBTQ+ health experience with Gendered Intelligence's trans-led community approach.
Matty Herring, Senior Adult Wellbeing Practitioner at Gendered Intelligence, put it plainly: many people in the South West are extremely isolated and disconnected from the trans community. A service run by trans and non-binary people helps individuals know they are not alone. That matters. Isolation during a multi-year wait does not just feel bad; it compounds distress, erodes mental health, and makes the eventual arrival at a clinic far harder than it needed to be.
Alex Matheson, Director of Inclusion at LGBT Foundation, said something that stayed with me. Too often, conversations about trans lives happen without trans people themselves. This service corrects that, at least within its own scope. It is shaped by lived experience, and that is not a small thing.
Support is not the same as care, and we should say so
I do not want to dampen what LGBT Foundation and Gendered Intelligence have built here. Peer support is genuinely valuable. Voice workshops can reduce dysphoria in ways that matter day to day. Feeling less alone is not nothing; for some people waiting years without community or information, it could be the thing that gets them through.
But I would be doing a disservice to those 42,000 people if I did not name what this pilot is responding to. Five years is not a wait. It is a period of life. People lose relationships, housing, jobs, and in the worst cases, themselves, during waits that long. The NHS Constitution's 18-week standard exists precisely because prolonged waits cause harm, and gender identity care is currently operating at 14 times that standard as a matter of routine.
Waiting Well's own stated ambition is to run until access to trans healthcare consistently meets the 18-week standard. That framing is honest and I respect it. It is a service designed to bridge a gap that should not exist, and the people running it know that. The goal is not for this pilot to become permanent. The goal is for it to become unnecessary.
What needs to change
The pilot is a South West England initiative for now, which means the other tens of thousands of people on waiting lists elsewhere in England and Wales are not yet reached by it. A national rollout is the longer-term ambition, and I hope it happens quickly, because the need is not regional.
What would actually fix this is investment in gender identity services at a scale that matches demand: more clinics, more trained clinicians, genuine political commitment to the 18-week standard in gender care as in every other area of the NHS. That has not happened. Instead, services have contracted, been reorganised under enormous political pressure, and left people waiting longer than ever.
In that context, Waiting Well is a community stepping in where institutions have stepped back. That is something to admire, and something to be angry about at exactly the same time.
If you are in South West England, registered with The Laurels, and on that waiting list, please do reach out to this service. You can self-refer online or call 0330 355 9678, open Tuesdays 10am to 1.30pm and Thursdays 3pm to 6pm. You deserve support now, not only when your appointment finally arrives.
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Dr Helen Webberley is a gender specialist, medical educator, and advocate, and the founder of GenderGP. She writes about gender diversity, trans healthcare, and the lives of trans people and their families.