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. That is roughly fourteen times longer than the maximum referral-to-treatment period the NHS Constitution sets out. Some people have been waiting closer to a decade. Against that backdrop, LGBT Foundation and Gendered Intelligence have launched Waiting Well, a national trans waiting list support service, beginning as a pilot in South West England. I welcome it, and I want to say what it tells us.

What Waiting Well actually is

The service offers peer support groups for people at different stages of their journey, gender-affirming voice workshops, and webinars to help people understand and prepare for what gender identity healthcare actually involves. It has been shaped by trans and non-binary people themselves. Alex Matheson, Director of Inclusion at LGBT Foundation, put it plainly: too often, conversations about trans lives happen without trans people in the room. Gendered Intelligence's involvement changes that. Their Senior Adult Wellbeing Practitioner, Matty Herring, described something I hear constantly from trans people in more isolated parts of the country. "Many people in the South West are extremely isolated and disconnected from the trans community," they said. A service run by trans and non-binary people helps individuals feel they are not navigating this alone.

The pilot is open to adults aged 18 and over who live in South West England and are registered with the Exeter Gender Identity Clinic, also known as The Laurels. People can self-refer online or contact the dedicated phone line on 0330 355 9678, open on Tuesdays from 10am to 1.30pm and Thursdays from 3pm to 6pm.

Why the South West, and why now

Waiting times in the South West are among the longest in the country, which is why the pilot is starting there. That isolation Matty Herring described is not incidental: it is geographical, cultural, and structural all at once. Trans people in rural and semi-rural areas are often far from any visible community, far from services, and far from the kind of casual, ordinary contact with other trans people that reminds you that your experience is shared and your life is liveable. Peer support, done well, can do something real for that. I have seen what it means to someone to hear another trans person describe a feeling they thought was entirely their own.

The honest thing I also need to say

Support during a wait is not the same as care. The evidence cited in the launch of Waiting Well is striking: 71% of people on NHS waiting lists say their health worsened while waiting. Nearly three quarters of people who are waiting for gender identity healthcare are getting worse, not better, not staying the same, getting worse. A service that helps people feel less isolated and more informed is genuinely valuable. It does not fix that number.

Alex Matheson said it well: "While pressures on a free national health service are real, waiting for care should never undermine dignity or wellbeing." I agree, and I want to add that the existence of Waiting Well is itself a kind of testimony. When a coalition of experienced organisations comes together to build infrastructure specifically for people waiting, it is because the waiting has become so long, so damaging, and so normalised that it now requires its own care pathway. That should trouble us. A support service for the wait is an admission, in the kindest possible institutional language, that the wait itself is causing harm at scale.

What the ambition needs to be

Waiting Well's stated goal is to run until access to trans healthcare consistently meets the NHS's 18-week referral-to-treatment standard. That sentence contains multitudes. Eighteen weeks. We are currently at roughly 260 weeks on average. The distance between those two numbers is the distance between a functioning health system and what trans people in England and Wales are actually living with.

I do not say any of this to diminish what LGBT Foundation and Gendered Intelligence have built. Peer support, community connection, voice workshops, information: these things help. They help people feel less alone in a wait that is unreasonably long. They help people arrive at appointments, when they finally come, with more understanding of what to expect. They may, for some people, be the difference between coping and not coping. That is real, and it deserves recognition.

But the ambition cannot stop at coping better. The ambition has to be the 18 weeks. The ambition has to be the 42,000 people getting the care they need in time for it to matter most. Waiting Well is a generous, thoughtful, community-driven response to a failure that should not have been left to community organisations to manage. The people who built it deserve credit. The system that made it necessary deserves scrutiny.

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Dr Helen Webberley is a gender specialist, medical educator, and advocate, and the founder of GenderGP. She writes about gender identity, trans healthcare, and the lives at the centre of both.