In the United Kingdom, trans people can currently expect to wait an average of 25 years for an initial appointment to start gender-affirming care with one of the nation’s gender clinics, according to a new analysis of freedom of information requests conducted by Queer AF.

That wait time is almost a third of the average life expectancy for an adult in the United Kingdom, and several gender clinics have wait times that are years longer. The most extreme of those is found in Glasgow, Scotland, where the waiting list means new referrals could have to wait 224 years before getting an initial assessment.

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In the U.K., to receive gender-affirming care on the national health care system, NHS, it is required to first get a referral to a gender clinic from a general practitioner before waiting for an initial assessment and to eventually receive recommended prescriptions. All stages of this process regularly include excessive invasive questions about a trans person’s identity, life, and sex life that can leave them feeling like they have to “prove” that they’re “trans enough.”

The website for the Tavistock and Portman gender clinic in London shows that it currently has over 16,500 patients on its waitlist and is currently offering appointments to people first referred in March 2020. While they have received 300 referrals in the last month, they have only offered 73 first assessment appointments in the same time frame.

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For gender-affirming medical intervention, which is recognized as life-saving care, wait times should be weeks or possibly months. Once a trans person has acknowledged that they want to medically transition, years of waiting risk allowing their bodies to change irrevocably under the wrong hormones, or leaving them feeling trapped in their own bodies.

U.K. Health and Social Care Secretary Wes Streeting, who is an out gay man, announced a new pilot scheme in the southwest of England last month, aiming to support trans adults suffering the long wait times for gender clinics. “This pilot marks a major step – acknowledging the unacceptable waits endured by thousands of transgender patients and starting to tackle it head-on. As we build an NHS fit for the future, we will ensure that it is there for everyone equally and stamp out systemic health inequalities that the LGBT+ community face.”

Streeting is part of a relatively new Labour government that took power after the general election in 2024. The U.K. currently has 15 gender clinics, with five of those having opened in the last five years. However, waitlists are still growing faster than appointments are being supplied. Queer AF’s data shows that as of March 2025, there are 48,000 people awaiting their initial appointment with a gender clinic in the U.K., a 12.5% increase from the previous year.

The gender clinic backlog is far from a new problem. Speaking to INTO back in 2021, a trans woman named Fiona explained that she had to wait six years from receiving a referral to receiving her first prescription for hormone replacement therapy.

Claire Prosho, founder of Claire’s Trans Talks, suggests that gender care in the U.K. needs wider reform. “It is beyond time for the current failed ‘diagnostic’ service models to be replaced by a simple informed consent model, in line with international best practice and consultation with the trans community.”

While there are private gender clinic options available that have considerably shorter waitlists, the cost for these clinics is prohibitive to most. Juliet spoke to Queer AF about her experience, saying she was at first told she’d wait 20 months, but that turned into seven years. So she decided she had to go private: “The level of cost is prohibitive. To afford it, I’ve had to move back in with my parents […] I see other people saving up to buy houses, moving on with their lives, and going on holidays, which is not an option for me because of this burden I have to deal with.”

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