NHS England has seemingly no idea how many trans people currently reside in the country, according to an excerpt from the newly-published Levy Review.

A section from the NHS’ service specification on non-surgical trans healthcare suggest the public health body has “no official data” on how many people in England exhibit signs of “gender variance.”

Inconsistent data collection, the document reads, poses “difficulties” in accurately reporting the size of the trans population in the region, which is only exacerbated by a “limited evidence base.”

“There is considerable variation in estimates, and the absence of reliable prevalence data exacerbates the challenges in planning and commissioning gender identity services,” the specification continues.

“What is consistent across the literature is a recognition that the number of people pursuing treatment options – the incidence of expressed need – is rising significantly.”

An operational review into NHS adult gender identity clinics (GICs), headed by Dr David Levy, was published on Thursday (18 December).

Among Dr Levy’s 20 recommendations on improving the notoriously backlogged services are calls for NHS England to develop national datasets ensuring that every trans person on the over 15-year-long waiting list is accounted for.

He said the lack of structure or strategical oversight around data collection had left every GIC’s clinical workforce “fragmented.”

As a result, clinics reported having huge gaps in key information on patient care, such as the number of adults who had “aged-out” of youth gender clinics and moved to adult care.

The only data collected or shared by GICs, Dr Levy reports, are reports of waiting times and clinic activity datasets. Even then, he reports that very little data is actually submitted and that some clinics have shared no data at all.

Dr Levy called on NHS England to establish a national minimum dataset on population numbers while ordering clinics to conduct more audits on safety and provision of care.

NHS England prioritises wait times following Levy Review

NHS England directors John Stewart and professor James Palmer thanked Dr Levy for his recommendations in an open letter published alongside the review.

They clarified their immediate priorities would be to minimise wait times and ensuring GPs are confident enough to provide care to trans patients under shared care agreements.

Advocacy groups and experts expressed concern that the Levy Review was a “missed opportunity” to implement stronger changes, such as informed consent, that would help relieve the pressure on the already strained regional clinics.

Tammy Hymas, policy lead for TransActual, a trans-led advocacy and education organisation in the UK, said that while it was an encouraging first step, the Levy Review doesn’t do enough to address the core issues around trans healthcare provision.

“We are concerned that this review is a missed opportunity to give all trans people timely and local access to gender-affirming hormones on the basis of informed consent – the most effective way to clear eight-year long waiting lists,” Hymas said.

“With the acknowledgement from Health Secretary Wes Streeting that trans people are being failed by the NHS, Dr Levy’s review of adult gender services should prompt this government to turn words into action and provide long term funding to end this crisis”.

How many transgender people are there in the UK?

The short answer is: it’s unclear, despite the fact that census data from 2021 found that over 262,000 people, 0.5 per cent of the UK public, do not identify with their sex assigned at birth.

However, the Office of National Statistics later backtracked on these figures and said that data suggesting there were 262,000 trans individuals ‘should not be used’ as an exact reflection of the population.

This change was made after the Office for Statistics Regulation found that people whose first language was not English were four times more likely to say they were trans than English speakers.

However, the ONS did then say that it had ‘high confidence’ that the 2021 data could still be used to provide a ‘broad indication’ of the overall size of the trans population.

PinkNews has contacted NHS England for comment on the service specification quote.

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