High Court to hear urgent case against NHS over ‘life-threatening’ wait times for trans healthcare

A groundbreaking legal challenge against the years-long healthcare waits UK trans people face on the NHS will now be heard in court.

Four trans people, trans-led charity Gendered Intelligence and the Good Law Project have been given permission to bring a judicial review against NHS England on grounds stemming from massive waiting lists and failures by the NHS to help trans people access affirming healthcare. 

One of the claimants, Eva Echo, described being on the waiting list for specialised gender healthcare as “torture”. Echo added there were times when “I felt like I may not even be alive long enough to receive my first appointment”. 

“My mental health was worse than it had ever been,” Echo described. “Coming out had allowed me to recognise my gender dysphoria, but I was left completely alone to manage it.”

Echo felt, and still feels, “completely let down” by the healthcare system that “I thought was there to save me”. 

The NHS has a statutory requirement that at least 92 per cent of patients using the healthcare service should have a referral-to-treatment time of less than 18 weeks. 

However, thousands of trans people in England face extensive waiting lists – facing a three to five year wait depending on what part of the country they live in – for even an initial appointment at one of the seven NHS Gender Identity clinics. The trans healthcare delays predate the pandemic – which brought many vitally needed services to a grinding halt – by many years. 

This has resulted in trans people turning to crowdfunding for private healthcare or travelling abroad to access gender-affirming healthcare. 

In December, two trans adults, two trans children, the Good Law Project and Gendered Intelligence launched legal proceedings against these massive wait times. The claimants argued the extensive delays and other failures in the trans healthcare system are unlawful and discriminatory.

Now, a justice has agreed that these six counts – which include that the NHS failed to treat trans patients within the 18 week referral period and failed to provide trans youth with puberty blockers before they hit puberty – are arguable. So the case will now proceed to a full High Court hearing.

Jo Maugham, director of Good Law Project, said trans people have faced “life-altering” and “sometimes life-threatening” waits for specialist NHS healthcare. 

“This court case will be a vital moment in the fight for healthcare justice for trans and non-binary people,” he added. “Healthcare should be for everyone.” 

Cara English, head of public engagement at Gendered Intelligence, said the organisation knew “first-hand” from “working closely with and for the trans community” that these waiting lists are “proving disastrous to people’s health and wellbeing”.

“These illegal waits long predate the pandemic, and are only getting worse as time goes on,” English said. “We need action, not words.”

She added that the claimants hoped that “we can help kickstart the proper, timely healthcare for trans and non-binary people that’s needed” through the judicial review. 

A court date has not been set, but the Good Law Project estimated that they may be in court this autumn.  The non-profit organisation has launched a crowdfunding campaign to help assist in the case. 

A damning survey conducted by Trans Actual, a trans-led organisation in Britain, last year painted a horrific portrait of how discrimination in the healthcare system impacted trans Brits. 

An overwhelming majority (98 per cent) of the nearly 700 respondents said transition-related healthcare available on the NHS was not completely adequate. Almost half (47 per cent) described such services as “not at all” adequate. 

A vast number (90 per cent) of trans people reported experiencing delays when seeking transition-related healthcare. 

Over 53 per cent of non-binary respondents said they never attempted accessing gender-affirming healthcare on the NHS, compared to just 29 per cent of the respondents overall. 

• Dec 01 2023

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