What we are hearing: the pause to gender-affirming surgery

In late August 2026, referrals for gender-affirming surgery, surgical assessments and scheduled operations through the Welsh Gender Service were paused while an independent clinical review takes place. The decision was taken by the NHS Wales Joint Commissioning Committee (NWJCC), which commissions specialist services on behalf of Wales's seven health boards.

Since then, people affected, and the organisations that support them, have told us about severe distress, surgery cancelled days or hours before it was due, and months of not knowing what happens next. Some told us they first heard about the pause on social media. The health board that hosts the Welsh Gender Service wrote to 451 people. The first stage of the review covers around 60 people, so most do not yet know when their case will be looked at.

People told us they want:

• clear and regular communication about the review and its progress
• clear reasons for the pause, and the evidence behind it
• timescales they can plan around
• a real say in decisions about their care
• emotional and psychological support while they wait
• confidence that decisions are clinically led, transparent and based on evidence

This report sets out what people have told us. We are sharing it with the NWJCC to inform its Quality, Safety and Outcomes Sub-Committee meeting on 30 October 2026. Llais will set out its own view on how the decision was made, and its formal representations to the NWJCC, separately.