Gender Dysphoria: Health Services

In 2024, NHS England commissioned the National Operational and Delivery Review of Adult Gender Services (the Review), the report of which was published in December 2025. The report concluded that some adult gender services undertake little or no quality improvement work or knowledge-sharing between services, and that the senior clinical leadership approach at some clinics also limits opportunities to identify ways to improve patient outcomes.

The report makes a number of findings and recommendations for implementation by the National Health Service, overseen by NHS England and Department officials. This includes a recommendation that each Adult Gender Dysphoria Clinic requires a senior clinical lead who can demonstrate evidence of appropriate experience and expertise in specialised gender dysphoria practice; significant management experience; and significant evidence of continued professional development. The report also recommends senior clinical leads and managers in each Adult Gender Dysphoria Clinic creating a compassionate, safe, positive culture for the benefit of patients and staff in line with the NHS Leadership Competency Framework and profession-specific guidance.