Safeguarding is firmly embedded within the core duties and statutory responsibilities of all organisations that provide National Health Services. The organisations that manage adult gender dysphoria clinics will have reference to NHS England's Safeguarding Accountability and Assurance Framework, 5th edition, published 2026, that sets out the safeguarding roles and responsibilities for NHS-commissioned providers and sets out the legal framework for safeguarding adults.

As an outcome of an Independent Patient Safety Investigation by the National Health Service, the WellBN Practice in Brighton has stopped prescribing hormone medications to children under 18 years old for gender dysphoria, outside of NHS clinical commissioning policy.

The Care Quality Commission (CQC) suspended WellBN’s ‘Good’ rating while concerns with the practice were investigated further. Suspension of ratings does not mean closure of the practice or suspension of the service’s registration with the CQC.

As part of their ongoing inspection, the CQC is also reviewing historical information relating to prescribing practices at the service. This may involve the use of the CQC’s legal powers to investigate incidents where individuals may have experienced harm or been put at risk of harm within health and social care services in England.

Additionally, a number of former and current clinicians at WellBN have been referred for the purpose of further professional investigation, both through their independent professional regulator and/or through the NHS professional standards mechanism.

The NHS has analysed prescribing data relating to hormone treatments given to children under 18 years old among general practices across England and it found that the WellBN Practice was a clear outlier.

No such guidance has been issued.

NHS England has a published service specification that covers the provision of surgical interventions for individuals on the National Health Service pathway of care for the treatment of gender dysphoria. Providers are expected to follow this service specification.

Neither the Department nor NHS England hold this information.

NHS England has undertaken further due diligence on the data sources that will underpin the study, and taken time to re-engage with data-sharing organisations, on which the study will be dependent, including refining the study design and data sharing requirement following discussion with adult gender clinics.

We now expect all commissioned adult gender services to collaborate with the study to enable its successful completion.

The Department continues to support NHS England in progressing the study.

No disciplinary action has been taken.

NHS England has undertaken further due diligence on the data sources that will underpin the study, and taken time to re-engage with data-sharing organisations, on which the study will be dependent, including refining the study design and data sharing requirement following discussion with adult gender clinics.

We now expect all commissioned adult gender services to collaborate with the study to enable its successful completion.

The Department continues to support NHS England in progressing the study.

No disciplinary action has been taken.

The Cass Review concluded that the percentage of people who subsequently detransition following medical intervention remains unknown due to the lack of long-term follow-up studies.

In response to the recommendations of the Cass Review and the Operational and Delivery Review of Adult Gender Services, NHS England plans to consult on a service specification for a detransition pathway later this year, an element of which will be proposals for building the evidence through data collection, formal research and clinical audit.

NHS England plans to publish proposed clinical commissioning policies for the use of masculinising and feminising hormones in adult gender services later in the summer, for the purpose of public consultation. Separately, NHS England plans to publish new service specifications for adult gender services, for the purpose of public consultation, later this year.

NHS England plans to publish new service specifications for adult gender services, for the purpose of public consultation, later this year. As part of its work to build new service specifications, Dr David Levy, who chaired the Operational and Delivery Review of Adult Gender Services, is overseeing work to define 'clinical complexity' in the context of the adult gender pathway, and for the new service specification to describe the clinical approach for responding to complexity.

We recognise that waiting lists for specialist gender services are too long. This has been caused by multiple factors, including unprecedented demand for gender services and a shortage of specialist clinical staff to meet the rapidly rising demand.

This is why NHS England is working to open new services for both children and young people and adults.

In line with the findings and recommendations of the Cass Review, NHS England has opened three new services in the North West, London, and the South West that offer a fundamentally different clinical model, embedding multi-disciplinary teams in specialist children’s hospitals. A fourth service is anticipated to open in the East of England shortly and NHS England is aiming to deliver service provision in each region of England by the end of 2026/27.

For adults, NHS England has also increased the number of gender dysphoria clinics in England from seven to 12, with the rollout of five new adult gender clinics since July 2020.

We are also working closely with NHS England to implement the findings from the Review of adult gender dysphoria clinics, chaired by Dr David Levy. This includes creating a single, national waiting list that will help effectively manage the wider waiting lists and end the disparity in wait times between the adult gender dysphoria clinics.

We recognise the negative impact long waiting times can have on mental health. This is why the Department has commissioned a pilot to support patients on the waiting list for the Adult Gender Service in the South West of England. This pilot launched on 7 April. We will evaluate the effectiveness of the pilot in due course.

Separate to this, through implementation of the NHS Adult Gender Services Review that was chaired by Dr David Levy, NHS England is working to develop further waiting-well pilots to provide support to patients, including mental health access and self-management resources.

In line with recommendation 25 of the Cass Review, NHS England is developing a clinical pathway for individuals who wish to detransition.

Following engagement with those with lived experience, on 30 October 2025, NHS England published a call for evidence on a clinical pathway for adults who have previously undergone a gender transition and who wish to detransition to bring together professional opinion. The call for evidence closed on 28 December 2025.

NHS England is considering all relevant feedback that was submitted. It will collate views, evidence, and insights into a summary evidence report. NHS England will use this evidence, together with other intelligence and further engagement, to begin to define a clinical pathway which will be tested through further stakeholder engagement and public consultation later this year.

In line with recommendation 25 of the Cass Review, NHS England is developing a clinical pathway for individuals who wish to detransition.

Following engagement with those with lived experience, on 30 October 2025, NHS England published a call for evidence on a clinical pathway for adults who have previously undergone a gender transition and who wish to detransition to bring together professional opinion. The call for evidence closed on 28 December 2025.

NHS England is considering all relevant feedback that was submitted. It will collate views, evidence, and insights into a summary evidence report. NHS England will use this evidence, together with other intelligence and further engagement, to begin to define a clinical pathway which will be tested through further stakeholder engagement and public consultation later this year.

In common with other publicly funded research, the Data Linkage Study is subject to the formal approval of the Health Research Authority (HRA) before the study can begin. For the Data Linkage Study, this requires the consideration of an ethics committee and the Confidentiality Advisory Group.

As the study application remains in active progress with the HRA, and it remains important for the approvals process to be undertaken independently, it is unfortunately not possible to provide an expected date for the HRA approval process to be concluded.

The Department continues to support NHS England in progressing the study.

Following the completion of the Independent Cass Review of NHS Gender Services for Children and Young People (the Cass Review), NHS England brought forward its planned review of adult gender dysphoria services. This review, led by Dr David Levy, examined the operating procedures in each adult gender service and the appropriateness of the service model for the presenting population, considered areas of concern for improvement, and identified good practice that could be shared with other clinics, as well as actions being taken to improve service quality.

In accordance with the Cass Review, the review of adult gender dysphoria services identified the need for improved clinical data, and for further research, to build a more comprehensive evidence base on which to better understand the needs of individuals being referred into adult gender services, to shape service and treatment delivery, and to better understand patient experience and outcomes.

Alongside work being undertaken to develop a common data set and associated registry arrangements, to embed quality improvement, to build and support research capacity and capability, and invest in clinical service delivery across National Health Service gender services, the James Lind Alliance is running two priority setting partnerships (PSPs) which are providing the opportunity to help identify and prioritise future gender research priorities. The Youth Diversity PSP will produce a top 10 list of research priorities for children and young people aged five to 25 years old, whilst the Trans, Non-Binary and Gender-Diverse Adults PSP is focussing on the research priorities for adults aged 18 years old and over. The National Institute for Health and Care Research will be able to build on the outputs of both PSPs to inform future calls for further gender research that specifically responds to the most important research questions identified in collaboration with stakeholders, including patients and their families, clinicians, and education and social care professionals.

We accept that waiting times for gender services are too long and we are determined to change that.

In line with the Government's aim to bring down waiting lists and improve the care offered to individuals being cared for in gender services, NHS England has increased the number of adult Gender Dysphoria Clinics (GDCs) in England from seven to 12, with the rollout of five new GDCs since July 2020. Both the rollout of these new clinics and the changes being made elsewhere in the service are helping to tackle long waiting times.

Furthermore, through implementation of the NHS Adult Gender Services Review that was chaired by Dr David Levy, NHS England is working to develop waiting-well pilots to provide support to patients, including mental health access and self-management resources.

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.

To ask His Majesty’s Government at what age they consider it appropriate for an individual to be able to consent to the administration of puberty blockers on a trial basis.

I appreciate that the noble Baroness has strong views—so do a number of noble Lords, as we heard on the Statement that I presented and responded to yesterday. On consent, I remind noble Lords that this is a sensitive, emotive and difficult subject, but that is why we have to be driven, as the previous Government were, by clinical evidence and experts. I recall that the noble Baroness, Lady Cass, who was rightly entrusted with an independent review, said:

“This is an area of remarkably weak evidence”.

There are always choices. We could continue with uncertainty and risks to the safety of children and young people, which I think none of us wants, or undertake a scientifically guided trial for 233 children, with all the right safeguards that I have referred to, and protect children and young people.