NHS Gender Identity Services for Adults - Service Specifications Consultation


This document consists of our analysis and response to the ongoing consultation of the NHS Gender Identity Services Service Specification and to the changes discussed within both the consultation guidance and the service specification documents.

We highlight a number of changes that we believe are improvements of the current situation, but also draw attention to and make recommendations around a number of concerns we have around the new specifications.

While we are pleased that the draft service specifications have been published, we feel that these have not sufficiently addressed a number of issues with the current arrangements for gender identity services, and, in some cases, introduce new issues which must be resolved.

We also recommend informed consent models, which would be a great improvement for many trans people, and would also reduce waiting times and resources required to to provide these services.

The consultation guidance and draft service specification documents can be found on the NHS England consultations site.

Table of Contents


Referral Process



Acute conditions

Age and GIDS

Intersex issues

Assessment Process

Family members

Gender presentation and nonbinary people


Preferred model of arrangements: “D”

Bridging prescriptions and self-medication

Ensuring option “D” meets the 18 week referral-to-treatment criteria

The other options

GRS and other surgeries


Lived experience

Corrective procedures

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