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Number of trans people receiving NHS treatment rises 75% in five years amid national HRT shortage


The number of adults in the UK being treated for gender dysphoria on the NHS has risen 75 per cent in five years, MailOnline can reveal.

Latest figures for 2021 show more than 11,000 patients received care for feeling that their gender does not match the one they were born with.

This is 74 per cent more patients with the condition compared to the 6,371 being treated in 2016.

Being diagnosed with gender dysphoria is the first step to getting prescribed cross-sex hormone therapies that can help trans people develop the characteristics of their preferred gender. 

It comes amid a nationwide shortage of hormone replacement therapy which is also used to help alleviate the symptoms of the mesopause.

Around 1,600 trans patients were prescribed the female hormone oestrogen in 2021, the most popular HRT drug that is most short in stock. 

However, the total figure is believed to be higher because data is only available for four out of the 12 of the gender clinics that provided information to MailOnline. 

A current HRT shortage has left menopausal women rationing doses, trading supplies in car parks or paying eyewatering prices from online suppliers.

This map shows the geographic distribution of gender dysphoria patients in the UK from NHS clinics that provided data to MailOnline

This map shows the geographic distribution of gender dysphoria patients in the UK from NHS clinics that provided data to MailOnline

And this map shows the number of these patients prescribed oestrogen, which helps people with the condition become more feminine from the four clinics that provided their data to this website

And this map shows the number of these patients prescribed oestrogen, which helps people with the condition become more feminine from the four clinics that provided their data to this website

MailOnline complied the data on gender dysphoria from freedom of information requests from 12 NHS gender clinics in the UK.

Of these, 11 provided data on their patient numbers stretching back to 2016, or to when they first opened.

Only four of the services were able to provide the number of patients prescribed oestrogen as part of their treatment, meaning the total is likely much higher.

In total there were 11,085 gender dysphoria patients being treated in 2021, though figures includes some patients in the first few months of 2022 as some trusts recorded their data by financial year.   

This compares to 6,371 gender dysphoria patients in 2016.

Fury over ‘ideological’ new NHS trans pregnancy advice that refers to ‘chest-feeding 

New NHS advice for trans parents has been described as ‘ideological’ for failing to mention the word breasts and ‘normalising’ a potentially dangerous chest-binding technique.

The guidance also encourages people to keep taking hormone transitioning drugs when they ‘chestfeed’, despite admitting ‘it is unclear what effect this could have on your baby’.

The advice was written a year ago but was only issued online this week after nearly a year of internal wrangling over whether to publish. 

It has provoked concern among nurses and members of the public, who said the advice fails to warn people about health risks to both parents and babies. 

A page titled ‘chestfeeding if you’re trans or non-binary’ makes no mention of breasts and refers to breast reduction operations as ‘top surgery’.

The advice also has a section on binding, a technique used by women transitioning to men to flatten their breasts, usually with extremely tight fitting bras.

Experts have previously warned the technique can cause bruised ribs, fractures, breathing difficulties and infections.

Even NHS England advice in 2008 said bindings should only be used for short periods of time because they ‘may cause back problems’ and can distort breast tissue, which could affect any future surgery to remove the breasts. 

Of the 2021 patients 1,592 were prescribed oestrogen.

For men wising to be feminine, oestrogen helps reduce facial hair, leads to development of breast tissue, rounder hips shrinkage of the testes, and less general muscle mass. 

In women going through the menopause HRT replaces the hormones the body naturally produced the lack of which causes the famous symptoms.

Women with menopause on HRT can have symptoms like hot flushes, brain fog, joint pains, mood swings and vaginal dryness disappear within weeks or months. 

About a million British women are estimated to be taking HRT of some sort for their menopause symptoms, with NHS data showing prescriptions for these medications rose to over 500,000 in February alone. 

The current HRT crisis has left desperate women rationing doses, turning to the black market or even smuggling medications into the UK from abroad. 

Nottinghamshire Healthcare NHS Foundation Trust accounted for the lion’s share of gender dysphoria patients in the UK, our analysis shows.

The Trust’s Nottingham Centre for Transgender Health, treated 5,050 patients in 2021 nearly half of the total for the year.

In second place was The Welsh Gender Service, which only launched in 2019 and recorded 1,679 patients in the 2021 financial year.

This is more than double the patients treated at the service in the previous year and eight-times more than its first year of operation.

In third place for 2021 was Northamptonshire Healthcare NHS Foundation Trust’s Gender Dysphoria Clinic, with 1,475 patients, roughly double the number being treated in 2016.

For Scotland, the clinic with highest number patients was Sandyford run by NHS Greater Glasgow and Clyde, with 742 in 2021, only eight more patients than 2016.

Northern Ireland’s gender dysphoria service, run by the Belfast Health and Social Care Trust’s Brackenburn Clinic, recorded just 58 patients in 2021.  

Four NHS trusts provided data on the number of patients given oestrogen in 2021.

These were Chelsea and Westminster Hospital, NHS Highland in Scotland, Sheffield Health and Social Care, and Northamptonshire Healthcare. 

Northamptonshire Healthcare had the most patients on oestrogen in 2021, with 1,341.

That accounts for about 91 per cent of the people it was treating for gender dysphoria that year.

This was followed by Chelsea and Westminster Hospital with 201 patients, about 55 per cent of its total patients, and NHS Highland with between 40 to 50 patients had been given a prescription for oestrogen.

NHS Highland told MailOnline it couldn’t provide an accurate figure due to how different HRT medications were listed in its database and prescription rules changing in 2021 due to Covid. 

Sheffield Health and Social Care provided 38 patients oestrogen in 2021, about 12 per cent of its total patient number. 

It should be noted the figures collected by MailOnline only show adults treated for gender dysphoria.

Children with the condition are treated via the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust which has two main clinics, one in London and one in Leeds. 

GIDS has seen a dramatic rise in its annual caseload over the last decade. Just 138 children were referred for treatment in 2010/11. But this has grown to 2,383 in 2020/21, a 17-fold increase. 

There are also 5,500 children currently on the NHS waiting list for gender swap treatment after post-lockdown surge in demand .

Children with gender dysphoria are not given HRT straight away but can be given puberty blockers after going through several rounds of counselling. 

They can be given HRT once they turn 16-years-old, and if they have been on hormone blockers for at least a year.

Waiting times for gender identity clinics have become grown considerably in recent years as the condition has become more widely accepted. 

Some clinics like the Nottingham Centre for Transgender Health are now contacting patients originally referred in February 2020. 

Whereas Nottinghamshire Healthcare NHS Foundation Trust has a 49 month long waiting list. 

There are currently five oestrgoen medications that are in serious short supply in the UK.

These are various doses of Oestrogel, Ovestin, Premique, Lenzetto and Sandrena.

There has been a big increase in women seeking HRT, with an estimated 538,000 prescriptions issued in December, compared with 238,000 in January 2017.

Prescriptions for Oestrogel, which is used by around 30,000 in the UK, have also risen dramatically. 

Some gender dysphoria clinics have also warned their patients about Oestrogel shortages and advising users to substitute their usual does with alternative medications like Lenzetto and Sandrena.

There were about 512,000 NHS prescriptions written for 'female sex hormones and their modulators' in England in February, the latest official data shows, compared to 265,000 in March 2017. Many of these will be HRT medications but some may include other female hormone drugs such as contraceptives

There were about 512,000 NHS prescriptions written for ‘female sex hormones and their modulators’ in England in February, the latest official data shows, compared to 265,000 in March 2017. Many of these will be HRT medications but some may include other female hormone drugs such as contraceptives

It is not known how many trans people in total might also be impacted by shortages of oestrogen medications.

If transwomen, a male-to-female person, stops taking HRT male features like facial hair can return which can trigger or exacerbate feelings of gender dysphoria.

Health minister Sajid Javid has continually promised action on Britain’s HRT crisis.

Last month he appointed a new HRT tsar Madelaine McTernan with a mission to secure menopause medications from countries with excess supplies in Europe and North America.

About two weeks ago Government also issued officials issued a Serious Shortage Protocol (SSP) enabling pharmacists to hand out substitute forms of HRT without the patient having to go back to her GP for a fresh prescription.

But pharmacists have warned that, despite official assurances, local rules are still deterring GPs from prescribing the brands of HRT many women want.

There are no accurate estimates on how many trans people there are in the UK, however the Government estimates there are between 200,000-500,000. 

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