Patients told gender surgery was cancelled while they were already in hospital

Some patients of the Welsh Gender Service found out that their operations had been called off while they were already in hospital preparing for them, Cardiff and Vale University Health Board has confirmed, in the clearest account yet of how last week's pause on gender affirming surgery was carried out in practice.

Paul Bostock, chief operating officer at the health board, said the instruction to halt scheduled surgery had required the board to contact care providers in NHS England to stop operations that were imminent, and that a number of patients were told while in hospital getting ready for theatre. He said the board was sorry for the effect this will have had on patients and the people around them, and acknowledged that surgery can be a significant and deeply personal stage of someone's care.

What happened

The NHS Wales Joint Commissioning Committee, a body representing all the Welsh health boards, instructed Cardiff and Vale to pause referrals, assessments and scheduled surgery through the Welsh Gender Service following a subcommittee meeting on 24 August, at which members heard that the service was referring patients for surgery at higher rates than comparable services in England and that there were concerns about whether referrals were appropriate.

The committee has described the pause as a precautionary and clinically led step taken to allow urgent clinical assurance work, and said affected patients were being contacted directly. It declined to set out its reasoning in detail when the decision was first made public, on the basis that patients needed to hear first.

The patient view

Sion Jewell, who is 29 and from Anglesey, had waited five years from their initial GP referrals for chest surgery, had already had the operation postponed twice on mental health grounds, and had packed for hospital when a phone call came through 24 hours beforehand telling them it was off.

Jewell described being "heartbroken" and disheartened, said that the surgery was what they needed in order to feel right in their own body, and put the experience of gender dysphoria in terms of wearing skin belonging to someone else. They said the decision left trans people feeling as though they were regarded as second class citizens, and raised a comparison that is likely to be repeated a good deal in the coming weeks: had the referral rate been for hip replacements or cancer treatment, higher numbers would be read as a service doing its job rather than as a problem requiring suspension.

Jewell also said they feared for the wellbeing of trans people affected by the announcement.

Where the referral figures come from

Part of the public case for a review has been built by the investigative journalist Nick Wallis, who has spent several months examining the Welsh Gender Service and has analysed data obtained through Freedom of Information requests. Wallis has written that the service referred adult patients at three to four times the rate per head of population of other UK clinics, and told BBC Wales that referrals for genital and chest surgery across 2024 and 2025 ran well ahead of the numbers in England, Scotland and Northern Ireland.

Wallis has also relayed the account of a mother who told him her child's comorbidities, including autism, had not been properly considered and that no proper mental health assessment had taken place, and who felt she had been treated as an obstruction for raising it. That account is second hand and has not been independently verified, and the health board has not commented on any individual case.

Asked about the FOI data, the commissioning committee said it had been looking at more recent figures covering 2025 to 2026 and carrying out a wider analysis of its own.

The politics

The pause has produced an unusual alignment. Dan Thomas, Reform UK's Welsh leader, said sensible people in Wales would welcome it and argued that a fuller review of the service was still needed. Natasha Asghar, the Welsh Conservatives' shadow health minister, who had already called for a review, said cancelling surgery while it takes place was the right course.

Criticism has come from inside the governing party. Matthew Jones, the Plaid Cymru member of the Senedd for Sir Fynwy Torfaen, questioned the reasoning behind the decision in a statement posted to the party's official Instagram account, argued that a higher referral rate in Wales was not in itself a problem, described Wales as a last bastion of dignity, said he was disappointed that the service had given way to external pressure, and called for the pause to be lifted as soon as possible.

Plaid Cymru has run the Welsh government since its election win in May, though the decision sits with the arm's length commissioning committee rather than with ministers. Asked whether Jones was speaking for the government, a Welsh government spokesperson said the health minister, Mabon ap Gwynfor, understood the concerns of those affected and expected the health board and the committee to put proper support in place and to act on anything necessary as a priority.

What happens next

The independent clinical review of the service's assessment, referral and governance arrangements is under way and has no published reporting date. Referrals, surgical assessments and scheduled operations remain paused. Hormone therapy support, endocrine review, psychological support and speech and language therapy are unaffected, and patients with existing appointments have been asked to keep them.

If this story has affected you, Umbrella Cymru offers gender and sexual diversity support in Wales, Switchboard runs a free LGBTQIA+ helpline, and Samaritans is available at any hour on 116 123.