1. Overview
NHS England is developing a clinical pathway for adults who have previously undergone a gender transition and who subsequently wish to detransition.
In April 2025, as one of several planned engagement exercises to help shape this programme of work, NHS England invited individuals with lived experience to share their views and experiences of detransition. NHS England heard the challenges that people who detransition may face, including that many people live with physical and mental healthcare needs but struggle to access the right support to address them.
Building on these insights, NHS England is now calling for evidence from healthcare professionals.
The call for evidence will run for 8 weeks between Thursday 30 October and Sunday 28 December 2025.
Individuals with lived experience who wish to be involved in this work as it develops may register their interest by emailing england.scengagement@nhs.net.
2. Definitions
Detransition
This document uses the Cass Review’s definition of ‘detransition’ as the process of discontinuing or reversing a gender transition, often in connection with a change in how the individual identifies or conceptualises their sex or gender since initiating transition.
This definition generally describes individuals who have medically transitioned through medical intervention (hormone therapy or surgery) and who subsequently self-identify with a process of detransition.
Regret is not a defining feature of the definition. Individuals may detransition with, or without, feeling regret about their previous transition or experiencing a change in their gender identity.
3. Introduction
In 2020 NHS England commissioned the Cass Review, which was an independent review of NHS gender identity services for children and young people.
While the Cass Review focused on young people under the age of 18, the final report also highlighted issues around the clinical approach for adults. Among her findings, Dr Cass highlighted an increasing number of people seeking to detransition with no clear route to access care.
The Cass Review recommended that the NHS should ensure that there is suitable provision for individuals who choose to detransition, recognising that some people may prefer to engage with services other than their previous or current Gender Dysphoria Clinic. In August 2024 NHS England published a plan for implementing the Cass Review recommendations.
There are challenges in the formation of a pathway or service for people who choose to detransition. Historically, data and research on detransition has been limited. This has meant that not enough is known about the health and care needs or experiences of people who want to detransition. There are no professional guidelines, or defined interventions, in the UK for healthcare professionals to use when supporting people to detransition.
The first step towards addressing these began earlier this year, with NHS England engaging with people with lived experience. As a next step, NHS England is now extending the call for evidence to healthcare professionals.
4. About the call for evidence
Aims
All specialised services that NHS England commissions are defined by national service specifications which set out the core standards of care that providers must meet. We are asking for healthcare professionals to help us to identify the elements of a service specification for a detransition pathway.
NHS England wants to hear from healthcare professionals supporting people who wish to detransition, as well as relevant professional organisations. We are particularly interested to identify and understand examples of care provision.
Who can respond
There are three different question sets in this document, aimed at:
- Healthcare professionals (and/or their employing organisation) who are providing care to individuals who wish to detransition, and who are not working in NHS gender dysphoria clinics
- Healthcare professionals (and/or their employing organisations) who are providing care to individuals who wish to detransition, and who are working in NHS gender dysphoria clinics
- Professional bodies (healthcare)
How to respond
You can respond by completing the survey at: www.engage.england.nhs.uk/consultation/clinical-pathway-adults-gender-detransition/
The call for evidence runs for 8 weeks and closes at 11:59PM on Sunday 28 December 2025.
If you are experiencing any difficulties in accessing the form, or you require it in an alternative format, please contact england.scengagement@nhs.net.
Submitting further evidence
As well as answering the questions, we welcome you to upload documents that you think NHS England should consider in developing a detransition pathway. These may be published or unpublished, and could include:
- Case studies of care and support provided to individuals who detransition
- Current examples of evaluated and non-evaluated practice, projects that aim to support individuals who detransition
- Ongoing data and research on services provided to individuals who detransition
- Data and statistics on how often individuals detransition back to their birth-registered gender
- Data and evidence on why individuals may choose to detransition
Your submissions will be limited to three separate files of a maximum of 10 pages each. They must not include any personal data or patient identifiable data.
5. Next steps
After the call for evidence closes, NHS England will consider all relevant feedback that is submitted. We will collate views, evidence and insights into a summary evidence report.
We 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 in 2025/26.
6. Privacy notice
NHS England’s privacy notice describes how we use your personal data and explains how you can contact us and exercise your rights as a data subject. We will process information about you in accordance with the requirements of the UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018 (DPA 2018).
Participation in the call for evidence
Your involvement in this call for evidence is voluntary and you are free to opt out of the survey at any time. Only submitted responses will be included in the analysis, and no attempt will be made to identify you as an individual, other than if you state that you are interested in being involved further with this work. By submitting a completed survey, you are consenting to the processing of your data for the purposes set out below.
Use of data
Data collected through the call for evidence will be used to help NHS England to identify the elements of a service specification; understand current examples of care provision; and support NHS England’s statutory functions in relation to the provision and improvement of NHS services.
Personal data
To validate responses to this call for evidence, we will process some limited personal data:
- name
- professional background (i.e., clinical discipline, such as psychiatry or endocrinology)
- type of employing healthcare organisation (for example, an NHS Gender Dysphoria Clinic)
- name of employing healthcare organisation, where respondents opt to provide this
Other than when prompted in the ‘please tell us about you’ section, do not provide any person identifiable data in your responses to questions or when giving evidence or examples. Any personal data or patient identifiable data included will be removed prior to analysis of these responses and will not be considered in the analysis.
Processing and retention
Data collected through the survey will be stored in the strictest confidence by approved NHS England National Specialised Commissioning officials in line with NHS England’s retention schedule.
Your personal data will not be retained for longer than the analysis of the survey. We expect this to be for a period of one year from the closure of the survey. NHS England will not share your personal data with any other party.