Gender identity: Belfast Trust apologises for 'excessive delays' at clinic

The Belfast Health Trust has apologised for "excessive delays" experienced by patients waiting to be seen by Northern Ireland's gender identity clinic.

BBC News NI has learned 698 people are on the adult waiting list.

The trust said that the longest waiting time is five years and three months.

Forty-seven young people are on a waiting list for the gender identity service for those aged 18 and under, with the longest wait currently 50 weeks.

The trust said it wanted to "sincerely apologise" to everyone affected by delays.

A Stormont report published by the Department of Finance on Monday described current provision for people seeking to change their gender in Northern Ireland as "severely lacking".

It said the sole adult clinic was located in Belfast and could be difficult to access.

The Belfast Health Trust said it fully accepted that the waiting times were excessive.

The trust also said that a review of gender services in Northern Ireland has been undertaken and that the report is currently with the Department of Health for consideration.

The Belfast Health Trust runs two gender identity clinics - one for adults experiencing gender dysphoria and one for young people under 18, called the Knowing Our Identity (KOI) service.

Gender dysphoria is defined by the NHS as "a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity".

Adults can be referred to the gender identity service by GPs or some other medical professionals, while young people are referred to KOI by children and adolescent mental health services (CAMHS) teams.

Some people with gender dysphoria may eventually decide to change their gender through the use of hormones or surgery.

The Department of Finance's report had described services for people seeking to change their gender in Northern Ireland as "severely lacking".

"There is one gender identity clinic which is located in Belfast and for which there are long waiting times to access the service," it said.

"Restricted access to healthcare" was also seen as a cause of mental health problems in the transgender community, according to the study.

Amelia Clarke, the trans youth officer with the LGBTQ support organisation Cara Friend, said waiting so long to access the gender identity clinic affected many of young people she worked with.

"It is absolutely detrimental to their mental health," she told BBC News NI.

"Even if they've been on the waiting list with Knowing Our Identity, moving on to the adult waiting list is like a kick in the teeth.

"They've been waiting all this time and then all of a sudden they're back to square one again, back to waiting many years even just for an appointment to be seen.

"It creates anxiety, it negatively impacts their gender dysphoria, it really brings down their mental health.

"I can see them struggling with their mental health because of the waiting list, because of the wait they're having to experience."

Ms Clarke said that the waiting list figures also showed that more health services for trans people were needed in Northern Ireland.

"Provision is just not there and the provision that we do have is not adequate for the amount of trans young people and trans people in general," she said.

"It is completely swamping the workers that are doing it, they are trying their best.

"But they really need to bring in more people to ease down the wait time.

"There's definitely a lack of provision and a lack of staff that needs to be addressed."

If they decide to, people in Northern Ireland can change their legal gender under the Gender Recognition Act (GRA) 2005.

However, they need to be at least 18 years old and provide two medical reports, one from a specialist detailing their diagnosis of gender dysphoria and another listing any treatment or surgery they may have had to change their sexual characteristics.

They also must prove they have lived full-time in their acquired gender for at least two years and have to apply to a UK gender recognition panel.

The Department of Finance report, which was compiled by academics from Queen's University, said that reform of gender recognition laws in Northern Ireland would have a "significant positive impact" for the transgender community.

There has been significant recent debate over plans by the Scottish government to make it easier for people in Scotland to change their legally recognised gender.