{
  "abstract": "Introduction/Background TransPlus is the first integrated Gender, Sexual Health and HIV service commissioned by NHS England, based at 56 Dean Street, London. During its pilot scheme, it provided gender dysphoria services to clients on the national waiting list, who had previously had any other care with 56 Dean Street. This created a unique dataset of people who had been on waiting list for a gender affirming service for between 4 months and 6 years, including people who had aged out of the Gender Identity Development Service (GIDS) waiting list.Aim(s) This project examined the demographics, pre-existing needs, prior access to gender affirming care and requests from the TransPlus service of young people aged ≤ 25, specifically considering those who had transitioned before 18.Materials and Methods Retrospective electronic case-note review of all clients who attended the TransPlus clinic between July and December 2022 inclusive (n = 176). Clients attending TransPlus for a second surgical endorsement (n = 13) or not meeting diagnostic criteria for gender dysphoria during the study period (n = 4) were not included in the analysis.Results 55 eligible clients were aged ≤ 25 at their first TransPlus appointment. From the clinic notes, it was clear that 26% had socially transitioned before 18 and 18% had taken gender-affirming medical care before age 18, either through a private prescription of cross-sex hormones or sourced from the internet without a prescription. None of the young people disclosed taking hormone blockers privately. Of the 56% of remaining clients, case notes did not cover adolescent experiences or social transition, but they had not had gender affirming medical or surgical care.Of those whose clinic notes demonstrated they had transitioned as teenagers socially and/or medically, 12 were Trans Women, 10 were Trans Men and 2 were Non-Binary AFAB. 13 had a diagnosis of neurodiversity (ASD, ADHD, dyslexia or dyspraxia), 10 had an intercurrent mental health condition (depression, anxiety, 1 personality disorder), 10 had an intercurrent physical condition and 8 identified as having a disability. 12 identified as White British. The demographics of this group of 24 clients appeared to be in keeping with data from the rest of the pilot scheme, though was too small to statistically analyse further.Conclusions A number of Trans and Gender Diverse young people are transitioning privately or through self-sourced medication whilst they wait for or age out of the GIDS waiting list. It is unclear the support, advice and monitoring they are receiving during this time, though unlikely to be as high as through an NHS service. Some are then able to be seen in adult services, but an unknown number will continue to self-source. Further work is required to reach and support these underserved young people earlier and examine any intersectional health disparities.",
  "authors": [
    {
      "affiliations": [
        "Dean Street, Chelsea and Westminster Trust"
      ],
      "name": "Rebecca Kiesel"
    },
    {
      "affiliations": [
        "Dean Street, Chelsea and Westminster Trust"
      ],
      "name": "Jaymie Huckridge"
    },
    {
      "affiliations": [
        "Dean Street, Chelsea and Westminster Trust"
      ],
      "name": "Tom Rew"
    },
    {
      "affiliations": [
        "Dean Street, Chelsea and Westminster Trust"
      ],
      "name": "Frances Lander"
    }
  ],
  "title": "8270 Trans and gender diverse young people entering adult services: a retrospective study of prior access to gender affirming care",
  "uid": "39778699-8d56-5b3e-9baf-64b9f62ff475"
}