I estimate only ~10% of children & young people who we might expect to see accessing transgender health care & support are doing so. This is due to the significant systemic barriers in accessing services. societal stigma, lack of GP support, Geographically distant locations, ££.
Today it is practically near impossible to access medical treatment for a 13 year old or older, simply due to the 4 year wait for medication & then aging out into adult services with further lengthy wait lists. This undoubtedly has an impact on the known demand for services.
Private care is filling this gap to some extent, though this introduces a cost barrier, difficult for those adolescents who are supported by family & impossible for those who are not. This relies upon supportive GPs willing to share care with a GMC suspended private provider.
Others are looking outside the UK altogether and seeking healthcare in Europe or USA. Based upon figures I've received from private providers I estimate another 500-1000 adolescents from England & Wales are accessing private treatment.
Then there is an unknown group of adolescents who are 'self-medding' that is purchasing drugs online with or without parental/family support, & without supporting baseline and monitoring blood tests. I estimate this group to be small - due to costs & perceived safety risks.
Even at the highest estimate I doubt whether self-medding is more than a few hundred individuals. Taking lowest prevalence est of 0.4% of population this still leaves a shortfall of ~23,000 trans youth who we would expect to be seeking treatment who are not. #nhsfailingtranskids
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