Following public consultation, NHS England published new service specification1 for specialised gender dysphoria services in September 2018. The new service specifications will be used in a national process of procurement later in the year that will determine which organisations are best able to deliver gender dysphoria services from 2019/20. The new specifications also describe that in order to increase clinical capacity to meet increasing demand, and thereby reduce waiting lists over time, new models for delivery will be explored. Note: 1https://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-e/e10/