Thousands of Scots children and adults are on the waiting list for treatment at a gender identity clinic as health leaders warned the toxic row over self-ID has led to a recruitment crisis.
Figures show 3,797 people are waiting for an appointment at the Sandyford service, run by NHS Greater Glasgow Clyde, which is the only one in Scotland that sees children as young as 13.
Clinics offer a "comprehensive" service for young people who are uncertain about their gender identity and adult transgender and non-binary people considering medical treatment or surgery.
In February, a message posted on the clinic's website stated it was unable to offer new appointments to young people due to demand for treatment.
The health board later removed the message and said the waiting list remained open.
A freedom of information request by The Herald has shown the extent of pressure on the service.
A total of 1046 children under the age of 17 were on the waiting list as of April 14 with a further 2751 adults, aged 18 and over still to be seen by health workers.
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No children aged 13-17 have been given appointments this year.
The average wait for young people is three years and ten months and almost five years for adults. The Scottish Government has allocated an extra £500,000 to increase capacity at the service.
NHS GGC runs four Sandyford clinics in Glasgow, including the main centre at Sandyford Place and others in Clydebank, Greenock and Paisley.
In a statement, NHS GGC said: "People wishing to access our gender services are unfortunately experiencing considerable waiting times, and we would like to apologise to them for that.
"Gender services are a complex speciality which demands a particular set of clinical skills and other qualities from staff, and it is true that we are facing specific challenges around recruitment in some areas."
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The health board said extensive efforts had been made to recruit staff but suggested the inflamed response to the Gender Recognition Reform (Scotland) Bill may be discouraging health workers from taking up positions.
It said: "Efforts are made more challenging by ongoing media and political scrutiny, and the additional public attention that has followed.
"We are very aware of the impact this scrutiny may have on our teams within gender services, and in other services provided by Sandyford, and we are doing everything we can ensure staff are appropriately supported."
NHS GGC said it was constantly reviewing recruitment procedures and said it was prepared to "widen our search for the right staff if that is deemed appropriate".
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The Scottish Parliament bill, which was passed in December, lowers the age someone can legally change their gender from 18 to 16 and removes the requirement for a medical diagnosis of gender dysphoria.
Scotland’s social justice secretary, Shirley-Anne Somerville, announced last week that ministers would lodge a petition for a judicial review of Westminster's plans to use section 35 of the Scotland Act 1998 to prevent the Holyrood bill from going for royal assent.
The UK Government say the bill poses a threat to UK-wide equality laws.
While the political wrangling continues, charities say the young people requiring support are bearing the brunt of public disharmony.
The charity LGBT Youth Scotland has said it intends to close the group's Twitter account from May because it no longer believed the social media forum was a "safe place" for the young people it supports.
A message on the charity's website said: "LGBT Youth Scotland creates safe, healthy spaces where LGBTQ+ young people can flourish and thrive.
"We no longer believe that Twitter is a safe or healthy space to encourage young people to join us in, and so we have taken the decision to close our account from May 2023."
The charity said it would continue to support young people on its other channels.
There have been some calls for the Sandyford gender clinic to be closed after NHS England decided to wind up the equivalent service in London.
It followed a review that raised concerns about gender dysphoria being treated in isolation from other mental health issues at the Tavistock clinic.
There are three other NHS-run clinics in Scotland that take referrals from adults in Edinburgh, Aberdeen and Inverness.
NHS Lothian said its service was experiencing high demand and is currently contacting people who were referred up to October 2020.
For information and support go to www.scottishtrans.org
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