This report contains descriptions by 149 people who were (and are) seeking help for gender identity issues.

Their perceptions, experiences and views are discussed about outcomes of care and treatment quality. We did this work to complement the work being carried out by NHS England, and we have heard locally in Devon about long waiting times and problems accessing treatment.

We intend, as a result of this survey, to help increase participation in better decision making about services, by providing recommendations based on what people told us, to help to enable and inform:

• on a personal level, for readers seeking help and the professionals involved

• locally with commissioners and providers

• strategically in planning and delivering services