Image copyright iStock

Transgender people in Wales face a "contorted" route to medical or surgical help, campaigners have claimed.

GPs in England and Scotland can refer patients whose mind identity is different to their body directly to a Gender Identity Clinic (GIC).

But in Wales the process takes five steps, which campaigners have said is too long.

The Welsh government said it would publish a transgender action plan soon.

'Life or death'

Jenny-Anne Bishop, of Unique Transgender Network, said Wales was "about five to 10 years behind England and Scotland" when it came to treating transgender people.

She said: "The steps take you from your GP to a specialist for diagnosis. This is then sent to the local health board gatekeeper, who either agrees or disagrees with the diagnosis.

"Once the diagnosis is agreed, a request is sent to Welsh Health Specialised Services (WHSCC) for funding to be referred to a GIC in London.

"Think about the cost of one suicide attempt or lifelong depression or self-harming. The cost of not treating people is horrendous."

Image copyright Thinkstock

Harry, 19, who is currently awaiting treatment at a GIC, told BBC Radio Wales' Eye On Wales programme he always knew he was a man but was born in a woman's body.

"It's like you're stuck and trapped and you can't breathe. You just need to scream and get out. This isn't just 'I fancy growing a beard and lowering my voice' - this is life or death," he said.

A Welsh government spokeswoman said its Transgender Action Plan would include a care pathway and guidance for health workers.

"This will be progressed as a priority and any service realignment required to support the pathway should begin during 2016/17," she added.

Campaigners have estimated 30,000 people in Wales are "gender diverse".

Of these, about 6,000 will have transitioned, are transitioning or will transition in the next year or two, they have said.

About 500-600 are currently seeking treatment, with up to 120 more referred each year.

That figure is growing at a rate of 30% a year for adults and 50% a year for people aged under 18, campaigners have said, with numbers seeking treatment expected to reach 1,000 within three years.

The cost of transitioning from a woman to man is about £60,000, while transitioning from a man to a woman costs about £20,000.

Gender diversity includes transgender men and women as well as people who identify as "agender" or "gender neutral" - those who feel they are a mix of the two genders or neither gender.