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Thousands of children, some as young as 4, are being referred to the United Kingdom’s Gender Identity Development Service, creating a waiting list at the National Health Service facility.

The Tavistock and Portman NHS Foundation Trust has revealed in a new report that referrals for children are up 25 percent from just a year earlier.

Polly Carmichael, a consulting psychologist and a director for the GIDS, said there is more recognition of students with gender issues and more acceptance, which apparently translates into more referrals.

“There is no single explanation for the increase in referral figures, but we do know in recent years that there has been significant progress towards the acceptance and recognition of transgender and gender diverse people in our society,” Carmichael said in the report. “There is also greater public knowledge about specialist gender clinics and the pathways into them, and an increased awareness of the possibilities around physical treatments for younger adolescents.

“Addressing the waiting list is a top priority for us. We appreciate how distressing it can be for young people and their families who are on the waiting list. We are doing all we can to bring down the waiting times, and are continuing to look for innovative new ways to shorten the wait such as group work and online video appointments – which have been welcomed by the young people. We have also created a telephone helpline for queries so that young people on the waiting list can speak with a clinician if necessary,” she said.

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“Given the large increase in referrals in recent years it will take some time to address the waiting list of those young people waiting to be seen by the service. We also need to find and train the appropriate staff for these highly specialized roles, and that takes time,” she added.

“As the majority of our users do not take up physical treatment through our service, any decisions around hormone treatments need time and considered thought. The long term health and psycho-social wellbeing of young people is always our priority. In all our work we aim to be extremely careful to properly support people and allow them to explore their full range of options.”

The Tavistock and Portman report said that during 2017-2018 there were 2,518 referrals at the clinic, a jump of 25 percent.

Of those, 1,806 were for young people “assigned female at birth,” the report said, and 712 were for those “assigned male at birth.”

The Christian Institute posted a warning from Stephanie Davies-Arai of the parents’ group Transgender Trend.

“Teenagers are being influenced by an online culture which celebrates medical transition as cool,” Davies-Arai wrote. “Girls especially are being encouraged to identify as boys if they don’t fit a stereotype. All debate is shut down as transphobic.”

Of those referred, there were 157 children under age 10.

The institute said that to be recognized as the opposite sex, individuals in the U.K. must live as that sex for two years and be medically diagnosed with gender dysphoria.

But there is a plan under consideration that would simply let people declare their gender.

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