Echo, who is part of a potential legal challenge to England’s National Health Service (NHS) over waiting times, said the delay left her “drowning” in gender dysphoria – the distress caused by someone’s gender identity not matching their body. “There’s no way to tell where I am on the list or when I’m likely to be seen,” said Echo, 41, who lives in Britain’s second-largest city, Birmingham. “I basically feel like I’m in limbo – my life is on hold.” As greater awareness and acceptance leads more people to come out as trans worldwide, waiting times for gender care are soaring – even in wealthy countries with relatively generous state-funded healthcare provisions.