Although the race for House speaker remains unsettled, House Minority Leader Kevin McCarthy (R-CA) is already moving into the speaker’s suite.

Sharing a video of a man carting a stack of blue containers in what appeared to be the U.S. Capitol, NBC News’ Haley Talbot reported McCarthy “has moved into” the suite of offices and will have to move all his stuff back out if he loses the vote Tuesday. In fact, boxes from McCarthy’s office were spotted being transported to the speaker’s suite as early as last week, per CNN.

GOP Leader McCarthy has moved into the speakers suite but if he fails to secure 218 he will have to move all his stuff back out ⁦@AllieRaffa⁩ pic.twitter.com/Lb2swMgQ2p

— Haley Talbot (@haleytalbotnbc) January 2, 2023

The flurry of activity kicks off the new year in which Republicans take control of the House by a small margin. McCarthy did not get into specifics but did flash confidence when pressed by reporters on Monday.

“I think we will have a good day tomorrow,” McCarthy said.

Q: Speakers votes locked in?
KM: and take away all the excitement?
Q: do you have the votes locked in?
KM: I think we will have a good day tomorrow
Q: Leader McCarthy are you prepared to make more concessions in exchange for votes?
KM: *sigh* hope you all have a nice new years pic.twitter.com/k6HFLAUME7

— Haley Talbot (@haleytalbotnbc) January 2, 2023

McCarthy is well positioned to be picked by his peers to replace Rep. Nancy Pelosi (D-CA) as House Speaker, and Republican National Committee Chairwoman Ronna McDaniel said McCarthy appears to be “on track” to winning in a Sunday interview.

But there are a handful of GOP holdouts who threaten McCarthy’s bid. Over the past few days, McCarthy offered concessions to woo conservatives, including making it easier to remove the sitting speaker of the House. Despite his overtures, nine House Republicans signed a letter opposing McCarthy’s bid saying “specific commitments” remain missing.

While Republicans have a 222-seat majority in this new session of Congress, McCarthy needs only 218 votes to win the speaker’s gavel. The threshold to secure a majority would decrease if members vote “present,” decline to vote, or are absent.

Rep. Andy Biggs (R-AZ), a former chairman of the House Freedom Caucus, has presented himself as an alternative candidate to McCarthy. Roll Call reports there is a longshot backup plan for a group of Republicans to work with Democrats to nominate retiring Rep. Fred Upton (R-MI) for speaker if there are multiple ballots.

New numbers from the United Kingdom’s largest state-funded pediatric gender clinic show thousands of teens waiting in line for services. 

In July 2022, the Tavistock Clinic’s Gender Identity Development Service (GIDS) released referral data that indicated more than 5,000 children and adolescents were seeking gender-related services between 2021-2022. Official documents obtained by Reuters found thousands of additional minors on a GIDS waiting list, capturing the fuller picture of teens seeking medical transitions in the U.K.  

Reuters’ review of the state-funded National Health Service (NHS) documents shows “at least 8,000 young people in England and Wales waiting to receive gender care” as of October 2022.

According to GIDS, 5,234 minors sought services in the financial year that ended in March 2022. Between April and October, “over 1,000 young people” were referred, the clinic said. A decade ago this number was 210, indicating that annual referrals to the GIDS clinic have surged 2400% since then.

New documents reviewed by Reuters indicate 7,696 children and adolescents were on the waiting list for their first appointment at GIDS as of July 2022. The number is up 67% from October 2020, when England’s Care Quality Commission (CQC), the NHS watchdog, inspected GIDS and found 4,600 such children on the waiting list.

These numbers do not represent the entire picture, as minors in the U.K. seek puberty blockers, cross-sex hormones, and gender-related surgeries outside state-sponsored clinics, such as through private health insurance and private practice. 

Rather than wait an average of 3 years, some English teens are opting for private providers such as GenderGP, an online clinic registered in Singapore that operates outside the supervision of the NHS. The company told Reuters that 800 youths are currently seeking their services and make up a growing portion of its U.K. patient population.

Although GIDS is set to close after an independent review by Dr. Hilary Cass found serious ethical concerns in the clinic’s practice, it is still booking appointments for those at the top of its waiting list until its closure in spring 2023.

Following the Cass report, the NHS published new guidelines for treating trans-identifying youth, abandoning its previous endorsement of the “gender-affirming” model of care for a more cautious approach. 

The NHS now recognizes that children and adolescents identifying as transgender may be experiencing a “transient phase” and has banned the use of puberty blockers in patients under 18, making exceptions only in certain cases for strict clinical trials.

The new guidelines “reflect evidence that in most cases gender incongruence does not persist into adolescence” for young children. The guidance states that instead of encouraging transition, physicians should take “a watchful approach.”

GIDS will be replaced by regional centers that can better accommodate a fast-growing patient population and will operate under the new treatment guidelines. Those remaining on the waiting list will receive assessments and mental health support but will not likely obtain medical transition services unless they participate in research.