Britain has "a long way to go" to ensure equality for transgender people, according to the first report on the issue produced by a UK parliamentary committee.
The report called on the Government to produce a new strategy for full transgender equality within six months, warning that an existing plan issued in 2011 remains "largely unimplemented".
People whose gender identity differs from that assigned them at birth experience "high levels of transphobia" on a daily basis, undermining their careers, incomes, living standards and mental and physical health, said the report from the House of Commons Women and Equalities Committee.
It cited estimates that as many as 650,000 people in the UK are "gender incongruent to some degree" and said it was believed that around one third of transgender adults and half of young people attempt suicide.
The cross-party panel of MPs said the NHS is "failing in its legal duty" to provide equal access to services and guarantee zero tolerance of transphobic behaviour. It called for a "root-and-branch review" by the summer of the health service's treatment of transgender people.
Among more than 30 recommendations, the report called for:
: : Reduction from 18 to 16 in the age limit for obtaining official recognition of a new gender without parents' consent;
:: Mandatory training for police officers on transphobic hate crimes;
:: Replacement of the terms "gender reassignment" and "transsexual" with "gender identity" in equality legislation, and the extension of hate crime laws to cover gender identity;
:: Introduction of the option to record gender as 'X' in a passport, and removal of the requirement to show a doctor's letter to alter the gender shown;
:: The Government to inform itself about ways to address the problem of married transgender people being "victimised" by spouses who "with malicious intent" withhold the consent required for official recognition of their partner's new gender;
:: Action to prevent the "outing" of transgender people in court cases;
:: Moves towards "non-gendering" of official records, so gender is only noted where it is relevant;
:: Guidance for sports organisations to make them aware that exclusion of transgender players on grounds of safety or fair competition is rarely justified;
:: Action to ensure all school staff are trained to support "gender-variant" young people;
:: Tougher action on "unacceptable" levels of bullying in universities and further education colleges, including gender identity awareness training for all staff.
The report also warned of a "clear risk of harm" if trans people are held in prisons according to their birth genders, citing the case of two transgender women who died in 2015 while serving time in male jails, and another who spent a week in a men's prison before being moved. The position of transgender prisoners must be "urgently" clarified in new guidelines being drawn up, the committee said.
Committee chairwoman Maria Miller said: "Fairness and equality are basic British values. Britain leads the world in recognising lesbian, gay and bisexual rights, but despite some welcome progress, we are still failing trans people in so many ways.
"Our report challenges attitudes towards trans people calling for them to be treated equally and fairly.
"Media coverage of transgender issues has improved a great deal in recent years, but it still tends to focus on transgender celebrities. There is a stark contrast with the day-to-day experiences of many ordinary individual trans people, who still endure routine hostility and discrimination."
The report was particularly scathing of transgender people's treatment by the NHS, warning of "significant problems ... due to the attitude of some clinicians and other staff", driven by "lack of knowledge and understanding and even in some cases to out-and-out prejudice".
The NHS as an employer was "failing to ensure zero tolerance behaviour of transphobic behaviour amongst staff and contractors", the report found.
And it reported "overwhelming" evidence of "serious deficiencies in the quality and capacity of NHS Gender Identity Services", particularly in "completely unacceptable" waiting times for first appointments and surgery.
The committee also voiced concern about "the apparent lack of any concrete plans to address the lack of specialist clinicians in this field".
Gender identity should no longer be treated as a mental health issue, and official recognition of gender should be based on "self-declaration" by the individual involved, rather than a "medicalised" assessment, it said.
The inquiry heard evidence that numbers of children and teenagers "coming out" as transgender have increased fourfold over the past five years, and that as many as 1,000 young people have transitioned to a new gender with the support of their parents.
Consideration should be given to quicker provision of puberty-blocking drugs - which delay the onset of adulthood to give young people more time to consider whether they want to press ahead with gender reassignment before they develop adult sexual characteristics - and cross-sex hormone treatments, said the report.
It found "a clear and strong case that delaying treatment risks more harm than providing it", due to the danger of self-harm and suicide if treatment is withheld.
But the committee stopped short of backing calls for official recognition of changed gender for children aged under 16, warning the Government should consider possible risks before taking this step.
Jackie Driver, lead director for lesbian, gay, bisexual and transgender (LGBT) issues at the Equality and Human Rights Commission, said: "We welcome today's landmark report on transgender equality. Despite the marked progress that has been made towards achieving equality for trans people, prejudice and barriers still remain."