NHS accused of prioritising male-to-female trans people for breast surgery over women

NHS accused of prioritising trans people for breast surgery over women with medical needs

  • Report for NHS England found difference between breast surgery ‘striking’
  • Breast asymmetry ops halved while gender dysmorphia increased seven-fold
  • Patients said NHS should be offering ‘breast care and not a breast wishlist’

The NHS has been accused of giving preferential treatment to men changing gender over women with medical needs when funding breast surgery.

Gender reassignment ops have surged sevenfold in the past decade at the same time as admissions for congenital breast problems have more than halved.

An NHS report last year found the difference between accepted funding applications for gender dysmorphia compared to congenital breast asymmetry ‘striking’.

Neither procedure is routinely offered on the NHS, with patients having to apply to find out if they can have the up to £8,000 surgery on the health service.

Reconstructive surgery for breast cancer survivors is the only breast implant procedure that is routinely funded by the NHS.

One female patient today hit out at the disparity of gender reassignment patients who ‘are not in physical pain’ being offered the procedure while women suffering from painful conditions are not. 

Gender reassignment ops have surged sevenfold in the past decade at the same time as admissions for congenital breast problems have more than halved. A report for the NHS in England last year found the difference between accepted funding applications for gender dysmorphia compared to breast congenital breast asymmetry ‘striking’. Pictured: stock of woman at breast implant appointment

A breast surgery report for NHS England, published last year, set out that the number of patients admitted for gender reassignment jumped from 53 per year to 355 over the last decade.

Meanwhile, congenital breast problem surgery fell from 1,342 annually to 506.

The report, seen by the Telegraph, states: ‘It is becoming harder for individuals to access aesthetic breast surgery despite having a recognised medical condition.’

The report added: ‘It is striking to note how NHS Specialised Commissioning has facilitated greater access to gender reassignment surgery for gender dysphoria — even though some of the surgical procedures involved are the same as those used to treat e.g. congenital breast developmental issues.


The vast majority of women have to pay for breast implants on the NHS.

Women who have very uneven breasts or no breasts may be able to get the procedure on the health service.

And those who have had a breast cancer diagnosis can receive the procedure, which usually costs £3,500 to £8,000 for free.

There are also additional aftercare costs for those not eligible. 

However, the NHS website states breast implants for trans women are not routinely available on the health service.

‘We see it as both inconsistent and illogical that a procedure can be deemed of limited clinical value for one group of patients or medical condition, but acceptable for another, where there is no substantial difference in the surgical outcomes.’

Natasha Gothard, 32, was given breast implants when she was 13-years-old to treat congenital breast asymmetry — when there is a big difference in the size or shape of each breast.

But the implants, which were replaced when Ms Gothard was in her twenties, caused capsular contracture — unusually hard scar tissue that forms around the implant.

She has struggled through six years of pain and was left unable to feed her daughter.

The civil engineer’s surgeon applied to the health service to replace the problem implant, but the local funding body only offered to remove it.  

The mother-of-two told The Telegraph: ‘I am left with the options of chronic pain or permanent disfigurement. I don’t expect those to be the choices from the health service.’

She added: ‘When surgery was first proposed to me by my NHS doctor I was 13 and it was never suggested that it was a cosmetic procedure.

‘This is not something that I can control. It was the NHS’s idea to have this surgery and they have abandoned me without any follow up care.’

Ms Gothard, who is planning to spend thousands on the surgery privately, told the newspaper: ‘It adds insult to injury, people who wish to undergo gender reassignment are not in physical pain. The NHS should be funding breast care and not a breast wishlist.

‘Women’s breast care services should be afforded first and foremost to women. No service should be cut mid treatment.’

Ms Gothard’s local NHS body, Kent and Medway Clinical Commissioning Group (CCG), rejected her application and told her that only those undergoing gender reassignment and cancer survivors would be able to get breast implants on the NHS.

But it later told the newspaper that whether trans people can get the surgery is down to the health service’s central specialist service, rather than the CCG.

An NHS spokesman said: ‘It is incorrect to suggest that the small number of patients undergoing gender reassignment surgery are in any way being prioritised over the tens of thousands of women undergoing breast surgery, including for cancer and other conditions, each year.’

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