Trans egg storage ‘should be funded’
‘The number of people with gender dysphoria has rapidly increased, but NHS funding is yet to catch up’
WOMEN transitioning to men must be offered egg storage on the NHS, because they have the right to become parents too, the British Fertility Society has said.
Gender reassignment surgery has been available on the NHS since 1999 but the number of people choosing to change sex has rocketed in the last decade, with some London clinics now handling 2,000 referrals a year.
Many Clinical Commissioning Groups (CCGS) do not fund fertility preservation for transgender people, even though hormone therapy and surgery prevents them having children.
In new guidelines presented today at the Fertility 2018 meeting in Liverpool, healthcare experts called for “equity” in the NHS to allow “transfolk” to freeze eggs, embryos or ovarian tissue.
Dr James Barrett, lead clinician at the Gender Identity Clinic at Tavistock and Portman NHS Foundation Trust, said: “The number of people coming forward with gender dysphoria has increased rapidly, but the provision of NHS funding for fertility preservation for this group is yet to catch up.”
He added: “This is medical. It’s people whose fertility is impaired as a result of actual NHS mandated treatment for a well-established condition that has been treated by the NHS for the last 50 years.”
Last year, 202 sex swap operations were carried out at a cost to the NHS of £9 million – up a quarter since 2012.
Dr Melanie Davies, of the Department of Woman’s Health at University College Hospital London: “I think five years ago we would not have been talking about treatment of transgender.
“Some CCGS say they will only fund for cancer. What I would like to see is equity. Yes we should be funding it.”
Although Wales and Scotland allow fertility preservation for transgender people, experts said availability in England was still “patchy”.
Fertility doctors said it was crucial to end the postcode lottery of funding. However, Josephine Quintavalle, from Comment on Reproductive Ethics, said: “The cash-strapped NHS should be concentrating on good basic healthcare to women or helping them to beat cancer, and not get sidetracked with these kinds of novelties. Egg freezing is an invasive procedure and the outcomes are far from clear.”
Experts also warned that transgender and cancer patients were being denied fertility preservation treatment because clinics were using IVF criteria, which rule out patients who are overweight or too young. In 2013, the National Institute for Health and Care Excellence (Nice) recommended that IVF criteria should not be used, but many CCGS have ignored it.
The guidance was drawn up by fertility experts from University College London Hospitals, Imperial College, Oxford University Hospitals and Central Manchester University NHS Foundation Trusts, the Medical Research Council, Edinburgh University and Leeds Beckett University.