NHS ‘prioritises gender reassignment for men over breast surgery’
THE NHS has been accused of looking more favourably on men wishing to change gender than women with illnessess when funding breast surgery.
As breast surgery services across the country are cut for women suffering painful medical conditions, there has been an increase in the number of surgeries provided to those wishing to undergo gender reassignment.
A report for the NHS in England noted that it is “striking” that it has “facilitated greater access to gender reassignment surgery for gender dysphoria” while women with medical need are increasingly struggling to access the same procedures. One woman who was refused surgery, Natasha Gothard, 32, is in constant pain and was unable to breastfeed her daughter after the NHS refused to replace implants it had given her when she was 13 to treat congenital breast asymmetry.
The implants, which had already been replaced when Ms Gothard was in her 20s, had caused capsular contracture, a build-up of scar tissue that contracts around the implant, causing pain.
The civil engineer said: “I have been in pain for nearly six years.
“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.”
In response to her surgeon’s application to replace the implant, the local NHS funding body, said it would only remove it.
Ms Gothard added: “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.”
When Kent and Medway Clinical Commissioning Group (CCG) sent Ms Gothard their policy, it said that those undergoing gender reassignment were excluded from the ban on funding along with those recovering from cancer.
The CCG last night clarified that the policy, which has since been replaced, excluded trans people as this surgery is funded centrally by the NHS specialist services and is not the responsibility of local providers.
Investigations by this newspaper have found that many local NHS funding groups will not pay for breast augmentation for cancer survivors unless there is an “exceptional” reason.
As in Ms Gothard’s case, medics have to apply.
Breast augmentation for gender reassignment is also not routinely funded by NHS England and an application has to be made.
A report into breast surgery for the NHS, published by a leading surgeon last year, found that over the last decade the number of admissions for gender reassignment in England had increased from 53 admissions to 355 admissions. In comparison, admissions for surgery for a congenital breast problem has dropped from 1,342 a year to 506, with authors noting “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.”
Ms Gothard, who is planning to pay for the surgery privately after the birth of her second daughter, said: “People who wish to undergo gender reassignment are not in physical pain.
“The NHS should be funding breast care and not a breast wish-list.
“Women’s breast-care services should be afforded first and foremost to women. No service should be cut midtreatment.”
An NHS spokesman said: “It is incorrect to suggest that the small number of patients undergoing gender reassignment surgery are being prioritised over the tens of thousands of women undergoing breast surgery, including for cancer and other conditions, each year.”
Paula Wilkins, chief nursing officer at CCG, said: “We work to make sure all patients are treated fairly and have access to effective care and procedures.”