Should The Government Pay for a Boob Job? How About a Transexual’s Boob Job?


Normally we wouldn’t give the thumbs up to asking the government to pay for elective cosmetic surgery, like a breast enlargement. But we’re not sure where we stand when the person making that request is a MTF transexual woman, and when she lives in a country (Britain) that provides health care for “gender dysphoria sufferers.”

A woman identified only as “C” has not had gender reassignment surgery (read: no “bottom stuff” done), but is on hormones and has had other treatments to appear feminine. She’s been living as a woman for the past 10 years. Since 2006, she’s been trying to get the government’s National Health Service to pay for her breast enlargement (or rather, “breast creation,” since she has nothing to enlarge just yet.) On Oct. 20, a court plays host to a hearing on whether denying C’s surgery amounts to sex discrimination. Telegraph:

Her barrister, Stephanie Harrison, said it amounted to sex discrimination that she had been treated in exactly the same way as a “natal female”, not suffering from gender dysphoria, applying for cosmetic breast enlargment on the NHS.

Arguing that C would “derive psychological benefit” from breast enhancement, Miss Harrison said the PCT’s refusal “leaves a treatable condition and untreated” and exposed her to “significant suffering”.

Breast augmentation would be “an appropriate and cost-effective treatment” that would enable C to achieve “a congruent physical, psychological and social identity”.

But the PCT’s policy that breast augmentation will only be funded in “exceptional” cases is so tight as to amount almost to a blanket ban, the barrister added.

She pointed out that, over the past three years, West Berkshire PCT has funded just one breast augmentation operation, for a natal woman who was treated as an exceptional case due to the psychiatric impact of her deep dissatisfaction at the size of her breasts.

However, Mr Lock said the “fundamental flaw” in C’s discrimination claims is that she cannot show she was “less favourably treated” than any other woman.

The most frustrating part? It would be cheaper for the government to just pay for the single boob job than argue the case in court.

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  • RM

    There are pretty clear requirements about this stuff in Medicare.

    Basic surgery (e.g., boob jobs) are covered, but more cosmetic changes aren’t. It makes sense–the insurance should cover the surgery needed to make you look like a woman, but there’s no obligation to make you beautiful.

  • Heather

    Its as simple as this:

    Wanting to be a women, when you are ORIGINALLY a man, should not in any way be covered. I am not being a conservative, up the arse gay basher, it is just the way that things ought to be.

    The only things that should be covered are those life-threatening situations, or ones that severely affect your BODY. Deciding to become a gender you are not, is a personal thing and should be paid for personally.

    What if I decided I wanted to kill myself if I did not look like Angelina Jolie? Would that be grounds for fully-covered plastic surgery? That is B.S. It would not, and should not, be covered by the tax dollars of hard working individuals.

    My money should go to things that help our society. Not to people who have made a decision they can’t afford!

  • Tallskin

    /////The most frustrating part? It would be cheaper for the government to just pay for the single boob job than argue the case in court.

    *****Yeah, but if this case is won then the floodgates will be opened for others to follow.

    If this person loses the case then he/she should pay the damned legal costs! why should the taxpayer pick up the tab for this case??

  • Anna

    Heather: Deciding to become a gender you are not, is a personal thing and should be paid for personally.

    Then thank the stars this person isn’t becoming a gender they are not — I mean, that would be horrible. Personally, I think it’s great they’re becoming the gender they’ve been since birth.

    Oh, you meant SEX. Yes, well, I see your point. You are aware that this isn’t just plastic surgery for transgenders, right?

    These treatments are necessary and vital to the mental health of transgenders. Would you rather spend $5,000 on breast implants for this person, or $500,000 over their lifetime in anti-depressants and hospitalization?

    The real truth is that cosmetic surgery is as important for transgenders as it is for burn victims, people born with cleft palates, or mastectomy patients. None of those conditions are life threatening, after all, but we in a passionate society understand the balance between mind and body. Why is it so hard for some people to see the balance between those two in a transgender person who has been diagnosed with gender identity disorder?

  • Peter

    How about all the flat chested women who plan on remaining a woman; should they be able to get free enlargements too?

  • Steve

    Yep, this absolutely should be paid for on the NHS. I have no qualms about saying that at all and agreeing with Anna 100%.

    It’s a pretty disgusting that some people seriously think that other people don’t deserve treatment for a condition just because they cant afford it.

    Disgusting, but unfortunately not surprising from some quarters.

    Why SHOULDN’T the tax payer pick up the ‘tab’? Do you really only think your hard earned tax money should only go to things you like? Grow up, you live in a society, not your own personal little world. The state (yes, that means your tax money) has an obligation to alleviate suffering, even psychological suffering that you can’t see or sympathise with.

  • Erick

    Well, in Spain gender reassignment surgery is considered as part of the process of becoming oneself and, since it a medical procedure, its covered by the public healthcare system. As I understand it, the whole process is covered, but Im not entirely sure.

  • Tallskin


    Steve, I assume you are being ironic!

    Anna, No way!

    There are far more important things for the NHS to spend its money on than gender reassignment surgery!

    A pair of boobs at £50,000 means someone goes without a hip replacement or cancer treatment.

  • Alexander

    Just give her her damn tits already! Christ-on-crutches it’s not that expensive. Like the first poster said, they have to make her a woman, they don’t have to make her hot. I’m sure there’s a reality show out there that will do that for her.

  • Steve

    No Tallskin, just because you seem to think like a Daily Mail reader, it doesn’t mean the rest of us do. Of course I’m not being bloody ironic.

    And if you’re yawning, perhaps it’s past your bedtime? Or perhaps you’re being ironic.

  • Anna

    Tallskin: There are far more important things for the NHS to spend its money on than gender reassignment surgery!

    I am not being snarky or attempting to be offensive — I just wish to know your thoughts on this to expand my realm of understanding:

    You saying this leads me to believe that you do not consider treatment for gender identity disorder to be important. Why is that? Also, if you are going to argue that sex is unchangeable and therefore these people are delusional, what is your basis for that thought?

    These are huge questions I wish I knew the answer to, because they are vitally important. Here’s why:

    Everything you are arguing against this person’s surgeries and their “worthiness” can come back to bite you, if you are gay or an ally of gay people.

    An example of that would be “There are far more important things for the government to spend its money on than Don’t ask don’t tell and gay marriage!” A tax deduction for a gay couple at at $2,000 means a community goes without a bridge replacement or road repair.”

    Another would be “There are far more important things for the NHS to spend its money on than AIDS prevention! A box of free condoms at £3 means someone goes without Bibles or Hymn books.”

    These arguments may sound silly, but to some people they seem viable.

  • DeAnimator

    Gender reassignment is cosmetic surgery. End of story. If they want it they need to pay for it themselves.

  • Tina

    So….much….trans-hate. From a gay site!

    Breast enlargement I wouldnt expect to be paid for. Hormones, laser/electrolysis, and a BASIC level of human compassion and care in the medical field? yes please. These things are NOT elective…without them we have extreme difficulty making a living, going about our lives, and being accepted (by cisgender people? apparently by queers here too!)

    I got turned down from the clinic here due to my transgender status. I wanted a goddamn flu shot. My ftm friend? Can’t get his gall bladder checked out, cuz he’s trans.

  • Fitz

    I don’t enough about GB’s policy to see where this fits. I do know an awful lot about MediCare, and specifically MediCal. There are lots of important meds and procedures which are not covered which would make people healthier and happier. Smoking cessation is #1 on my list, for example. Dental work is also not covered. Most forms of psychotherapy are not covered. So it seems to me that we (society) have already said “This is the list of things I will cover, and the treatments I will pay for”.

  • Tallskin

    /////Another would be “There are far more important things for the NHS to spend its money on than AIDS prevention! A box of free condoms at £3 means someone goes without Bibles or Hymn books.” These arguments may sound silly, but to some people they seem viable.

    Oh per-leaze! This is just getting silly!

    A pound spent on HIV prevention prevents (hundreds of) thousands of pounds later on sick people: days lost at work etc.

  • Fitz

    I fail to see the analogy between the benefits of HIV prevention (on a society level), and one person having a procedure done.

    Money spent on condoms and lube pays it’s way back many times over.(side note: don’t give gay men condoms without lube, you will increase the risks)

  • Anna

    Tallskin: Oh per-leaze! This is just getting silly!

    A pound spent on HIV prevention prevents (hundreds of) thousands of pounds later on sick people: days lost at work etc.


    So you do agree with me — that it’s better to give her the implants for a few thousand pounds than pay for the potential depression medications and therapy sessions she would need in the future if she didn’t have them?

  • Anna

    Fitz: I fail to see the analogy between the benefits of HIV prevention (on a society level), and one person having a procedure done.

    Money spent on condoms and lube pays it’s way back many times over.(side note: don’t give gay men condoms without lube, you will increase the risks)


    Good. I’m glad it seems like an odd analogy. That’s why I closed my argument with, “These arguments may sound silly, but to some people they seem viable.” It IS a silly argument to us. The point is, to someone out there, it may seem like a viable argument. To some, Bibles and little union jack flags are more valuable than HIV prevention. They are narrow-minded, sure. But they are there and visible.

    The point of the analogy is — put yourself in someone else’s shoes. There’s too much in this world…too much suffering, too much hate. I find myself quite shocked and unbelievably appalled that I am defending a transgender woman on a GLBT blog. I could expect this sort of thing in the comment section of the Daily Mail or the Sun, but Queerty? Really? How many GLB people really understand the T at the end of that acronym?

  • Tara

    Some days it is hard to be a Transwoman on Queerty. Whew.

    So yeah. I am paying for pretty much everything out of pocket. It is my damn hope that some day my younger sisters and brothers wont have to.

    If you really think this is cosmetic surgery… I mean. You do see the similarities to telling me that and some theo-fascist telling a gay person it is just a choice right? You catch your own hypocrisy? Cause look. Seriously, if you are a willful hypocrite I can choose to ignore your existence, but it means you actually think so I have to respect you. But if you are willfully ignorant you are not only hurting the lbgt rights movement or the progressive moment but the species as a whole.

  • Lulu

    Why would they approve the procedure for an A cup but not for a mtf woman that just wants her exterior to reflect her interior. There’s a big difference between some woman that is sad about having small titties and an mtf woman that wakes up every day feeling like a woman and then is reminded that she physically isn’t the second she steps in front of a mirror.

  • YellowRanger

    No. The government shouldn’t be shelling out that kind of money for a purely elective surgery.

    What about flatter chested women who want a bigger pair? Or men who want one of those risky penis enlargement surgeries? Is the government going to foot the bill for them too?

  • Fitz

    You are allowed to be pro GLBT-rights and still not subscribe to the groupthink. I can disagree with you about the priorities of public benefits, and still feel very strongly about being humanistic. Though it wasn’t directed at me, I resent the idea that I would be some sort of facist for not wanting to spend limited public benefits in this way. I provide healthcare, and DAILY I see people who are ill for poor nutrition. That is a more universal need, and a bigger priority for me (for example). I do have a close friend who is FTM, and I know how important his operation was. I encourage people to do whatever they need to in order to feel right, and move on with life. That is not the same question for me as public benefit money being spent. I can’t even order state of the art Blood pressure pills, or newer statins, or psych meds that aren’t older generics.

  • Distingué Traces

    To the questions in the article title: no and no.

    A transwoman doesn’t need tits to be a “real woman” any more than any other woman does.

    Love your bodies, girls. They are you.

  • FU

    as a gay man, i am absolutely appalled and disgusted by the level of transphobia and ignorance exhibited by gay men on trans issues. this is not cosmetic surgery issue, it is a trans-health care issue, and to say that other procedures are more necessary or more medically deserving of coverage shows how clueless you are when it comes trans-health care issues and standards of care for trans folks. if you don’t understand why these procedures are medically necessary, do your friggin homework before talking out your neck.

  • Dr. Jillian T. Weiss

    The blatant prejudice against transgender people here is, I must admit, a bit disheartening. Breast implants don’t cost 50,000 pounds. Transgender people are not like people who want to kill themselves because they don’t look like Angelina Jolie. This is a routine operation done by the thousands in private medical offices (400,000 in the US in 2007), and costs between $2,500 and $7,500, depending on how fancy the surgeon’s office is. The number of transsexuals is low enough that the per capita cost is likely to be pennies. Despite the fact that I am transsexual, I’m actually not sure whether I think it should be covered. However, the arguments made by most of the commenters here reek of transphobia, going far beyond a mere discussion of the numbers. The fact that more people have not spoken out against this obvious transphonbia makes me wonder about my community. Again, I don’t say that because you must answer yes to breast augmentation for transsexuals. I say that because of tone of these comments, going far beyond just saying no. For shame.

  • tavdy79

    My money should go to things that help our society. Not to people who have made a decision they can’t afford! — Heather

    Correct me if I’m wrong, but I’m assuming you’re a lesbian. Did you choose to be a Lesbian? Did you wake up one day and decide “I’ll choose to become something other people hate; I’ll choose to become someone they want to dehumanise, torture and kill”?

    If you didn’t, what makes you think being trans is a choice, any more than being lesbian, gay, bi or straight is a choice? And given how trans people are targeted by violent homo- and transphobes why would you, and another LGBT person, choose to deny them basic compassion?

    Gender reassignment is cosmetic surgery. End of story. If they want it they need to pay for it themselves.
    — DeAnimator

    Not under British law which, in this case, trumps your personal opinion. US healthcare insurance generally does cover gender reassignment, therefore gender reassignment is paid for by those people who pay into the insurance scheme. For the vast majority of Britons, the role played by American health insurers is covered by the NHS; it would be unreasonable for the NHS to deny a minority access to important surgery when that surgery is not denied to Americans. It is, after all, being paid for by those who pay into the NHS. And since healthcare is viewed as a civil right in the UK, denying gender reassignment surgery should rightly be viewed as a breach of civil rights.

    Also, a sizeable minority of trans people are actually born intersex and have their gender incorrectly surgically assigned shortly after birth – like all forms of infant genital mutilation it is barbaric, yet it still continues, and happens while the person is too young to give any form of consent, let alone informed consent. Given that it was the barbaric practices of certain medical “professionals” that caused their problem in the first place, does it really sound fair to deny these men and women the right to have their sex realigned with their gender? IMO it’s merely a case of correcting a past mistake.

    In this case, the key issue is the effect it will have on the person’s health and well-being. If her lack of breasts makes it more obvious to others that she is a transwoman, denying her surgery places her at risk of physical harm, limits her options for employment or promotion, and has a significant negative impact on self-image and psychological well-being due to increased anxiety. I doubt she would be requesting surgery be funded by her PCT if she had an alternative option available, due to the fewer hurdles of the private option and due to the fact that West Berks PCT does not have a good track record on acting in patients’ interests – it is well known for denying cancer treatments in the past.

    What you propose – that she pay for the surgery out of her own pocket – may well leave her in a catch-22 position. It’s entirely possible that, whether consciously or unconsciously, she is discriminated against in work because her lack of breasts make it obvious she’s trans. As a result she’ll have a low income, or perhaps find it impossible to hold down a job, so doesn’t have the money to pay for the surgery herself. She doesn’t have a good job because she doesn’t have breasts; she can’t afford breast augmentation because she doesn’t have a good job.

    Even if she does have the money to pay for it herself (which is probably the case if she’s paying her own court costs) there’s good sense in her bringing the case – just because she is able to afford the surgery doesn’t mean all trans people like her can. By bringing the case she would be acting in behalf of those who don’t have the option. She would be acting with compassion, which is more than can be said for you.

  • Julian Morrison

    If the NHS has an obligation to do sex reassignment surgery (and by law they do), they have a common sense obligation to do a proper job of it. SRS without boobs is half a job, it’s just obviously unacceptable.

  • Tallskin

    There is no conclusive evidence that sex change operations improve the lives of transsexuals, with many people remaining severely distressed and even suicidal after the operation, according to a medical review conducted exclusively for Guardian Weekend tomorrow.

    The review of more than 100 international medical studies of post-operative transsexuals by the University of Birmingham’s aggressive research intelligence facility (Arif) found no robust scientific evidence that gender reassignment surgery is clinically effective.

    The Guardian asked Arif to conduct the review after speaking to several people who regret changing gender or believe that the medical care they received failed to prepare them for their new lives. They explain why they are unhappy with their sex change and how they cope with the consequences in the Weekend magazine tomorrow (July 31).

    Chris Hyde, the director of Arif, said: “There is a huge uncertainty over whether changing someone’s sex is a good or a bad thing. While no doubt great care is taken to ensure that appropriate patients undergo gender reassignment, there’s still a large number of people who have the surgery but remain traumatised – often to the point of committing suicide.”

    Arif, which advises the NHS in the West Midlands about the evidence base of healthcare treatments, found that most of the medical research on gender reassignment was poorly designed, which skewed the results to suggest that sex change operations are beneficial.

    Its review warns that the results of many gender reassignment studies are unsound because researchers lost track of more than half of the participants. For example, in a five-year study of 727 post-operative transsexuals published last year, 495 people dropped out for unknown reasons. Dr Hyde said the high drop out rate could reflect high levels of dissatisfaction or even suicide among post-operative transsexuals. He called for the causes of their deaths to be tracked to provide more evidence.

    Dr Hyde said: “The bottom line is that although it’s clear that some people do well with gender reassignment surgery, the available research does little to reassure about how many patients do badly and, if so, how badly.”

    There are around 5,000 post-operative transsexuals in the UK, according to the transgender pressure group Press for Change (PFC). It is estimated that up to 400 sex changes will be performed this year on the NHS and privately. Each operation costs the NHS around £3,000, while private patients pay upwards of £8,000 for surgery.

    Christine Burns, of PFC, said the campaign group’s research suggested that the vast majority of transsexual people enjoyed much happier lives following surgery.

    Ms Burns added that the greatest flaws in medical literature about gender reassignment were in those studies unsympathetic to transsexual people. For example, one study was based on a survey of seven transsexual prostitutes interviewed in one gay bar in Chicago.

    She said: “The fact that research is badly constructed isn’t a poor reflection on transpeople, but on the people we should be able to trust for our care. If they “lose” half the patients they ought to be able to track the question is why? As we’ve repeatedly pointed out ourselves there is really no difficulty in getting transpeople to come forward and cooperate in research that is properly constructed and conceived with people’s true well-being in mind.”

    Research from the US and Holland suggests that up to a fifth of patients regret changing sex. A 1998 review by the Research and Development Directorate of the NHS Executive found attempted suicide rates of up to 18% noted in some medical studies of gender reassignment.

    Andrew McCulloch, chief executive of the Mental Health Foundation, has written to the mental health minister, Rosie Winterton, requesting a “thorough assessment” of the long-term effects of sex change operations. He wants the National Institute for Clinical Excellence, which decides what treatments should be available on the NHS, to draw up guidelines on gender reassignment.

    Transgender psychiatrists, who assess whether patients should change sex, agree that more scientific research is needed. But Kevan Wylie, chairman of the Royal College of Psychiatrists’ working party on gender identity disorders, said that all of his patients’ lives have drastically improved following gender reassignment surgery.

    Dr Wylie added that it was difficult to conduct research on the outcome of gender reassignment, or to compare its effects with alternative treatments, because transsexualism was such a “rare experience”. Urological surgeon James Bellringer, who has performed more than 200 sex changes over the past four years, claimed that trying to carry out research that involves studying a control group of transsexual patients who were denied hormones and surgery would be unethical.

    Mr Bellringer, who works at the main NHS gender identity clinic at Charing Cross hospital in west London, said: “I don’t think that any research that denied transsexual patients treatment would get past an ethics committee. There’s no other treatment that works. You either have an operation or suffer a miserable life. A fifth of those who don’t get treatment commit suicide.”

  • Fitz

    Well, since I am not willing to walk in lock-step, I guess you can count me in the group of fascists and klansmen.

  • RM

    Gender identity dysphoria is a disease. Boob jobs are part of the cure. Tummy tucks are not.

  • Kian

    Tallskin quoted: “But Kevan Wylie, chairman of the Royal College of Psychiatrists’ working party on gender identity disorders, said that all of his patients’ lives have drastically improved following gender reassignment surgery. Dr Wylie added that it was difficult to conduct research on the outcome of gender reassignment, or to compare its effects with alternative treatments, because transsexualism was such a “rare experience”.”

    The article you chose to post makes contradictory statements and ultimately comes to the conclusion that there is no way to know WITH CERTAINTY whether gender reassignment is the best treatment because they can’t withhold care for the sake of science. Maybe we will never know that it works for every single transsexual because of this quandary, but that does not mean that right now its the BEST treatment available for gender dysphoria.

    If you are going to use a crappy article that doesn’t cite anything, then you might as well not post. Its bullshit that people can use one article to refute thousands of trans people willing to testify and sue for the right to transition. If this doesn’t convince you that perhaps you need to take a look at your own prejudices, then I don’t know what will. Its very disheartening to hear hurtful arguments against this transwoman’s need for surgery because these arguments are often based on pseudo science and faulty arguments.

    So tell me again that you are just not conforming, that you’re not really bigoted, that you have a friend who’s trans… because I don’t believe you.

    When you argue against the best treatment option available for trans people you open the door for criticism. To then deflect that criticism into posting that article is cowardly, manipulative, and ignorant.

  • Jo

    As a transwoman I can assure you that surgury was the only way for me, without it I KNOW that I would not be here today. I couldn’t live the lie any more. It wasn’t a choice I made one morning, any more then you woke up and thought “hmmm… today I shall be gay”, and furthermore I wouldn’t wish it upon my worst enemy!
    Many post-op transexuals opt to at least try and blend in with the rest of the population, to disappear if you will, which is why many surgeons don’t see or hear from their patients ever again. Not that after care is a priority for the doctors involved.
    Gender Dysphoria is a recognised medical condition and not a cosmetic choice or even a life-style choice, so I say yes, under certain circumstances the NHS SHOULD pay for implants.
    I understand that most here have no clue as to what it’s like to be Trans – how could you REALLY understand without actually being Transexual? How ever I would’ve expected to find less bigotry, especially from those that have been on the recieving end themselves.
    I’ve had surgury, I’m alive and well; I’m more then happy with the results – as are my friends who have had surgury. To me that’s more reliable then an article written 5 years ago by a newspaper that has no more idea about transexuals then I do regarding Inter-Dimensional Physics!

  • Julian Morrison

    You know, there’s nothing more human than for a disadvantaged group to find someone more disadvantaged, and assert what little privilege they do have and kick them when they’re down. Even the Klan were/are mostly rural yokels, far down every ladder of privilege except the one they picked to define themselves, skin color. But still it’s sickening.

    If you think trans women aren’t real women and SRS is just a vanity kick, if you think they should just suck it up and stay male-looking, if you are trying to push a half-argued agenda equivalent of the “ex-gays”, that some transitioners regret it and so it’s OK to tell every trans woman “no” – then you are a bigot. You are in exactly the same category as homophobes who make disingenuous arguments about “waste” when a government spends its money promoting tolerance of gays. You have made yourself part of the problem – be ashamed!

  • Krpoptkin

    It’s kinda funny that people having heart attacks over one trans having a $5,000 boob job when there are other areas where nhs genuinely wastes oodles and oodles of money in other areas. In fact since NHS olny treats about 800 people a year, the price to get every MtF person that NHS treats would be about $500,000 which is a drop in the bucket compared to the total NHS budget.

    I can think of cases where a breast enlargement would make the lives of some trans people better, so i support this. What you people don’t understand is that the NHS treatment of trans people is antiquated and very rigid, I’ve heard many a horror story about the NHS system in regard to trans people, so this is probably making up for it a bit.

    But people are going to get hot and bothered by this? Get over yourselves, seriously people.

  • Joanna Sue

    I do not know where they get the figured they quote, and frankly I am not sure I care to find out. I just know that until these people who speak so firmly against SRS or breast augmentation for Transsexuals have someone in their life who suffers from this condition, they will never understand the need for these procedures. I would also submit that those who claim that up to 1/5th regret getting the SRS are using old insurance industry figures that are being used to keep even insurance companies from paying for a medical needed procedure(s). With a morbidity of untreated Transsexuals of upward of 50% by the age of 30, I would say it is a valid condition for treatment. The figures I heard that the success rates of a positive outcome viewed 5 years post treatment after SRS is about 98%. I would submit that much of the percentages of those who did not have successful outcomes are due to one of three factors. The first of which is poor pre-screening by the therapists signing letters of recommendation. The second being medical issues from surgery or other treatments for transition, causing an ongoing problem for the patient. The last and perhaps the largest issue is the intolerance of others toward a Transsexual based on their Victorian beliefs about this entire subject or a narrow religious viewpoint in regard to it. I wonder how many of these people that argue so pointedly about the spending of $10,000.00 dollars for SRS or $4000.00 for breast augmentations would be so willing to argue their current position if they or someone like a son or daughter come forward as a Transsexual? My guess is many of them would change their tune pretty quickly then. It is indeed sad when people can minimize the suffering to a matter of dollars ( or pounds or Euros ). Always seems to be those who are not suffering who yell the loudest to discount someone else’s suffering however. Sad, very sad. Wonder how that type of treatment will stack up when they stand being judged? I somehow doubt that they will be told they did the right thing by ignoring the suffering of those who had such a condition. Funny how they will of course open their hearts to the infant born with a Clef Pallet or some other condition that can be corrected by surgery but find it so hard to understand what it would be like to have to suffer daily for their entire life trapped in a body that did not match that persons gender.

  • Fitz

    The simple option is to fund it yourself. Or, if you are so inclined, form a non-profit that hires a surgeon to do the procedure. I am ALL for the procedure.. but it’s just not on my priority list for public funding at this point.

  • Zoe Brain

    “Gender reassignment is cosmetic surgery. End of story.”

    Hmmm….where have I heard this kind of thing before….

    “The Earth is Flat. End of story.”
    “Gays are mentally ill. End of story.”
    “God created Adam and Eve, not Adam and Steve. End of story.”
    etc etc

    Here’s what the people who actually know the facts say:

    — Such a therapeutic regimen, when prescribed or recommended by qualified practitioners, is medically indicated and medically necessary. Sex reassignment is not “experimental,” “investigational,” “elective,” “cosmetic,” or optional in any meaningful sense. —

    That’s from the medical standards of care, which if they’re not followed, leave a medic wide open to charges of malpractice.

  • Jo

    Many transpeople do fund it ourselves, but it’s not always possible (and doesn’t always give the best results).
    But regardless of that, Gender Dysphoria is a recognised medical condition, same as any heart condition, a cancer, the afore mentioned Clef Pallet and anything else you care to look up in any medical dictionary. Would you with-hold NHS medical care for any other condition? Would you tell the patient with serious burns for example that “Sorry but you’ll have to pay for your own medical treatment”?
    Clearly it’s not a priority for you Fitz, because you’ve never suffered from it and you never will. But take it from someone that has, it’s not cosmetic surgury and it was urgent – infact it took a hell of a lot longer then I would’ve liked!
    There aren’t that many Trans-people in the UK so why shouldn’t the NHS – a service they pay into – provide them with the medical care they despiratly need?

  • Fitz

    Aside from your ability to be emotional, you have convinced me of nothing. If I have only so many $ to spend on public health care, my priorities remain life threatening, treatable illnesses which effect us all. You seem to think that I am minimizing the pain of GID, or of the potential for good treatment. Neither is true. I am talking about public health money in a less-than-perfect world. There are a LOT of procedures and medicines which should be available to all who need them- I fully believe that. I am just talking about the titration of very limited funds. There are people who will die, loose limbs, lose eyesight, all for lack of available, proven treatment. I think that until we fix how health care is funded (including how professionals’ education is funded), that we basically have to triage every uninsured person and treat medicare as the glorified emergency-only coverage that it is.

  • Fitz

    And, obviously, I am in the US, and work in health- so my perspective is informed by medicare, which is probably piss poor compared to NIH.

  • Joanna Sue

    Hey, I am in the good old USA myself, in the wonderful state of Michigan who has such a booming economy we have about a 20% unemployment rate. I would like to know how easy most people would find it to fund a series of medical procedures at even twelve thousand dollars or so. (the last time I checked the cost of an SRS in Trinidad, CO is $19,000.00 ) Try going to your local banker and tell them you need a loan for SRS. See how hard they laugh at you. You know I heard at one time that if you included insurance coverage for SRS, and associated surgeries on the group health care plans it would add about 25 cents per month to the amount each person paid. Hard to believe that such coverage is left off, fought tooth and nail by insurance companies, and of course the cause of debated by people. Most of whom don’t have a clue as to the need for such a series of treatments! All over an average increase of 25 lousy cents off the amount paid on everyone’s group health care costs. Of course the insurance company looks at it as 25 cents in their pocket I suppose. The fact is that only about one in ten thousand people born are Transsexuals from the best data I have seen on the subject. One in 30,000 if you listen to some of the older data. Whatever the case it seems like a small overall cost on the health care bill regardless of who is paying for it.
    As for me I was fired from my job when news got leaked that I was Transsexual and starting treatment. A job I had done for years and well. However I have little or no recourse because I am Transsexual in a state that does not protect my job. So I have concluded most people will never get the reasons why someone is transsexual or why treatment is needed. Much like trying to explain the night sky to a blind person, you have no way to relate to the subject. As such nothing I will say will ever convince someone who considers the procedure of SRS or breast augmentation for a Transsexual an option and unnecessary. I and about every Transsexual breathing knows that being Transsexual is a birth defect really, and one that few that are not also transsexual will ever understand. We are easy to ignore because we are a very much a minority and as such really easy for the majority to deny our position or needs has any validity. I can only hope that I am not wasting my time writing this and that someone might change their opinion.

  • Distingué Traces

    As a transwoman I can assure you that surgery was the only way for me, without it I KNOW that I would not be here today. I couldn’t live the lie any more.


    Many post-op transexuals opt to at least try and blend in with the rest of the population, to disappear if you will

    You’re beautiful.

    Don’t hide.

  • gabbygetsme

    You could argue that gays should not have treatment for Aids !

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  • Bill

    Well, if insurance will pay for a MTF persons breast job wouldn’t they also need to cover a flat chested woman’s or while we’re at it how about my penis enlargement or nose job. I’m all for the surgery, but my healthcare insurance costs are high enough without elective cosmetic surgery being added. My wife couldn’t get pregnant so I had to save up for hormone shots, donor eggs and a surrogate out of my pocket… it was our elective choice to have a child so we didn’t go petitioning those paying insurance premiums to all chip in on it. We made the best of the hand we were dealt. Breast augumentation and SRS for low income people should be funded by charitable organizatons such as a Transgendered group. What happens is someone doesn’t like the change and wants to go back… is that paid for by insurance as well. A hermaphrodite at birth might be another story as that would be like a cleft pallet for a very young child.

  • Joanna Sue

    OK what if your child was found to be suffering from Gender Dysphoria? Do you think your opinion about that insurance coverage for SRS and breast implants would change if it soon became clear that your child transitioned or they would be found hanged from a rafter in your garage someday? Gender Dysphoria carries by most estimates a 50% morbidity by the age of 30 years. The truth is those who have Gender Identity Issues would be far more likely to be productive people in life with treatment. The cost of the surgery, breast augmentation and hormones are cheap compared to a lifetime of drug or alcohol abuse or other social issues. The overall cost on insurance premiums was once estimated to be something so small on a monthly basis it would hardly be worth notice. I think I heard it to be less than 25 cents per month. The fact is it is a pre-existing condition which should be covered on anyone having it, but since it is not socially as accepted as say someone being alcoholic or diabetic which are perhaps more of a choice than being Transsexual, it is not covered and unlikely to be until it is accepted socially. This is not about someone waking up one day and thinking, Oh, I think I want to look like some actress, or it might be fun to try being a girl or guy. It is about a persistent from birth issue with the body they are in. One which is so serious those who have it are suicidal over it. Surgical correction has been shown to be the only effective treatment.

  • Luci

    Wow so much negativity!!!
    I am a post op Transsexual woman (yes woman!!!)
    It is impossible for you to understand the torment we go through thinking as one gender and living as another.
    I am 45 years old and have worked and payed my NIC since I was 16.
    What gives you the right to judge people like me and condemn the help we need?
    Do tell………

  • gabby uk

    a pre op who is older should not have surgery on the nhs as the benefit is minor

    As a pre op and young at the time I paid for everything myself

    As a post op the state pays now, I have paid my taxes and have a medical need for someone who is nearly a decade post op

    The answer that post ops blend in is really a lie I am 5ft 7,my own hair and slim less than 10st and a size 8 and look as good as most women my age but I know i get read, and I really don’t care I can tell a fellow transexual a mile away just some transexuals lie to themselves that they look good

    In my case I have a medical need to reduce my breast size to a smaller cup as I have lost a lot of weight medically related and due to stress and now have a lot of back pain and the psychological affects of what is now totally inadquate breast implants for my height and build and is affecting my mental health – because the implants need replacing the nhs will hopefully pay as they have already paid for another procedure

    Also transexuals are not mentally ill, society is unaccepting and makes us out to be demons based on hate and gay men are the worst purveyors of it a man that goes with a pre op transexual is gay though most won’t admit it

  • gabby uk

    Ps and for those transexuals scared of attack you can ignore the comments but if someone ever tries to physically hurt you learn self defence I did, and believe me its effective at getting rid of problems the attacker usually has the shock of their life when they run away with their tale between their legs

    You have to defend yourself certainly don’t rely on the police not in the UK anyway

  • gabbygetsme

    @Julian Morrison:

    The NHS does not have an obligation to do gender reassignment surgery in the UK. I do not know where you get your information from.

    Gender reassignment is seen as elective surgery, you may not like it, I don’t but many PCT’s take this attitude (Primary Care Trusts). You are more likely to get funding if you pass and adjust that if you don’t.

    The reality is an older transexual isn’t a good investment for the state. A post operative however is entirely different pre and post operative transexuals have different needs.

    You should also bear in mind many pre op transexuals prefer to remain just that, in some cases to be a sexual fetish for men to abuse !

  • gabbygetsme

    And one more thing, if I find it hard and I weigh less than 10st, roughly 140lbs, have my own hair not a wig and don’t have big hands or feet and have a height of 5ft 7 and am a size 8 please don’t tell me that other transexuals who are usually taller, with big hands and feet cannot be sussed I just don’t by that. The reality is the benefits of gender reassignment are dubious in a society that doesn’t tolerate transexuals that is fact

    A gender recognition certificate that is worth nothing if your social security, tax and police records are for all intent and purposes still in your original gender and name which they are in Britain.

    Because breast implants needs replacing if you don’t have the money because of the medical risk the NHS has to pay they don’t have a choice and a post operative of nearly a decade would be able to legally challenge this much more than a pre op based on living in the wrong body. It depends on individual circumstances.

    Being a transexual woman isn’t all about dressing in high heels and short dresses, those who think that make a big mistake, you are less equal than most genetic women and those with high earning jobs as engineers and still ride their motorbikes still behave as males in my view as most women are not like that

    It is a well known fact that you can pass, but you cannot be accepted. Sadly the only true transexuals that pass are those of 16 years and less at reassignment. Even the thai’s are distinguishable from genetic women and I am pretty hot on transexual issues. It isn’t as easy as people make it out to be you need be very brave and very strong, mobility and income is mainly downwards unless you are very secure and most stright men will not date transexual women. You cannot live in stealth no one can live a lie – unless they are pathologically predisposed.

  • gabbygetsme

    One other thing I should add, the cosmetic industry in the UK and the USA geared towards transexual procedures such as facial feminisation surgery, breast augmentation and gender reassignment is purely a commerical money making operation.

    Surgery even with experts can and does go wrong, and if you don’t have the money you can be left disfigured and desperate and bereft

    I strongly advise against FFS unless you really need it and only after two years on feminising hormones

    Finally, it is a fact that there is very little research on post operative follow up of transexuals in the UK and US but research that is available shows 92 per cent are scathing of the medical care and the way they are treated in society.

    Employment discrimination is rampant, those brave enough and I really mean they are brave take risks to sex work not all of us are like that certainly not me.

    You also put on weight with post op hormones and need to watch what you eat and excercise rigourously, other symptoms include leaky bladder, raised blood pressure risk of stroke and cancer not to mention brittle bones and nails if your hormone dosage isn’t high enough. I know of many transexuals that self medicate or pay for their hormones privately because the GP will not prescribe. In that respect I have been fortunate to have a great relationship with my GP’s over the years and also to minimise my own risks to my health because I look after myself –

    Depression also doesn’t alleivate with most post ops, society isolates you and gender dyphoria remains. It is medical fact. Some people have different experiences but what research there is out there on post op transexuals the argument gender reassingment works is dubious – it doesn’t
    So be warned !

  • Jesse Helms

    Until the NHS funds my testicular enlargement, I shall vote for fringe candidates in any and all elections.

  • gabbygetsme

    With the current electorate system good luck to you – by the way I am having a breast reduction and it is a clear medical need given what it is replacing – I am sure all men would like bigger willies but you live with what you got, bit late for me – there is such a thing as Human Rights Act in case you forgot !

  • Joanna Sue

    Until people understand truly what being Transsexual is, there is little hope that there will be any health care options for those suffering from it. Not being from the UK I cannot speak to what is or is not covered. I know little is covered in the USA and that is unlikely to change even if the pro-ported National Health Insurance Reform does come to really do something useful. Chances are they will exempt SRS, and surely they will exempt breast augmentation and FFS. Perhaps in time there will be a change in attitude toward the Transsexuals but it is unlikely to happen overnight and will surely be hindered at every turn by those who follow the leadership of the so called church. Which by the way is in error for the most part in regard to Transsexuals, fueled by poorly translated passages in the Bible. This has shaped the view of the Governments ( even though many claim separation of church and state ) as well as the people who control the laws which we are governed under. I know in my case I have fought hard for what is called ENDA in the USA but found my efforts largely in vain it appears. Hopefully some day this will change but until that time we who suffer from the condition of being Transsexual will still be treated as second class citizens.

  • jason

    A boob job is a private enterprise. Governments shouldn’t fund private enterprises.

  • gabby uk

    Sorey Jason but if you are post op transexual implants for breast augmentation an essential part of what is a serious long life illnesss have to be replaced every 10 years. If they are not the post op can die. In the UK people do have rights even transexuals sorry to say, so what would you suggest I do die.

    Sorry to disappoint your bigoted views but the NHS will be funding a replacement implant operation if you have an issue write to your mp about it, I am covered by HRA and I will use it

    That is the difference between pre and post op if you no longer have the funding because of bigotry I am sure not going to a.) curl up and commit suicide nor b.) live on psychiatric medication and deal with being labelled a freak just because a large part of the population have issues in both the states and in Britain and we all know how bigoted Britain is the fact that it had to be taken to the european court of human rights just to enforce a transexuals right to a birth certificate the only other country in that situation is backward albanian so please don’t say the brits are decent people they are anything but may be nice to everyone else but trans people are bottom of the pile.

    Some of us though will fight back and play you people at your own game – so complain the NHS have no choice but to fund it, because if I don’t and should I become ill as a result of the implants due for replacement then my pct are liable for huge damages – and I checked it out

    For other transexuals in Britain all I can say what will happen to you is pot luck really, how appreciated you are at work, how you were viewed before hand , what your support networks are like, and how supportive your gp and or health professionals are.

    Unfortunately there are people on here even so called gay men who have a bigoted hatred of us it’s not just the hetrosexuals. What saddens me, is a gay man isn’t any better than a transexual female to male or male to female –

  • gabby uk

    And one final thought, gender dysphoria, being intersexed, gender dysphoria unspecified, isn’t a lifestyle choice, it isn’t a perversion, we are not men dressed as women, some of us look OK, and above all WE ALL OF US are people, human beings.

    I am a great believer in karma and all I can say is what goes around comes around and over the last 3 plus years Britain as a nation has sure had it 10 fold. Long may it continue

  • gabby uk

    I would agree with this study.

    Post op transexuals are scathing of their medical treatment and in all honesty as a post op of 6 years it doesn’t work. I warn against it. Why because society punishes you in only the way it can – Britain is one of the most intolerable societies in the western world I can’t think why really but it is, the fact that it and Albania were the only two countries in Europe where a transexual didn’t have a female birth certificate says something

    I have been to europe many many times and always feel better treated in France, Belgium and Holland than I do in Britain. Britain isdefinitely more bigoted

  • gabby uk

    If you dont have surgery your have a miserable life if you do you have a miserable life because of british society and other societies. There is a saying, you can pass but passing isn ‘t the same as acceptance, society needs to change it’s attitude towards transexuals and really that is the role of government by educating children at schools who become the future generations and more tolerant as a result. Until that happens then suicides and depression and negativity and bitterness will continue as will mental health issues.

    My advice to any transexual do it before 16 and do it quick. Do it post 16 and you won’t pass not in western europe. Like I said for 5ft 7, own hair and 10st 6 I struggle to pass so if I do imagine a transexsual 6ft 2 that clearly looks male – tragic.

    You have to be seriously brave, seriously strong and I tire of it one day I might not be so strong any more and when that happens then I will die !

  • Joanna Sue

    The fact of the matter is even if you “pass” to the average person a Transsexual (M2F) has a great battle for acceptance. If you are so lucky to have been born in a location which allows you to change your documentation, lucky or fortunate enough to have the funds to afford the medical/surgical procedures to change you to the point that it is very hard to detect you were born male, you still have the hurdle of trying build a life when for the most part you will find it hard to find someone and live as the woman you have always felt yourself to have been from birth. Few of us ever obtain full acceptance as women even in the most liberal and progressive of social groups. It seems a shame that someone who seeks to change their Sex because of an overwhelming feelings they were born into the wrong body. Feelings that drive many to end their lives by their own hands mind you, are denied any help and unlikely in many cases to be considered a person who really suffered a birth defect as surely as any other.

    I know in my case growing up I was threatened with all manner of things to stop me from being who I was. It worked well enough to get me to the point of making the mistake of trying to be the person my body dictated. I ended up with demands on me that further prevented me from moving forward with transition. Finally after years of struggle and living with the thoughts of ending my life, I moved forward with transition. I was rewarded with loss of my job, alienation of many of my family and friends, and little or no help in regard to my medical needs. It is not a journey for the faint of heart. It is no more immoral than fixing the cliff pallet on a child, and perhaps some day people will come to understand how shamefully those of us who have this condition have been treated. How many of us are very strong and worthwhile people left to go to waste for reasoning that lacks any degree of compassion. I would wonder how many would argue so strongly about any medical treatment for a condition if they found they were afflicted by it.

    Some food for thought to those who would think me insane, perverted, or immoral. Given the rampant use of hormones leaking into our environment, the effects shown on some other life forms we share this planet with, we may find a high percentage of our descendants born Transsexual. This may fix the problem of acceptance in the long run.

  • chris


    i think you need to learn some respect your clearly a homophobia idiot with no respect for other get with the time and grow up will you!! silly moo!!!!!!!

  • gabbyuk

    Heather, why don’t you kill yourself? and who wants to look like Angelina what’s her face personally she looks more trans than most trans people.

    You are blatantly transphobic and I better I look better than you sweetie.

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