NHS is ‘failing’ trans men and non-binary people, Sajid Javid warned: ‘It’s a nightmare’

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A letter signed by nearly 200 trans men and non-binary people has been delivered to Tory health secretary Sajid Javid, protesting the failure of the NHS to provide gender-affirming genital surgeries.

“The current situation is a nightmare for trans men and non-binary people and we ask you to urgently put measures in place to support us,” says the letter, which was hand delivered to the Department of Health today.

Phalloplasty and metoidioplasty, two surgeries that construct a penis, have been unavailable for NHS patients since the beginning of the pandemic.

The sole UK provider of the surgeries, St Peters Andrology, stopped carrying them out in April 2021. The crisis slowly came to light in the first five months of 2021, with trans men telling PinkNews they felt left in limbo, let down by the NHS and ignored by the wider LGBT+ community.

In the letter delivered today to Javid at the Department of Health and Social Care, 176 trans men and non-binary people who are on the waiting list for the surgeries said that hundreds more trans patients are “facing an indefinite wait” for “life-saving operations”.

And yet more trans patients are “stuck” between stages of surgery, or waiting for surgery “to repair painful and life-limiting complications”.

“As a direct consequence of the current situation, many trans and non-binary people have experienced relapses of mental ill health, worsening symptoms of gender dysphoria, and are left unable to plan for our futures,” the letter says.

It continues: “Many of us awaiting our second and third surgical stages feel that we have been left ‘unfinished’. When we consented to the first stage of surgeries, it was in the understanding that our genitalia would be left ‘ambiguous’ for no longer than six months.

“At the time of writing, this six-month timeframe has been exceeded in dozens, if not hundreds, of cases. Despite these extremely distressing circumstances, the NHS has provided no mental health support to those affected.”

Speaking of his own personal distress, Keelin McCoy, a trans man who is waiting for surgery to fix a painful complication, said: “I’ve been waiting for stage three for two years. I need corrective surgery and until this is done I’m on pain medication as I suffer from bladder spasms hourly.

“I feel the NHS has completely failed me and thousands of others who are stuck in limbo, some of which can’t deal with this mentally, and the mere thought that fellow friends have contemplated suicide all due to failings in the NHS to negotiate a deal is disgusting beyond belief.”

Trans men and non-binary people say the NHS is failing them.
Activists from TransActual UK delivered the letter, signed by 176 trans men and non-binary people, to the Department of Health on 2 September. (TransActual)

NHS surgeries for trans men

Gender-affirming surgeries like bottom surgery are an internationally recognised treatment for alleviating the symptoms of gender dysphoria, and are known to significantly improve quality of life and mental health of trans patients.

Phalloplasty is an elective surgery, so operations were suspended during the COVID-19 pandemic as hospital resources were diverted to coronavirus patients. If not funded by the NHS, a phalloplasty is estimated to cost between £40,000 and £70,000 in the UK.

Former health secretary Matt Hancock announced on 27 April that elective surgeries could resume the following day, due to the decline in coronavirus-related hospital admissions and deaths.

But despite Hancock’s announcement, the only UK provider of phalloplasty, in London, did not restart operations. It later emerged that NHS Specialist Commissioning had decided to withdraw St Peters’ contract and retender it, leaving trans men and non-binary people with no access to the surgeries in the UK.

As the letter says, this is despite a 1998 court ruling that made it clear that “provision of transition related surgery is included within the requirement to provide a comprehensive health service”.

The letter says that many of those waiting for surgeries or repairs are currently living in pain, and urges Javid to instruct the NHS to provide funding for trans people to access phalloplasty and metoidioplasty overseas until the UK has resumed surgeries and significantly reduced the waiting lists. It also asks him to make the NHS apologise “for not notifying patients about the situation in a timely manner and for failing to fulfil their duty of care to those impacted”.

Trans activists ‘hearing of self-harm and worse’ as a result of ‘nightmare’ situation

The letter was organised and delivered by activists from TransActual UK, a community group.

Chay Brown, director of TransActual, said: “This is a problem entirely of the NHS’ making, and nothing to do with COVID-19. St Peter’s Andrology Centre is the only UK based surgical team commissioned or able to provide phalloplasty and metoidioplasty, specialist procedures sought by trans men and some non-binary people.

“The contract was withdrawn from the team by the NHS at some point between October 2020 and April 2021, but patients were only given confirmation that this had happened in May. So, when elective surgical procedures for general patients re-started in April, trans men and non-binary people could only wait.

“Since then, the situation has deteriorated further. After initially claiming that there was no issue, the NHS then promised matters would be resolved by July. It is now September; there is still no sign of a solution; and trans men and non-binary people no longer believe that the NHS is committed to supporting them.

“Patients promised swift follow-up surgery are now in limbo. Patients with complications, some serious and painful, are unable to access any treatment that would reduce their distress. We have received reports of individuals having mental health issues as a direct consequence of this delay. We are also hearing of self-harm and worse.

“That is why TransActual has today written to Sajid Javid to remind him that the NHS is obliged to ensure that trans men and non-binary people can access genital reconstruction surgery.”

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