Gender Reassignment Surgery Nhs Scotland

A PLASTIC surgeon is calling for Scotland to have its own transgender surgery centre which he says would save the NHS money and enable patients to undergo all procedures under one roof.

Michael Ng said the country should follow Finland, which has a similar population, and has submitted proposals to NHS Grampian outlining the case to base a new centre of excellence which would perform everything from facial feminisation to genital operations in the region. The plans are currently being reviewed at management level.

Mr Ng, 38, said he believed Grampian had "the will" at management level as well as theatre space, wards and clinics to accommodate the service.

He said: "Most importantly, Grampian were the ones that had the capacity to expand and were also willing to take things forward.

"They are having discussions on the health board level just now. I've given them a proposal about how it would impact their health board so they are going to go through that with a fine tooth comb and look through the costings.

"Importantly, I've also got the support from the surgery department and the clinical director and the management team there."

It comes after the Herald revealed that there has been a five-fold increase in referrals for transgender surgery in Scotland between 2012 and 2017, with a total of 153 procedures approved funded last year.

At present, trans patients in Scotland must travel to England for nearly all procedures. Only breast augmentation for trans-women is performed on the NHS in Scotland.

Mr Ng is originally from Malaysia but has lived in the UK - mostly in Glasgow - since1997. He has been practising gender reaffirmation surgery in Helsinki and Ghent, in Belgium, for the past five months as part of a training fellowship funded by the Winston Churchill Memorial Trust and the Royal College of Physicians and Surgeons Glasgow (RCPSG) and wants to bring his skills back to Scotland to spearhead the develop of a centralised service along the Finnish model.

He said providing all surgeries at one site would save the NHS money and improve care.

He said: "If you wanted to do any facial feminising work that could be very easily combined with breast surgery or even a vaginoplasty at the same time. Hysterectomy could be combined with chest masculinisation.

"If these things were combined you're actually reducing the stay of the patient, the amount of times they have to travel, time off work. And it's not just for the patients - it's also a good saving for the NHS."

Mr Ny said an initial phase to bring breast augmentation under one roof could begin within two years. Work could also get underway to bring chest masculinisation to Scotland too, he added.

James Morton, manager of the Scottish Trans Alliance, welcomed the proposal. He said: "Several years ago when they first looked at the gender reassignment protocol in 2012 there were insufficient numbers of surgeries taking place to be able to have a team in Scotland that would have been performing the operations regularly enough to maintain a good quality of surgery.

"Now there's obviously been the increase in referrals, so we would really welcome a proper consideration by NHS Scotland as to whether the numbers are now sufficient to support a surgical team based in Scotland."

NHS Grampian said it could not comment at this stage.

A spokesman for National Services Scotland, which advises health boards and the Scottish Government on the set up of new NHS services, said: "At this time no application has been received from a Scottish health board for the provision of gender reassignment surgery services. Therefore, we will continue to ensure people in Scotland have access to the appropriate services from specialist providers in England."

A Scottish Government spokesperson said: “The Scottish Government expects everyone who needs to access gender identity services to get timely access according to clinical need. There are gender identity clinics across NHS Scotland which are doing a fantastic job at caring for people who need their support and we expect NHS Boards to ensure that they are resourced appropriately.

“It is common for low volume, highly specialist services to be provided on a UK basis and, due to the specialist nature of gender reassignment surgery, services are provided on a UK basis in England. This means surgeons have a sufficient volume of cases to maintain their skills, getting the best outcomes for patients and ensuring a safe and sustainable service.”

Gender reassignment surgery is undertaken in the following locations:

Chest Reconstruction Surgery:

Miss Grit Dabritz
Consultant Oncoplastic Breast Surgeon
Audit and Governance Lead for Breast Services
The Pennine Acute Hospitals NHS Trust
North Manchester General Hospital

Pride in Pennine General Surgery – Gender
Patient Information Leaflet for Chest Wall Surgery – Last updated October 2016.


Male to Female Genital Surgery:

Mr Philip Thomas
Consultant Surgeon
Brighton Gender Clinic
Nuffield Health Hospital
Warren Road
Brighton, BN2 6DX

The following documents have been provided by Nuffield and are templates for information only. Patients undergoing Gender Reassignment Surgery (GRS) at Nuffield will be contacted on an individual basis, according to the care plans that are agreed.  The information received may differ from these templates, according to their individual requirements:

Conditions to be Placed on Surgical Waiting List
Thyroid Cartilage Shave Guidance

GRS – Without Vaginoplasty:
Discharge Information
Consent Letter to Patient
Letter Confirmation to Patient
Letter Confirmation to GP
Guidance What to Expect on Each Day of Stay

Gires have provided a useful information Guide: A guide to lower surgery for those assigned male, identifying as trans women, trans feminine, non-binary or non-gender.

What to Bring into Hospital

GRS – With Vaginoplasty:
What to Bring into Hospital
Information About Purchase of Care Pack If Not Brought By Patient
Discharge Information
Dilating Information
Consent Letter to Patient
Letter Confirmation to Patient
Letter Confirmation to GP
Guidance What to Expect on Each Day of Stay


Female to Male Genital Surgery:

Mr Andy Pryor
St Peter’s Andrology Centre
Hospital of St. John and St. Elizabeth
60 Grove End Road
Greater London, NW8 9NH

St Peter’s Andrology Centre, London
Patients Guide To Phalloplasty

Gires have provided a useful information Guide: A guide to lower surgery for those assigned female, identifying as men, trans masculine, non-binary or non-gender.

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