Trans men launch legal action over NHS surgery ‘failures’: ‘Left in limbo’

A group of trans men have launched legal action over the “industrial scale failure” of NHS delays in transmasculine gender-affirming surgeries.

Trans men seeking surgery to create a penis are facing waits of up to four years, as a result of NHS contractual issues.

With many experiencing “significant distress” while waiting in “limbo”, law firm Leigh Day, in association with LGBTQ+ advocacy nonprofit TransActual, has opened a legal investigation on behalf of a group of patients.

According to Leigh Day lawyers, the investigation could result in a lawsuit against NHS England and St Peter’s Andrology Centre.

The two surgeries in question are metoidioplasty or phalloplasty, in which a penis is constructed from genital tissue or from skin grafts from other parts of the body respectively. Typically, these are carried out over three operations.

The procedures were previously contracted out by NHS England to St Peters Andrology, which operates from private hospitals.

This contract expired at the end of March 2020 and was not formally recommissioned by NHS England.

A new provider, New Victoria Hospital, was not commissioned until September 2021, which Leigh Day argues contributed towards the backlog and delays.

“The breakdown in the commissioning arrangements with St Peter’s Andrology Centre, the failure to have any other service provision in place, and the delay in recommissioning a new service means hundreds of patients have been left in limbo,” Leigh Day senior associate solicitor Kate Egerton said in a statement provided to PinkNews.

Egerton, who is leading the investigation, has said that the delays left clients with significant “physical and psychological” damage.

Differences in policy between St Peter’s and New Victoria mean that some patients who have already been through the first stages of metoidioplasty are now facing additional surgeries.

Leigh Day says New Victoria Hospital’s policy is to perform stage two (hysterectomy and genital reconstruction) as two separate procedures. This means that those treated by the hospital are forced to go through four procedures in total, despite other recently commissioned NHS providers having policies that allow the stages to be performed in one procedure.

Some have even reported being left with “indeterminate genitalia” as a result of the length of time between procedures, with no mental health support from the NHS, according to Leigh Day.

‘My confidence has disappeared, I haven’t been able to socialise like I used to’

One of the clients, Oliver Lloyd, who Leigh Day is representing, said that the delays had forced his life to go “completely on hold” and that the wait times have felt like “limbo”.

“Another surgery will mean an additional general anaesthetic which has its own medical risks, additional time off work, and the additional physical and emotional effects of surgical recovery,” Lloyd said.

“I am appalled and disgusted at the way transmasculine people have been treated.

“Particularly that it took 18 months for NHS England to contract a new provider for these surgeries, leaving hundreds of patients without any access to urgent and important services, let alone mental health support to bridge the gap.”

Another trans man, named only as Matthew, said that he had been living for three years with an “incomplete penis reconstruction” that has been having a hugely negative impact on his mental health.

“My confidence has disappeared, I haven’t been able to socialise like I used to, travel, or gain new employment,” he said.

“I have been hugely affected by stress which has resulted in other knock-on health issues such as anxiety, depression, insomnia, hair loss and suicidal ideation.

“Aside from the physical strain of four procedures versus three or even one, each procedure sees me having to fund travel and accommodation in London and months off work to recuperate, resulting in major loss of earnings as well as physical, emotional and mental suffering.

“All of this, in the current climate of widespread hostility and transphobia in the UK, is unbearable.”

TransActual commended the investigation as a step towards holding those responsible to account and prevent future incidents like this from taking place.

Co-director Chay Brown said that the case is about “access to medical treatment” and an “industrial scale failure” in part due to the NHS delays.

“It is about patients traumatised by the wait for treatment. Worse, it is about patients who began treatment on the basis that ‘start-to-end’ would be no more than 18 months, and who have been left in limbo – sometimes in extreme pain – because that promise was not kept,” Brown stated.

“Beyond that, it is about a faceless service that has failed to explain to patients what is happening and has not even had the decency to apologise for the misery it has inflicted.”

Readers affected by the issues raised in this story are encouraged to contact Samaritans free on 116 123 (www.samaritans.org) or Mind on 0300 123 3393 (www.mind.org.uk). Readers in the US are encouraged to contact the National Suicide Prevention Line on 1-800-273-8255.