Thread by @DadTrans

There is a lot of misinformation on the question of legality of gender confirmation surgery for trans young people in the UK.

On the NHS gender affirmation surgery is technically available from 16 (for top surgery) though in practice from 18 due to very long waiting lists.

Trans youth can access adult services at age 17. This has been the case for a long time for some adult GICS,
however in 2018 the Gender Identity Services for Adults (Surgical Interventions) service specification standardised practice. All types of surgeries are available at 17.

This is the NHS specification. I'm also aware of some UK surgeons who have carried out top surgery on trans masc 16 year olds through private practice.

In reality those who can afford & with finances / supportive parents & carers frequently travel overseas for surgeries.

The USA is the most popular destination for trans masc youth from the UK, with some travelling for top surgery from age 15. Thailand is the most popular destination for young trans women, with gender confirmation surgery available from age 18. Historically this was younger.

There is no "ban" on gender confirmation surgeries earlier than this in the UK. Consented surgery at an earlier age is not, as frequently reported, "illegal". The largest barrier to access to surgeries is the staggering waiting lists - up to 5 years for some adult GICS.

As more evidence has been published on the outcomes of transgender youth, & as knowledge has been shared in the medical community, so there has been growing awareness that gender confirmation surgery is safe, low risk with extremely high satisfaction levels.

There has also been increasing demand for surgeries at an earlier age from trans young adults. This is for several reasons:
- Many want their first sexual experiences to be in a body which accords to their gender.
- They want to develop alongside their peers

- They want to get the 'trans stuff' out of the way before starting out on adult life - for many this feels on hold until body and gender match
- There may be a natural break between high school & post high school education or work which would be disrupted by later surgeries

@TransActualUK @stonewalluk @mimmymum @OwenJones84 @KatyMontgomerie @sirussly
Please read the NHS service specifications for surgical interventions. england.nhs.uk/publication/se…

For these reasons we are seeing gender confirmation surgeries in America, and by exception in Europe and elsewhere at earlier ages. At the very earliest this is from 13 or 14 for top surgery for trans masc Gillick competent adolescents & 15 or 16 for young trans women.

Worldwide there is now effectively (multiple tiers) or access to transition surgeries for trans young adults. There are two major factors in access. Firstly parental /familial support - few young adults are able to access surgeries without supportive family. Second Financial.

Gender confirmation surgeries are expensive and outside the reach of most adults, let alone those coming out of their teens. The barriers for the vast majority of young trans adults are insurmountable. Lack of parental support, barriers to education dysphoria, stigma

Associated mental health issues, barriers to access to standard, (non trans related) healthcare, high levels of forced homelessness, unemployment / under employment, discrimination, self harm and suicide ideation. This is every day life for many trans people around the world

Surgeries for many are a luxury that is beyond reach. When we hear of trans young adults accessing surgery it is usually because they have hugely supportive families & home life & with the financial means or determination to make financial sacrifices (remortgaging homes) to help.

I've used the term surgeries above because there are many different types of surgery & reducing all gender confirmation health care into a single 'surgery' is reductive & lacks clarity. I believe in body autonomy, gillick competence, medical expertise & access irrespective of £$

Also included in body autonomy is the fact that many trans people do not want or need surgeries. A trans person with or without surgery is no more or less trans. All require legal protections & access to medical care without prejudice or stigma.

Note gender surgeries do take place in the UK on children. The vast majority of these are on intersex children shortly after birth and without their consent. This is never talked about in the media. I support intersex people in their fight for voice, body autonomy & consent.