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Trans People are increasingly traveling abroad to the following countries Thailand Undergoing gender reassignment surgery (GRS) takes a long time NHS The backlog has left some patients waiting as long as 20 years for treatment.
Charities warn that difficulties accessing care in the UK will harm patients’ health mental health and create a “desolate experience” for the trans community.
As a result, in recent years, a growing number of transgender people have taken increasingly drastic action, paying thousands of dollars to seek faster treatment in countries such as Thailand, Poland, Spain and Turkey.
The scathing Levy Review published in December found that waiting times for first appointments at NHS adult gender dysphoria clinics are expected to reach 15 years unless improvements are made.
Dr David Levy found that long waiting lists also prompted people to self-source hormone drugs from high-risk online providers abroad, with “little data” available from adult clinics other than waiting times.
Freya Firewood, 31, was one of several Britons who traveled to Southeast Asia last January after she and her partner decided to have the surgery together.
After spending years getting used to her body, Freya used her savings to book a trip abroad as several of her friends had struggled for years to get NHS support.
“For some people, if they were to be put on the waiting list just now, they would feel completely hopeless,” she said.
Bangkok leads the world in GRS and is more cost-effective, with packages typically priced between US$9,000 and US$14,000 (£6500 and £10,000). Although there are few private clinics in the UK offering these surgeries, vaginoplasty often costs more than £34,000.
Although there are no official statistics on the number of people undergoing surgery in Thailand, it is reported that at least 100 Thai doctors will be qualified to perform surgeries in 2023, and there will be at least 20 medical centers to choose from.
Freya told independent: “The attraction is they have more advanced technology, the price difference, the ability to make appointments. For me, I was treated within 9 months.”
However, although Freya praised the medical team in Bangkok as “fantastic”, she developed complications and now faces a difficult six-month recovery period before having to return to Thailand for the same treatment.
“As soon as the surgery was over, my problems started,” she said. “I couldn’t urinate and I needed a catheter. Then I found some extra drainage holes on the sides of my vagina and I couldn’t walk for more than half an hour.”
She added: “It was something I had to accept, it was like getting a whole new body, but it wasn’t quite what I wanted.”
As a result, Freya spent two months living in a hotel in the city before returning to London and now fears complications from the surgery could affect her career and finances as she will have to fly out again later this year.
She said: “This whole thing has been happening but it’s never quite worked out. I’ve been struggling and knowing that it hasn’t quite worked out yet is totally devastating. I’m going to be a woman without a vagina.”
While the vast majority of people have had positive experiences of treatment abroad, charities and organizations are concerned that trans people now feel they have no choice but to travel because treatment is unavailable on the NHS.
Alex Matheson, director of inclusion at the LGBT charity, said: “Even with the best quality of care, there are always risks when you go for surgery and there are risks with surgical intervention.
“You may not speak the language, you may have limited access to services, and there are mental health risks beyond those you pay for. Even with the best outcomes, you will experience an invasive, emotionally constrained treatment, and you may receive treatment without a support network.”
While the NHS will treat emergency life-threatening complications arising from surgeries abroad, they are not obliged to provide routine, follow-up or corrective surgery for privately funded surgeries outside the UK.
Freya will therefore be in regular contact with a group of professionals in Thailand and Crowdfunding to help fund her return trip.
Speaking about the waiting list, Ms Matheson said: “To be honest, it’s a desolate experience for a lot of people. We see terrible outcomes for trans people who wait. It can take five to seven years for the first appointment, or ten years after diagnosis to get gender-affirming surgery. Someone might have to wait 20 years to get to where they are after Freya’s surgery – which is pretty scary when you think about the impact surgery has on people.” Someone. “
The Cass Review, published in 2024, looks at gender identity services for under-18s and calls for gender services to match other NHS care standards.
It comes after concerns were raised about the Gender Identity and Development Service (Gids) at the Tavistock Centre, which was the only specialist clinic for young people and closed shortly before the review.
The Levy Review noted that a large proportion of referrals come from people who have withdrawn from youth services.
Tammy Hymas, head of policy at advocacy group TransActual, said: “A survey has found overwhelming evidence that these long waits do have an impact on mental health.
“We are aware of several recent cases where coroners have reported that sometimes people have taken their own lives. This is a national scandal and a crisis we are going through. The NHS is not coping with the scale of the crisis.”
She continued: “It’s prompting people to make other choices, which does include going abroad, to Thailand, Spain and Poland. It’s definitely an increasingly common phenomenon. It’s a huge social justice issue because only those who can afford it can really do it, it’s a bit like a trans tax. Trans people spend thousands of extra pounds a year on gender-affirming care, which is money a lot of people don’t have in the cost-of-living crisis.
“This is a difficult situation for a lot of people because the impact of waiting is really dangerous for people’s mental health.”
The NHS has been contacted for comment.