Choosing a surgeon

This page is designed to support you when choosing a surgeon. It’s useful to do your research and make an informed choice about your surgeon. However, it’s important to know that there are fewer choices in relation to lower surgery.

Continue reading to find out what you might wish to consider and questions you might want to ask.

For people having mastectomy, or for people accessing private care, there are a number of surgical teams to choose from in England.

There are fewer surgical teams offering NHS genital surgery.

At the moment there are currently no transition-specific surgery teams based in hospitals in Scotland, Wales, or NI. Patients from those nations are normally sent to surgery teams in England.

Stand-alone hysterectomies and orchidectomies are available in all nations of the UK. You can find a complete list of surgeons who can be accessed via the NHS or the HSCNI on the NGICNS website.

If you have decided to pay for your own surgery, rather than using NHS or HSCNI funding, there are additional options available to you – both in England and abroad. For more information about these private surgery options read our private care page.

There is the option to apply to have surgery abroad via the NHS S2 Funding Route, which is available for people in any part of the UK. Whilst we believe that an S2 application for transition related surgery is unlikely to be accepted, some people might think it is worth a try.

Some key info about the S2 Funding Route:

  • The route applies to EU countries or Switzerland, Norway, Iceland or Liechtenstein (yes, event post-Brexit).
  • It’s available for people experiencing ‘undue delay’.
  • It’s only available for things that you could (in theory) access in the UK. So, you could use it to access phalloplasty but you couldn’t use it to access facial feminisation surgery.
  • It can only be used within state funded healthcare and in line with what people in that country would have access to. For example: If a resident of that country would be expected to pay 20% of the costs and the local health service pays the other 80%, then the NHS would cover 80% of the cost of your surgery and you would pay the other 20%.
  • Patients have to find the surgical team before applying for funding and have to make sure they agree to offering surgery via this funding route.
  • Patients have to have a medical professional who is willing to support their application.

It’s important to note that S2 funding does not cover the costs of travel and accommodation.

Read more about the NHS S2 Funding Route

To ensure that you choose an appropriate service, it is important to find out:

  • Does the surgeon offer the particular type of surgery that you’re interested in? Do they offer the outcomes you’re looking for? For example, a choice of nipple placement.
  • Do they require one or two signatures on your referral letter?
  • What are their requirements around BMI?
  • What are their requirements around smoking?
  • What’s their reputation like? Do past patients recommend the surgeon?
  • What do past patients say about their surgical results? Are they happy with them? How did they support them with post-operative care and with any complications they may have had?
  • Does the surgeon have experience operating on people with a similar skin colour and body type to you?
  • If you’re non-binary, have other non-binary people had a good experience with this surgeon and their team?
  • If you’re disabled or have a chronic illness, will they be able to meet your needs? This is both in terms of the procedure itself, but also in relation to any appointments and hospital stays.
  • How long is their waiting list?
  • What is the level of contact? Do they respond quickly to questions?
  • Are there physical examinations? Will they perform medically unnecessary examinations?
  • Do they offer any additional services to patients, such as access to a psychologist or dietician?
  • What post-operative care and support do they provide?

For people accessing surgery privately, it is useful to find out:

  • How do their prices compare to other surgical teams? If they are a lot cheaper than other providers, it would be useful to find out why.
  • What is included in the price? For example, does the price include hospital fees and medication? Is the cost of any implants or prosthetics included? For example, if you’re having phalloplasty, is the cost of the testicular implants included?
  • If they’re overseas, what support can they offer patients whilst they recover? For example, providing accommodation, regular check ins from a doctor, etc.
  • Do they offer payment plans?

You can find out about fees and costs for private gender services on our private care page.

A well-run service will be happy to help you with questions on these subjects. You may also find useful information on these subjects, and other people’s thoughts and experiences of services, by searching /r/transgenderuk for information.

When choosing your surgical team, it is useful to have considered:

  • How easy it will be to travel to and from appointments. Find out how long it would take you to get to in-person appointments, how much it will cost to get to them, and if you might need help from someone to get there.

    Typically you will have a consultation, a pre-op appointment, your hospital stay or day surgery appointment, and a number of post-op appointments (depending on the type of surgery).

    For people travelling a long distance, it might be possible to have your consultation and at least some follow up appointments via video call or phone. It might also be possible to get some of your pre-op tests done locally. With this in mind, it can be useful to ask about in advance.

  • How easy it will be to get home from hospital. After most transition related surgeries, you’ll be unable to drive yourself home. This is due to the effects of general anaesthetic as well as for reasons linked to your recovery from surgery. It is a good idea to have someone to travel home with you from hospital, and most hospitals strongly encourage it.

    Consider how you would get home from the hospital where your potential surgical team is based. It’s important to remember that you are unlikely to find travel as easy as you usually do.

    It is important to ask yourself:
    • Is there someone in your life that would drive you home?
    • Is there another way for you to get home from the hospital?
    • Would you stay near to the hospital for a few days or a week after you get out from hospital?

  • Whether you can afford any additional costs. Regardless of whether or not you go private for surgery, there are extra costs involved. These can include the costs of:
    • Travelling to and from appointments and hospital.
    • Staying in a hotel or other rented accommodation.

It’s important to be aware that hospitals often require patients to arrive early in the morning on the day of surgery, so you might wish to stay nearby the night before. Some people are eligible to claim their travel costs back from the NHS. If you’re in Scotland, Wales, or Northern Ireland or if you are a low income and living in England, take a look at our Claiming for travel costs page.

There are a lot of considerations, so we’ve got a page specifically about this. Go to Travelling Abroad for Surgery page.

It’s a good idea to find out about other people’s experiences with any surgical team you’re considering having surgery with. It’s particularly useful to talk to people with a similar body type and skin colour to you. If you’re disabled, chronically ill or neurodiverse, it might be useful to talk to someone with similar access needs to you.

You might want to ask people:

  • Were they happy with their outcome?
  • How was there experience whilst in hospital? Were their dietary needs and access needs accommodated?
  • How was the post-op care?
  • Did they have any complications and how did the team deal with them?
  • Could they share a photo of their results with you?

Good places to find out about people’s experiences and to see results photos include:

On many sites (such as reddit, Facebook, and TransBucket) it can be useful to search for a surgeon’s surname. That can often help you find people’s experiences of surgery with them.

It can be useful to go with a surgeon that regularly works with non-binary people and/or that you’ve heard of non-binary people being pleased with.

There may be different options available to you. For example, for top surgery they might be able to:

  • Use longer, higher or lower incisions.
  • Leave more chest tissue behind – it can be useful to take photos of the type of result you would want.
  • Leave your nipples and areola a larger size or with more projection or higher placement than they would for a man.

For phalloplasty or medtoidioplasty, people can ask their surgeon about their options in relation to retaining or removing their vagina, and whether or not they’d like a scrotum.

For vaginoplasty, vulvoplasty and orchidectomy, some surgeons might be willing to do things slightly differently. Ask them what your options are.

Take a look at the Surgery Introduction page for more information different potential options.

GDNRSS have produced detailed guides about gender surgeries, which you’ll find on the Introduction to Surgery page.

Other sources of information include:

Back: Intro to surgery
Next: Surgical referrals
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Parts of this page are based on information originally posted on genderkit.org.uk with permission.

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A disclaimer: TransActual do not provide medical, health, or legal advice. The content of this page is intended for information purposes only. It is not a substitute for medical advice, diagnosis or treatment from a medical professional. It is not a substitute for advice from a legal professional. We strongly suggest you consult a healthcare professional or legal professional for specific advice about your situation. TransActual do not advocate or recommend the purchase of any specific product and we do not endorse or guarantee the credentials or appropriateness of any health care provider, any product or any provider of insurance and legal services.

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