Double mastectomies for gender vs health purposes

[Blackcats7]

Does anyone know the criteria and waiting time for double mastectomies for “gender purposes”?
As a woman with very large breasts causing various health issues I have spoken to my gp over the years about breast reduction and have said I would be perfectly happy to have them completely removed or as small as possible. I was told that the criteria is to have maintained a bmi under 30 for at least a year before referral and then the waiting list is about another two years and even then funding is very limited on a case by case basis.
A friend who had one breast removed due to breast cancer was offered reconstructive surgery but actually wanted the other breast removed instead so she felt “even”. This was refused because her nhs trust counts this as elective and does not fund it.

I don’t. And people will roll their eyes at this when I say it. Are u over weight? I was and had huge breasts. And I lost a ton of weight and the size of my breasts halved. It was a massive relief.

Not the issue I am asking about.

In order to have a double mastectomy for gender dysphoria, you need a diagnosis of dysphoria and then will be referred to a gender dysphoria clinic. They have a team of experts who may then refer you for surgery.

I understand that this is a very slow process and can take years. It may also change under the new administration.

It's unlikely that without a referral from a gender clinic, that a surgeon would remove healthy breasts. Waiting times for breast reduction surgery would depend on your area. In the first instance, I would speak to your GP who may be able to give you an approximate time frame.

It will clearly vary by trust, as the reconstructive surgery post cancer is not considered elective in my trust, even if they want totally different breasts rather than to match the remaining one. I've known two women choose to have the healthy breast removed as well and have implants in order to match and remove the stress of worrying about it coming back.

Pretending to have a gender identity would be a childish and disingenuous way to get a mastectomy. It is also much healthier to have a reduction, the full mastectomy affects the pectoral muscles and your lymphatic drainage.

Keep fighting for the reduction, add your weight to the statistics of females needing care rather than trans services. Good luck.

I was never suggesting pretending anything so am not sure why you think I might?
My description of own situation and my friend's were purely as examples of the path for women trying to get mastectomies for other purposes.

Worth remembering that a diagnosis of "gender dysphoria" results in bodily mutilation (eg double mastectomy) to treat a mental health problem by altering the body to fit disordered thinking. What's worse is that this happens to teenagers and young women before they've fully matured and considered their future fertility. Surely going through puberty and reaching maturity before medics start medically experimenting on you seems to be a fairly basic human right?

This from an experienced clinical psychologist about gender dysphoria being a false construct with no clinical or evidentiary basis makes fascinating reading. It's also chilling when you realise what children are being told by adults who should know better:

https://x.com/Psychgirl211/status/1808825717204922755

I think perhaps my initial post has been misleading based on the replies.
I am a woman. I don't believe it possible to change sex and nor would I want to. Due to other serious health problems I would not bother trying to get a breast reduction myself anymore as I have much worse to cope with
My question was how women who want to be men are getting their double mastectomies when it seems very difficult for other purposes and a post code lottery like many other issues.
I wondered if nhs have different criteria considering the level of capture by Stonewall.

It's difficult to find information OP. Apparently since 2000 12 transmen have had surgery. I don't know if that's all top surgery.

At one stage the NHS was throwing money (millions of ££) at trans health care and it was possible for men to get facial, feminisation, hair removal and other expensive treatments for free while women were stuck in long queues. As the NHS has been ground down I suspect that the magic money tree has stopped producing - certainly the waiting lists for double mastectomies in some areas are as long as 6 years. Lots of girls and young woman go private where there's a range of ethics free medics looking for custom:

This Spectator article highlights some of the data and issues:

www.spectator.co.uk/article/the-troubling-truth-about-gender-affirming-mastectomies/

Where did you find that? 12 in 24 years?

From the Spectator article:

Freedom of Information figures show that, in 2022, the Wales Gender Service made 172 referrals for top surgery.

in the past six years, 51 teenagers aged 16 and 17 were referred from Scotland to hospitals in England to undergo further assessment for ‘specialist chest reconstruction’.

While NHS England does not collate the number of top surgeries it carries out, many are performed privately, with numerous plastic surgeons advertising their services online. One such surgeon, Philip Rubin, told the Mail on Sunday last year that he now carries out 20 double mastectomies a month, up from one or two 10 years ago.

It seems to be rather more than 12 in 24 years.

I remember a thread on here a couple of years ago about how much easier it was to get a double mastectomy for gender issues compared to breast reduction. It included a link to a hospital document which contained the criteria about eligibility for surgery.

Worth remembering that a diagnosis of "gender dysphoria" results in bodily mutilation (eg double mastectomy) to treat a mental health problem by altering the body to fit disordered thinking.

Yes. I remember having an interesting conversation with a very early pioneering feminist philosopher (her articles are now apparently given trigger warnings at universities) who said - Yes, this is a mind/body split problem, and it's easier to change their body than change society.

Depressing but true.

A younger female member of my extended family presents as a man, and had a double mastectomy at the age of 18 (I could have wept) - I think they went private ...

Mastectomy is a serious operation and interferes with so many physiological systems. For breast cancer it can save lives (mastectomy saved the life of my sister), but it has long-term consequences.

And @Blackcats7 I get what you're saying. Women have to fight, fight, fight for surgery for anything related to being female and in pain (look at the stats on endometriosis or birth trauma), but it seems as though claiming gender dysphoria gives people a fast track to all kinds of surgeries.

As a PP says above, "gender affirming" surgery (ugh) can take a long times, but the desire is not questioned, nor is the patient belittled or shamed in the way you have been @Blackcats7 eg focusing on your weight rather than your pain.

And for what it’s worth I actually lost weight and whilst the band size of my bra went down the cup size stayed the same so weight loss made no difference to my actual boobs. Bloody horrible things. Always in the way. Clothes don’t fit. Special bras which cost a fortune. Rash underneath and skin breaking leading to infection. Back, neck, shoulder pain. Grooves from bra straps. Pain when exercising. Men speaking to my boobs instead of my face and constant unwanted comments.
My friend who had breast cancer actually has a selection of knitted boobs now to put in her empty cup but still wishes she could have had the other one removed.

I think this is the earlier thread I mentioned:
https://www.mumsnet.com/talk/womens_rights/4541418-nhs-accused-of-favouring-men-changing-gender-over-women-with-medical-needs-for-breast-surgery

There's a link in that thread to this report with some statistics:
https://www.gettingitrightfirsttime.co.uk/wp-content/uploads/2021/02/BreastSurgeryReport-Mar21o-EMBARGOED.pdf

Ask Freddie McConnell. She had a double mastectomy (before giving birth to two babies then claimed that the surgeon hadnt told her she would not be able to breast feed her babies.) I don’t know how this was funded but I hope it was not out of our taxes.

OP, just for you to pass onto your friend but unless things have changed you can have a second elective mastectomy following a mastectomy due to cancer. It's over 10 years ago now, but I did. You have to be clear, unemotional and reason well but it's not that uncommon. My Consultant initially said no, but I argued that having no breasts would reduce my risk of recurrence (marginal in my case, but still true). That worrying about recurrence affected my mental health, so an elective mastectomy would reduce that worry. Also, they'd already said I'd need a cosmetic operation (to even up my breasts as the cancer free one was radically different from the implant post mastectomy breast - incredibly lopsided!), so I argued that I was having an op anyway, why not just have the second mastectomy and have matching implants on both sides. To get consent I had to see an NHS psychiatrist - she was lovely btw. Maybe your friend should go on some of the Breast Cancer charity forums and see if anyone there's had it done recently.

OK so my info came from 2010. From 2000-2010, there were 12 surgeries on the NHS for transmen. I cannot find current information. I've checked the NHS, Stonewall, Mermaids and other organisations and can't find the info.

Also the NHS doesn't have stats on top surgery. As far as I'm aware, the majority of top surgery is done privately.

The cup size (A,B,C etc ) isn't actually a fixed volume, it is a measure of the difference between the band measurement (under bust) and the measurement around the fullest part of the breasts. So even though you were still the same cup size, the fact that your band size went down would mean the actual volume of your breasts did go down a bit, but obviously not enough to ease the discomfort of your large breasts.

Hope you can get some help with this issue soon, it is shit that women's real discomfort and pain is all too often disregarded and minimised.

It's far more than 12 in the past 10 years, unless by some bizarre coincidence I know half of them. Off the top of my head:

My cousin's daughter.
My colleague's daughter.
My university friend's daughter.
DH's boss's daughter.
My son's colleague.

@cupcaske123, why do you call it 'top surgery'? Top surgery and bottom surgery are twee euphemisms that disguise the reality of what's being done to these people's bodies, i.e. major surgery removing body parts and interfering with essential body systems in the hope of alleviating mental distress. I think it's much better to be honest about what's happening and talk about double mastectomy.

So, I have had a double mastectomy for gender purposes.

My waiting time for this procedure was, by the time I had began the active process, five years. My waiting time was also slightly shorter than average, because towards the end of those five years I switched to private care. I then had two mental health assessments to determine genuine gender dysphoria and make sure I was going into this for the right reasons, and from that point it took nine months until my surgery date. In that nine months I had two consultations and a couple more check-ins.

I don't have any personal comparative anecdotes, but that's how long it took for me.

(For reference, I was originally referred to the Tavistock but the various issues they were undergoing at the time had pushed my waiting time back by one year, and was likely to be further delayed. I didn't want to put my postgraduate studies and moving plans on hold for any longer while waiting to hear from them for god knows how long, so I made the difficult decision to switch to private care.)