Management Summary
- The issue of gender re-assignment costs has
increasingly been in the press of late as part of the debate on NHS
cutbacks. In many instances the information provided has been inaccurate or
misleading: a few simple checks could have established better and more
accurate figures than those quoted.
- This paper reviews the standard procedures available
within the NHS: it sets out what a trans individual is likely to be offered
within the NHS (and also what they are not). Cost information is provided,
together with sources for that information.
- The broad conclusion is that treatment costs are highly
influenced by whether an MtF trans service user undergoes surgery or not.
- For the vast majority of MtF trans people seeking
treatment, who do not undergo surgery, the overall cost to the NHS is
unlikely to exceed £1,000 over the person's lifetime. For those who do go on
to seek surgery, the cost to the NHS is likely to be around £2,500 in
respect of hormone and endocrine intervention and around a further £11,000
for the surgery (both figures aggregated over a twenty year period).
- Over the same period, a FtM patient, on average, may
cost the NHS around £15,000 in respect of hormone and endocrine intervention
and those FtM patients that undergo full surgical re-assignment are likely
to cost a further £50,000 in respect of grs: since, however, the majority of
FtM patients do NOT undergo full surgical re-assignment, it would be highly
misleading to talk of this figure as “typical” or an “average”. The typical
or average figure for FtM intervention (excluding hormone treatment) is
likely to be much closer to £20,000.
- The way in which figures are quoted is discussed: in
particular, the use of terms such as “typical” and “average”. In general,
the press needs to be far more careful when it comes to estimating costs:
they need to distinguish carefully between the actual cost of treatment
applied to an individual; the typical cost of a particular procedure if it
is provided; and the expected cost of treatment, which in most cases is
unknowable.
Available in a pdf file in full.