FOI – 2024-000027 Gender Reassignment Surgeries (HTML)

Date received – 18 January 2024 | Date responded – 12 February 2024

Request

I am writing you to inform myself of the EU directive route application, of its process and length of review/approval of Gender Reassignment surgeries from Scotland, is State Funded and Private Healthcare the same through this process?

I would like to ask about specific ones, but unfortunately, I don't find the few listed ones I saw a while ago for MtF surgeries.

If you could please provide a list of Gender Reassignment surgeries MtF costs in NHS Scotland/UK it would be helpful for costs preparation please.

Response

I refer to your freedom of information request that we received on 18 January 2024. I can advise you that we have now completed the search of our records and can provide you with the following information:

I am writing you to inform myself of the EU directive route application, of its process and length of review/approval of Gender Reassignment surgeries from Scotland, is State Funded and Private Healthcare the same through this process?

NHS National Services Scotland, National Services Division (NSD) has no role in the approval nor management of requests for patients to receive treatment overseas in Europe under reciprocal funding agreements. Such arrangements are dealt with by local Health Boards across Scotland and the NHS Business Authority.

The EU cross-border healthcare directive allowing those residing in the UK to travel to Europe for elective treatment with funding was revoked on the 31 December 2020.

The current scheme available for applications is the S2 funding route. The S2 funding route applies to public healthcare providers only – it does not cover private treatment. Details on this scheme are available on NHS Inform:

https://www.nhsinform.scot/care-support-and-rights/health-rights/european-cross-border-healthcare/travelling-to-europe-for-planned-healthcare-the-s2-scheme/.

I would like to ask about specific ones, but unfortunately, I don't find the few listed ones I saw a while ago for MtF surgeries.

Whilst there are several procedures which individuals may undergo as part of their MtF transition, NSD are only responsible for access to the specialist genital confirmation surgery which is commissioned on our behalf by NHS England. NHS England routinely commission:

• Penectomy
• Bilateral Orchidectomy
• Vaginoplasty
• Clitoroplasty
• Vulvoplasty

At the present time, Scottish patients having engaged with a Scottish NHS Gender Identity Clinic travel to the providers of these genital confirmation procedures in England.

Other aspects of gender reassignment surgery are the responsibility of local Health Boards, and they would be best placed to say which procedures are available locally and the mechanisms in place to consider eligibility for treatment. Email addresses are as follows:

• Ayrshire and Arran – foi@aapct.scot.nhs.uk
• Borders – foi.enquiries@borders.scot.nhs.uk
• Dumfries and Galloway – foi@dumgal.gov.uk
• Fife – fife.foirequestfife@nhs.scot
• Forth Valley – fv.freedomofinformation@nhs.scot
• Grampian – gram.foi@nhs.scot
• Greater Glasgow & Clyde – dg.feedback2@nhs.scot
• Highland – nhsh.foirequestshighland@nhs.scot
• Lanarkshire – foi@lanarkshire.scot.nhs.uk
• Lothian – foi@nhslothian.scot.nhs.uk
• Orkney – ORK.FOIrequests@nhs.scot
• Shetland – shet.foi@nhs.scot
• Tayside – tay.informationgovernance@nhs.scot
• Western Isles – wi.foi-requests@nhs.scot
• NHS24 – foi@nhs24.scot.nhs.uk
• NHS National Waiting Times Centre – FOI@gjnh.scot.nhs.uk
• Scottish Ambulance Service – sas.foi@nhs.scot
• Healthcare improvement Scotland – his.foi@nhs.scot
• Mental Welfare Commission for Scotland – mwc.enquiries@nhs.scot
• NHS Education for Scotland – foidp@nes.scot.nhs.uk
• Public Health Scotland – PHS.FOI@phs.scot
• State Hospital Board for Scotland – tsh.info@nhs.scot

If you could please provide a list of Gender Reassignment surgeries MtF costs in NHS Scotland/UK, it would be helpful for costs preparation please.

Under Section 33 (1) (b) of the Freedom of Information Act 2002 - an organisation does not require to provide information if its disclosure under this Act would, or would be likely to, prejudice substantially the commercial interests of any person (including, without prejudice to that generality, a Scottish public authority) and as such any cost information is being withheld as it is commercially sensitive.

The commercial contracting arrangements and contract management are undertaken by NHS England on our behalf with various providers therefore we are unable to provide a breakdown of tariffs for this surgery as these are commercially sensitive. The needs of each individual patient may differ, and invoiced costs can therefore vary.

Should you require further information regarding commissioned surgical providers, the NHS Gender Dysphoria National Referral Support Service (GDNRSS) who operate a support line on 01522 857799 may best placed to help although it is unlikely they will be able to advise on overseas provision or care under the S2 funding arrangements.

I trust you will find the information of assistance and if you require any further information, please do not hesitate to contact us.

If you are unhappy with any aspect of how we have dealt with your request, you can make representations to us asking us to review the handling of your request.

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Contact

Address

If after a review you are still unhappy, you also have the right to apply to the Scottish Information Commissioner, who can be contacted at Kinburn Castle, St Andrews, Fife, KY16 9DS, or via their application form.

National Services Scotland (NSS) is committed to publishing all information released in response to Freedom of Information requests. You can view all FOI responses within our FOI Publications repository.