IN-DEPTH: GENDER REASSIGNMENT SURGERY


Roland with a patient at Charing Cross Hospital


ROLAND’S RESPONSE “The number of patients treated by us has nearly doubled in the past five years,” says Roland, who leads the Trust’s gender reassignment surgery team. “Even before the decision to apply the 18-week standard, we were struggling to meet the demand and have been working hard to boost our capacity.” “Performing gender reassignment surgery is technically fulfilling and you get real satisfaction helping patients make positive changes to what have often been difficult lives.” Despite this, the specialism struggles to attract trainee surgeons. Many worry they will be expected to provide both psychological and surgical support, but Roland explains that patients have already been assessed as psychologically ready before his team meets them.


There is currently a national shortage of qualified gender reassignment surgeons, with only six fully qualified in the UK, two of whom work exclusively privately. So, when one of Roland’s surgical team moved on and another took maternity leave, they proved very difficult to replace.


18 /Pulse


There is currently a national shortage of qualified gender reassignment surgeons, with only six fully qualified in the UK, two of whom work exclusively privately.


To boost capacity in the short term, the Trust arranges for around 30 NHS patients per month to be treated by private providers (at no additional cost to the Trust). Two surgeons have also been recruited from Amsterdam, a centre of expertise, to operate at weekends. Longer term, Roland is working with colleagues on a new training programme for junior surgeons. He also plans to recruit a new ‘training fellow’ which would allow a more experienced surgeon to move into the specialism.


“Whilst waiting times have been long, most patients referred today will now start treatment within 18 weeks,” says Roland. But this in itself brings new challenges. “For so long, patients


have had to wait; now we need to ensure they are prepared for how quickly surgery may be offered.” It is clear that Roland and his team are dedicated to meeting growing demand. “Gender reassignment patients absolutely have the same right to responsive care as


all other NHS patients,” he concludes.


What is the 18 week referral to treatment (RTT) standard?


The NHS Constitution sets out that patients should wait no longer than 18 weeks from the date they are referred to the date they are treated. All trusts must ensure at least 92 per cent of patients are treated within that timeframe. Find out more about how the Trust is improving gender reassignment surgery waiting times by visiting www.imperial.nhs.uk/ our-services/surgery/gender-surgery


www.imperial.nhs.uk


ROMAN SIGAEV / SHUTTERSTOCK.COM


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