An NHS Trust is to cut funding to gender transition as part of a move to limit non-essential operations in the area.
Hounslow Primary Care Trust has announced that from April 2007, anyone seeking NHS support for medical services such as gender reassignment, tattoo removal, or breast enhancements will have to pay for it.
It is hoped that the change will mean a reduction in hospital waiting times.
There will also be a consultation on IVF treatment in the borough, The Hounslow Guardian reports.
It is part of a wider scheme by the NHS to scrap post-operation care after 6 weeks to save the service money. Instead it is suggested that patients will visit their GP or a practise nurse.