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Trans woman goes to court after being denied breast implants

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  1. Not a fight I would take up as a trans woman myself. The best solution for this case would be an independent psychological assessment for her need of treatment.

    It would be interesting to know the age of the woman involved as breast development is greatly reduced the older you are. Maybe her expectations of her breast development via hormone treatment where unrealistic to start off with.

  2. I sympathise with this persons case, however, at a time when the NHS is struggling to cover even the most basic operations, many of which are life-threatening, one has to draw a line in the sand. I appreciate this is more than ‘cosmetic surgery’ as far as this person is concerned, however, it is not critical to that patients welfare, and there are alternatives.

    The operational costs are massive, and considering what could be achieved with the same money, one has to ask “What do people want hospitals for? Saving lives, or bigger boobs?”

  3. is it any wonder health care costs keep rising? I understand she wants the implants to give credence to her internal identification as a woman, but why should her insurance foot the bill for this? You want to become a woman, pay for it!

  4. Simon Murphy 8 Oct 2009, 2:45pm

    Many biological women are flat-chested. They would be refused breast enlargement as it would considered cosmetic. I don’t see why this transwoman can’t buy a Wonderbra?

  5. some pcts in the nhs covers cis women getting boobjobs if they are found deserving (of course this is never a story…). if her pct covers cis boobjobs then she has every right to sue.

  6. Wonderful, three transphobic comments and a trans woman replaying two false myths.

    After the normal age of puberty, when growth hormone may assist breast growth, there is no link between age and potential breast growth. It is down to genetic predisposition, hormones, and available fat. This transwoman might have unrealistic expectations but suggesting such delusion as the primary cause of the court case is verging on transphobia again.

    Much more likely is either that androgens in her still-male body have prevented breast development, or that the hormones she has been prescribed have been inadequate in some other way.

    Mostly, endocrine care of trans women in the UK is appallingly inadequate, reflecting widespread transphobia in a specialty mostly dealing with diabetics.

    And then people get denied breast augmentation; either the funding, or being turned away by local NHS breast surgeons, who, of course, have almost no experience of doing plain breast augmentations anyway, so who would choose to go under their scalpel?

    The surgery can often be accessed through NHS gender clinics (two of which have their own plastic surgeons), after considerable delay and inconvenience for those outside the few cities where they are located, and much subjection to multiple psychiatrists (which cost a PCT that insists on that route far more money). But that mostly results in people getting augmentation who might have developed naturally given proper hormones and a few years (it can take up to 8 years for full development with an ideal hormone regimen, which has to include a progestogen suitable for the patient, ideally progesterone).

    Whichever way the PCT is responsible. Given that they have never given funding for breast augmentation (let’s discount Pink News writing that they gave augmentation to a woman with excess breast development as another Pink howler), and they seem to have overlooked the now 18 month-old legal obligation not to discriminate, in providing healthcare, against people undergoing reassignment (which hasn’t been publicized so most NHS branches are that ignorant), they really have no leg to stand on. So their lawyer complaining of the legal costs is yet more money being wasted on lawyers time.

    Some PCTs will spend money on anything to avoid spending it on patients.

    Lets just hope the woman’s lawyer doesn’t screw up.

  7. Julian Morrison 8 Oct 2009, 7:54pm

    Seems pretty simple to me. Either NHS has an obligation to do sex changes or it hasn’t. Either way, doing half a job (like, genitals but not breasts) is obviously unacceptable.

  8. I totally agree with everything Su has already stated .It’s disgusting , that the level of surgical experience , and standards
    are so poor for Transexual patients with the NHS here in the U.K (Post code lotteries, ignorant medical practitioners, discrimination etc).
    Its also disappointing to read such stupidly ignorant comments from some of the people on this page .

  9. Su: How can I put this nicely? er.. I can’t, so F_CK OFF!
    I try to be as sympathetic as possible, as do others on here, but anyone that is faintly against this scenario is immediately deemed “transphobic”. I seriously f_cking resent that remark. Like the man said, stop being so f_cking selfish, and instead of spending thousands so YOU feel good about your tits, how about donating that to a cancer victim and wearing a padded bra instead?

    Selfish f_cking bitch!

  10. Simon Murphy 8 Oct 2009, 9:42pm

    No 6: Su: you say: “Whichever way the PCT is responsible. ”


    Are you trying to suggest that larger breasts are a requirement for being a ‘proper’ woman. That strikes me as being a tad sexist and mysogynistic.

    Or do you think the NHS provide boob jobs to all women unhappy with their appearance?

  11. simon,
    the nhs does perform boobjobs for women suffering from depression because of the size of their bust (at least by some pcts)

  12. Julian Morrison 8 Oct 2009, 9:58pm

    Some women have flat chests, some women have narrow hips, some women have broad shoulders, some women are tall, some women even are hirsute and get beard shadow. But put all those things together at once and the person will never be “read” as anything but a man. The surgery used to help trans people is all about replacing enough of those signals that the rest fall into the “normal” range and are read as female. So it can be much more important for a trans woman to have boobs than a non-trans woman.

  13. I doubt she’s asking to be turned into Jordan, just into someone who can reasonably read as female. As breast augmentation is a recognised part of gender reassignment surgery, I cannot fathom how the PCT can get round it.

    They seem not to have grasped:

    1. That GRS is not simply body modification for the sake of it, but is actually often a life-saving surgery (how many suicides caused by harassment and gender dysphoria, and how many tranny bashings does it take to underscore this point?), and
    2. That treating people the same is not necesarily treating them equally (equal access to recognised therapies and surgeries doesn’t mean we’re all given the same therapies and surgeries).


  14. No doubt the PCT will say ‘it’s the principle’ but the cost of defending (and no doubt appealing this issue all the way to the new Supreme Court) will run into tens of thousands of precious pounds. I wonder how many surgical procedures (including breast implants) that could pay for. Gender Dysphoria is a mental illness and, for some trans people, breast implants are part of the ‘cure’. Until DSM V is changed, then this is the medical situation. If PCTs are inconsistent in providing treatment for mental illness, then this must be challenged. What is needed is a consistent policy that applies to all PCTs. Either that, or stop medicalising and pathologising people who change their gender identity.

  15. Simon Murphy 10 Oct 2009, 3:57am

    No 12: Julian: you say:

    “So it can be much more important for a trans woman to have boobs than a non-trans woman.”

    But being a woman isn’t about ‘having boobs’. So why is it so important to have them? Are you saying that it’s purely about appearance?

  16. Julian Morrison 11 Oct 2009, 9:45pm

    @Simon I’m saying it’s mostly about social role. You won’t get treated as a woman if you are giving out signals that sum up to “man in a dress”. (It’s also important that the trans woman is likely to utterly despise looking like a guy and will have serious depression unless repaired to a more female appearance. But personal feelings aren’t the largest part of the reason.)

  17. As I am not a trans woman, I may have this totally wrong, but my understanding is that, having been treated from birth as a woman by everyone around me, the size of my boobs is not fundamental to my sense of self as a woman or the way others react to me as a woman – my appearance is clearly consonant with social expectations of Woman, and my whole history is of being treated as and living with the expectations of being female. Yes, boob size can affect self-esteem insofar as women are made to feel weird about our bodies generally, but those of us who have a whole life history of being female, going through puberty, periods, and being totally accepted as our actual gender identity don’t question our gender identities if our boobs are small – we can feel crappy about our bodies not conforming to some ludicrous ideal, but we don’t feel that it strikes at the heart of our femaleness because we have an entire life history of our gender identity and our treatment by others matching so closely that it’s not an issue. In my case, I have felt undesirable when I was really overweight, and pretty self-loathing when things were bad, but I never thought to question my femaleness.

    A trans person has a whole history of being treated as something other than their personal gender identity. It’s a massive emotional and psychological difference which can be drastically affected by surgery and cosmetic interventions (lasering or electrolysis, cosmetic surgery to alter “masculine” features so they read as “feminine”, GRS including breast implants whether tiny or large).

    Add to that the fact that trans women want to live lives in which the people around them accept them entirely as women, not as blokes in make-up and dresses, and the fact that being seen as a bloke in a dress can be physically incredibly dangerous.

    So it’s a combination of self-perception and public perception that has massive consequences, both in terms of mental health and physical safety.

    I hope that a) made sense, and b) is a fair assessment of the issue. As I say, I’m not a trans woman, so I’m clear that I may be missing or misunderstanding important parts of the issue. This is simply my understanding based on the couple of trans women I’ve been close to in the past.

  18. Oh, I should add to my lengthy, possibly incoherent, ramblings that I’ve family members who’ve had breast cancer and had breasts removed. Their reaction was that it made them feel weird about their bodies for a while, and made them feel “unfeminine”, but it did not affect their sense of themselves as being female. In fact, the idea didn’t occur to them until we had a conversation about gender identity, and they said they could understand that someone transitioning would find it really important, but that they knew they were female and so did everyone around them, so it just wasn’t an issue in the same way.

    So, equality is not necessarily the same as being treated identically, but about getting people to the same level playing field so they can actually play on it.

  19. Anon: “Equality is not necessarily the same as being treated identically, but about getting people to the same level playing field so they can actually play on it.”

    Erm,.. bollocks. That’s how we end up with positive discrimination and people ‘bending’ laws and rules how they see fit to accommodate one set of minorities over another. Equal is good, active promotion or suppression is not. Everyone should start at the same starting post, and some will do better than others. That’s life.

  20. Anon: “Equality is not necessarily the same as being treated identically, but about getting people to the same level playing field so they can actually play on it.”

    Erm,.. bollocks. That’s how we end up with positive discrimination and people ‘bending’ laws and rules how they see fit to accommodate one set of minorities over another. Equal is good, active promotion or suppression is not. Everyone should start at the same starting post, and some will do better than others. That’s life.

    A friend of mine is legally blind (she sees only blurs). Her employers got software called JAWS which allows her to use the computer. They not only let her bring her guide dog in to work, but actively encourage it by giving her a desk large enough for the dog bed to go underneath it. They’ve put bright luminous tape around doors and arches, etc., so she can distinguish them. They’ve got her a special phone.

    But I can see now that you’re completely right. They shouldn’t have made accommodations for her disability in order that she could access the workplace and do her job. The fact that she’s highly talented and considered by all her colleagues and employer to be a real asset to the organisation is irrelevant. She should have just been treated identically to everyone else, and if she couldn’t hack it without her guide dog and adaptive tech, she shouldn’t have been hired.

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