The number of gender reassignment surgeries carried yearly on the NHS has tripled since 2000, figures show.
In 2000, 54 surgeries were carried out, compared with 143 in 2009, the Daily Telegraph reports.
Since 2000, a total of 853 trans women and 12 trans men had state-funded surgery to change sex.
However, the true number of transgender people is estimated to be far higher, as many do not wish to undergo painful or complex surgery, or are unable to access it.
The average age for trans women to undergo surgery is 42 and only one NHS operation has been carried out on a person under 21 in the last nine years.
Gender reassignment surgery costs around £10,000 on the NHS. It became a right on the NHS in 1999 but trans campaigners argue that trans people are still subject to a postcode lottery, as health trusts vary in what they deem to be essential treatment.