The NHS’s enthusiasm for chopping off women’s breasts (or sucking them out from under the skin) shows no sign of abating. Figures released to GenderBlog (that’s me, that is) under Freedom of Information request shows that in the first half of this year at least 623 women across the UK were recommended for some form of Masculinising Chest Surgery (MCS) by their local gender clinic.
This is most likely to mean a cosmetic double mastectomy, or chest wall reconstruction, or repairs/tidy-up work associated with a previous operation. If the referrals continue at the same rate there will be a minimum of 1246 (and a maximum of 1294) this year, almost exactly the same number as last year (between 1275 – 1291).
The variables exist because the NHS choose not to specify patient numbers between 1 and 9 in its site-specific breakdowns, claiming to do so might cause someone to be identified.
Referrals are handled by a centralised service run by NHS England called the Gender Dysphoria National Referral Support Service. GDNRSS then commissions surgeries at private and NHS hospitals, all of which are in England.
These are the figures for patients sent for MCS by NHS England over the last two and a half years:
Of the sites which carry out gender surgeries for the NHS, Chelsea and Westminster, Castle Hill in Hull and North Manchester are NHS sites and the remainder are private. Other than the Nuffield in Plymouth, it broadly looks as if most private hospitals are scaling down their MCS operations whilst among the NHS hospitals, Manchester is ramping up.
The NHS has estimated the ballpark cost of each MCS procedure to be £5,800, but this figure was produced in 2023. Private clinics today (and don’t forget the majority of these operations are carried out in private clinics) can have minimum charges between £8,915 to £12,415 for each procedure. If we assume £7,500 to be a conservative per procedure cost estimate for 2026, the NHS is on course to blow around £10m on cosmetic mastectomies etc this year, assuming the vast majority of those sent for surgery go through with it. Weirdly, NHS England says it does not collect data from client hospitals on how many procedures are actually carried out.
What about the myriad ways to slice and dice male genitalia?
Glad you asked. These are called Feminising Genital Surgeries (FGS) and, on the NHS, can take the form of Penectomy (chopping the willy off), Bilateral Orchidectomy (castration), Clitoroplasty, Vulvoplasty and Vaginoplasty (in which a piece of bowel can be used to create what surgeons call a neovagina “if other vaginoplasty techniques are not possible because of inadequate donor site skin”).
In 2026, the number of people referred by NHS gender clinics for FGS surgeries has held pretty steady.
As we can see from the table below, there are only three hospitals carrying out these surgeries for the NHS. Remember, a referral from a gender clinic for surgery does not mean that NHS England will agree to send a patient to surgery, nor that the hospital they have been sent to will accept them, or that the patient will go through with it.
That should mean that the numbers of referrals sent for surgery by NHS England will be lower than the referrals received from NHS gender clinics. However it is possible – indeed likely – that the figures for those sent to for surgery will be bolstered by private clinic referrals to the NHS, which is the best reason I can think of as to why the number of men sent for the chop by the NHS this year is significantly higher than the referrals it has received from its own clinics. See below:
When we strip out the “transfer referrals” from the NHS figures to show new referrals only, we see how the total drops significantly:
We also see how few new NHS referrals Chelsea and Westminster are doing. If anyone knows why that might be, I’m all ears.
On the financials, in 2023, the NHS estimated the ballpark cost for what they called “male to female” surgery was around £10,000. That is now a baseline estimate, with the full monty (castration, penis removal and hole carved into the body and lined with tissue from the bowel or penis/scrotum) costing between £24,000 and £30,000.
Let’s assume each procedure averages out at £20,000. This means the NHS is on course to blow more than £23m castrating people this year.
Talking Cock
Finally let’s look at phalloplasties et al, the riskiest and least successful gender op of all. These are known as Masculinising Genital Surgeries (MGS). And something odd is going on. If you look at the number of referrals from NHS gender clinics, you can see the number of referrals holding steady year to year:
But if you look at the number of women actually sent for this surgery, the numbers are all over the place:
The New Victoria Hospital has given up the ghost. The only place the NHS is sending women to is Chelsea and Westminster, but this year the numbers have ramped up significantly. Yet when you look at the table for new referrals only…
… NHS England has not commissioned a single new phalloplasty this year. How queer.
Phalloplasties cost between £20,000 and £60,000 “due to their complexity and multiple stages involved”. Taking £40,000 as a ballpark, it looks like the NHS is on course to spend around £12.5m on phalloplasties this year so surgeons can have multiple goes at harvesting a woman’s fat and skin from her leg, arm or belly, rolling it up into a tube, sewing it into her genitals and hoping it doesn’t start to rot. They call it a neophallus.
So by my educated guesstimate, using these new figures, the NHS is going to spend around £45.5m on gender surgeries in 2026.
I’ve asked the NHS department which supplied me with the figures above to tell me the actual cost of the surgeries commissioned to date. I’ve also asked them to explain what new and transfer referrals are, why they don’t hold actual surgery figures from the hospitals they commission and the total numbers of referrals for each class of surgery so that I’m not mucking about with minimums and maximums when looking at the overall picture.
If you have any specific insight on what the data above tells us, please message me via the contact form on this website. If you have a speculative comment or thought, by all means leave it below. If you think I am massively misreading the data in my analysis, please let me know! Thanks.
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