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27 March 2011

Trans man loses court battle for bigger breasts on NHS

A transsexual man who wanted his local NHS trust to pay for him to have bigger breasts has lost his case in the Court of Appeal.

The 59-year-old was challenging West Berkshire Primary Care Trust’s decision not to fund the £2,300 operation, claiming that it violated his human rights and amounted to sexual discrimination.

But on Friday three judges in the Court of Appeal ruled in favour of the Trust’s decision, upholding a previous High Court judgement.


The man, who is known only as C, began hormone therapy in 1996. His lawyers argued that his breasts had failed to develop to a size appropriate to his “size and frame”.

But lawyers acting on behalf of the PCT warned that the surgery wasn’t essential, and that there was not any evidence that it would be clinically effective or cost effective.

Although C has been living as a woman since 1996 and adopted a female name in 1999, he has not requested funding for genital reassignment surgery.


Neither has he applied for a gender recognition certificate under the 2004 Gender Recognition Act, meaning that he is legally regarded as being male.

Critics of sex-change surgery warn that gender dysphoria is a psychological problem, not a physical one.

In November a man who underwent sex change surgery to look like a woman – then changed back – said that the NHS should halt all sex change operations.


Charles Kane, who spent £100,000 on operations to make him look like a woman, said he needed counselling, not surgery.

“Based on my own experiences, I believe sex-change operations should not be allowed, and certainly not on the NHS”, he said.

Mr Kane said: “People who think they are a woman trapped in a male body are, in my opinion, completely deluded. I certainly was.

“I needed counselling, not a sex-change operation.”


He added: “In many ways I see myself as a victim of the medical profession.”

Mr Kane was born Sam Hashimi but had an operation to make him look like a woman in 1997.

He believes that the decision to have sex change surgery came as a result of the trauma of the breakdown of his marriage.


In 2002 doctors from the NHS Portman Clinic – an internationally acclaimed centre – stated that after surgery, “what many patients find is that they are left with a mutilated body, but the internal conflicts remain”.

Many transsexuals regret their decision to live in the opposite sex. A Home Office report on transsexualism, released in April 2000, said: “Many people revert to their biological sex after living for some time in the opposite sex”.

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