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The National Health Service (NHS) is facing a wave of criticism over its transgender surgery practices, following revelations that approximately £20 million of taxpayer money has been spent on "feminising genital surgery" for biological men, including teenagers, over a three-year period. The Telegraph newspaper investigation has sparked ethical concerns and calls for an urgent review of these procedures.
The investigation, based on Freedom of Information requests, revealed that 18-year-olds were among those undergoing irreversible surgeries, which involve the removal of the penis and testicles and the creation of a "canal" to mimic a vagina. The NHS itself acknowledges that the surgery is not reversible and can cause permanent infertility, as well as potential complications such as loss of sexual function, incontinence, dissatisfaction with appearance, and infection.
Clinicians have labelled these procedures "unethical" without sufficient evidence of long-term impacts, particularly given that over a third of the patients are under 30. Detransitioners, individuals who regret their transition, have also voiced concerns about the brutal impact of the surgery. Ritchie Herron, for example, is suing the NHS, claiming his underlying mental health issues were not adequately addressed before he underwent the procedure at 28.
While the NHS states that only adults with a clinical diagnosis of gender dysphoria can receive this surgery after assessment by multiple clinicians, critics argue that the long-term physical and psychological consequences, especially for young people, are not fully understood. Germany, for example, is eliminating the remonstration procedure, meaning rejected applicants will no longer have an informal appeal option.
British South Asian Muslim Trans Surgery Statistics: A Complex Issue
While national statistics on transgender surgery within the UK are available, specific data on the British South Asian Muslim community is scarce. Research indicates that the topic of transgender identity and surgery is complex within Islamic scholarship. Some Islamic legal opinions (fatwas) in recent decades have permitted gender-affirming surgery in specific cases, primarily to address gender dysphoria or correct ambiguous genitalia (intersex conditions). These opinions often emphasize the need for a panel of experts, including religious scholars, psychologists, and surgeons, to make such decisions. However, traditional Islamic scholarship has largely viewed sex reassignment surgery as prohibited (haram).
This creates a tension for British South Asian Muslims who may be considering or have undergone gender-affirming surgery. They navigate both their religious and cultural background, where such procedures may be stigmatized, and the medical framework provided by the NHS. The lack of specific data highlights the need for further research to understand the experiences and needs of this community better.
Ethical and Long-Term Concerns
Beyond the immediate surgical risks, ethical debates persist regarding the appropriateness of irreversible procedures, particularly for young adults. Concerns include:
Informed Consent: Ensuring young people fully understand the long-term consequences of surgery.
Mental Health: Addressing underlying mental health conditions before pursuing surgical intervention.
Long-Term Outcomes: The limited research on the long-term physical and psychological effects of gender-affirming surgery. Some studies suggest higher risks of mortality, suicidal behavior, and psychiatric issues in individuals who have undergone such procedures.
Resource Allocation: The ethical implications of spending significant NHS funds on these procedures when other areas of healthcare face funding constraints.
The NHS is currently undertaking a wide-ranging review of adult gender services, which will inform a revised service specification for supporting patients with gender dysphoria in the future. This review must address the ethical and long-term concerns surrounding transgender surgery and ensure that patient safety and well-being are paramount.
Some information from Daily Telegraph
