A Guide to Gender Confirmation Surgery in the UK

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Gender confirmation surgery may form part of a treatment plan to help people with gender dysphoria, where a person does not identify with the sex they were assigned at birth. These people are often called transgender or ‘trans’.

It is estimated around 1 per cent of the UK population – 600,000 people – identify as trans or non-binary. Some trans people choose to transition to their preferred gender socially and/or medically.

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What does gender confirmation surgery mean?

Gender confirmation surgery is a permanent surgical procedure, or series of procedures, that change an adult transgender person’s physical and sexual characteristics to those that society associates with their preferred gender identity.

Gender confirmation surgery for transgender women in the UK may involve:

  • removal of the penis and testes, known as a penectomy and an orchidectomy
  • breast implants
  • facial feminisation surgery

Gender confirmation surgery for transgender men in the UK may involve:

  • removal of the breasts, known as a double mastectomy
  • removal of the womb, ovaries and fallopian tubes

Gender confirmation surgery on the chest is commonly referred to as top surgery, while gender confirmation surgery on the genitals is commonly referred to as bottom surgery.

What happens before gender confirmation surgery?

Candidates for gender confirmation surgery must first transition socially, and live as their preferred gender identity full-time. They must have pre-surgery counselling, generally for at least two years, and usually receive hormone therapy for at least six months before surgery.

Gender confirmation surgery is only offered once the person and their care team are sure it is the right choice for them.

What is hormone therapy?

Not everybody with gender dysphoria chooses to undergo gender confirmation surgery.

Ongoing support and advice from a specialist gender identity clinic can help transgender people. Services include counselling, speech and language therapy, hair removal treatments, and peer and family support groups.

Gender identity clinics also offer hormone replacement therapy (HRT). Some people who take hormones go on to have gender confirmation surgery, while many others find hormone therapy is enough.

How long does it take to recover from gender confirmation surgery?

Recovery from genital reconstruction surgery, known as bottom surgery, is generally expected to take around two months. Patients are usually in hospital for three to six days, followed by a further week to ten days of outpatient supervision. Recovery from top surgery is much quicker, with patients usually returning to their daily lives after about a fortnight.

Can you get gender confirmation surgery for free on the NHS?

Yes, gender confirmation surgery is available for free on the NHS. Transgender health services at NHS gender identity clinics are also available.

Unfortunately NHS waiting lists for gender confirmation treatment can be long, which is why some people choose to seek treatment privately.

How much does gender confirmation surgery cost privately in the UK?

Gender confirmation surgery costs vary. Fees can range from £10,000 to £100,000, according to trans support network, TransUnite.

Female to male gender confirmation surgery is more expensive, often in the region of £60,000. Male to female gender confirmation surgery costs between £10,000 and £20,000.

For top surgery only, the cost generally falls between £5,000-£8,000, including aftercare.

Of course, there are also a number of hidden costs to gender confirmation surgery. The cost of an initial assessment usually falls between £200-£300 for an hour with a clinical specialist. Then there are travel costs, accommodation costs for loved ones staying near the hospital and various post-op expenses such as walking aids – as well as the cost of taking time off work to recover.

Get help paying for gender confirmation surgery

Given how expensive gender confirmation surgery can be, paying for it can be tough. So how can you pay to cover top or bottom surgery costs privately?

Take out a loan

Taking out a loan is quick to do, but be wary as high interest rates could lead to financial problems down the line.

Reach out to a charity 

Charitable organisations may be able to provide you with some financial assistance in the form of a medical grant.

Organise a rainbow dress-up day

One of LGBTQ+ charity Stonewall’s top fundraising ideas is to organise a rainbow dress-up day at your workplace. Talk to your employer about your plans for gender confirmation surgery and rally support from your colleagues. The idea is that everybody swaps their boring office attire for an outfit in all the colours of the rainbow, in a nod to the well-known LGBTQ+ flag, in exchange for a donation to your cause.

Stonewall sells fun rainbow laces at a discounted rate to fundraisers, so you might consider selling these on the side and giving the proceeds to them to raise further awareness of trans issues.

Host an LGBTQ+ movie night

Encourage friends to donate by hosting a big night in complete with movies, popcorn and a floor full of duvets.

Throw a fundraising party

Your local LGBTQ+ nightclub could make the ideal venue for a fundraising party, especially if you offer them a cut of your proceeds. Consider asking any LGBTQ+ groups you’re involved with whether members could spare some time to help you sell tickets, book some entertainment and/or organise a raffle.

Try your hand as a quizmaster

Fundraising over a drink or two is hard to beat. Get in touch with your local pub about hosting a quiz there one night. Explain why you’re fundraising and see if they’d be willing to donate a prize for the winner in exchange for you promoting the event and bringing people their bar.

Raise funds by asking people to donate as much as they can in place of the usual quiz entry fee. Throw in a few questions about trans issues, language and equality – your quizzers will learn and have fun at the same time.


Thousands of transgender people have successfully set up crowdfunding campaigns on sites such as GoFundMe to help raise funds for treatment.

In 2019, a transgender man called Jude smashed his £1,200 crowdfunding target, allowing him to travel to Poland for top surgery. “My whole life, I’ve detested the body I live in,” he wrote on his GoFundMe. “It feels like a cage. It feels monstrous. Jude isn’t the only one who had success crowdfunding. Laura met her £550 goal to raise funds to cover her initial appointment fee and travel costs, while Mia raised nearly £5,700 for facial feminisation surgery.

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GoFundMe makes fundraising quick and easy for you and your donors. We’ll guide you through the set up process and our blog is packed full of tips to set you up for success. Plus, we’re the only crowdfunding company to offer a donor guarantee. What are you waiting for?

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Written by dina