Failed Gender reassignment surgery appeal

Hi Everyone,

My name is Joanne, I’m a 40yo transwoman, living in the UK for 19 years.

Even though my year started with the happiest moment in my life, with gender reassignment surgery, I developed the rarest complication. My body rejected the skin and the operation failed

The only option available is to have a brand new surgery, which is not currently funded by the NHS.

This operation has to be done as soon as possible, before it is too late. If my body closes completely, the operation won't be possible and there will be no other options.

My physical and mental health is deteriorating every day, and I'm scared.

Even though it is the hardest thing I ever had to do, I feel that there are no choices left. I have no option than to expose myself and lose my privacy. I am fundraising for the £25k cost for the remedial surgery, which is so urgently needed.

I worked so hard to be where I am. Literally defied death with a terminal cancer diagnosis, attempted suicides, HIV.  I am not about to give up!

So, I'm sharing my story, in hope and trust, that with your help I'll finally be able to be my true self and have the happiness I fought so hard for my entire life.

And then, I will be able to fulfil my true potential, representing the trans and other communities in need, through my volunteering with the 3 Trans and HIV charities I currently volunteer for.

(Some people have told me about technical difficulty to donate here. If that's the case, for alternatives to support me, feel free to contact me directly)

My story

I always felt ‘different’, non-relatable. At the age of 6, when my sister was born, I understood why - I was also a girl!

Though my parents at times tried to understand me, those were different times and we lived in a very Catholic country. I understood that being different and my feminine feelings were never going to be acceptable so I had to hide these feelings and try my hardest to be as expected. I looked up to my older brother, but I could never be a real boy like him. I became a recluse, a robotic version of what I thought was acceptable 

I became more and more withdrawn, emotionally self-trained to go to a place of guilt and sadness.  I battled severe depression and self-harm. In my late teens understanding that I was attracted to men, I made suicide attempts. I knew then, I needed to fight to be the real me. That wouldn't be possible in Portugal and I moved to England.

In my determination to resolve my gender incongruence, by my mid 20's, I started therapy. After a lot of refection, I started self-medicating oestrogen to ease the increasingly growing dysphoria.

In 2005 I found out that my only ever partner had passed away with complications through undiagnosed HIV, which I also carried since 2000.

That created spiralling of mental health, where hope for any future seemed unattainable. My world collapsed again in 2008 when I was diagnosed with a rare form of Lymphoma inside my head, only found when was already at a “terminal” stage 4b stage. Against all odds I survived a very long and arduous battle.

My surgery

My year started amazingly, with my so longed for Gender reassignment surgery. Happiest day ever as you can imagine. It felt amazing. It still does of course.

But it failed.

I had complications, eventually the beginning of a bladder prolapse and ultimately heard my surgeon say “as we expected, the necrosis expanded and all skin tissue is dead”. The surgeon treated me there and then, burnt all skin with silver nitrate and scraped all dead tissue out.  I was devastated, in pain, bleeding and worried for my future. The surgeon emphasized that the only option was a colon vaginoplasty and to preserve the opening I would have to continue to dilate.

I was having meltdowns constantly, thinking it was all my fault, blaming myself, etc...  I wouldn't leave the house, because of the bleeding. 2 weeks ago, I couldn’t deal with anymore and I contacted the surgeon again.
He then gave me the news the news that NHS doesn't have any funding in place to support  the surgery I need.  
It is not classed as “remedial”, but as a complete new operation
The decision has to be appealed... HOWEVER this could take years in the current situation we are living in.

Meanwhile, my physical and mental health is deteriorating day by day. I don’t sleep, I stay in the dark during the day, in shutdown mode. To compensate for my mental health, I’m over eating anything left in the house, and that’s making my mobility worse.  My Fibromyalgia symptoms are flaring and I spend the whole day having to take extra pain killers that don’t work.

I’m deteriorating. It’s getting more difficult to dilate, with daily bleeding and my body fighting to heal the “wound”

I worked so hard to be where I am. Literally defied death with a terminal cancer diagnosis, attempted suicides, HIV.  I am not about to give up!


I have no life outside my 4 walls. The only contact I have with the outside world is through zoom, helping within my volunteering roles. And that’s what’s keeping me up everyday! Being able to help them still. I can smile every time one of my “mentee's” has a happy “memory snapshot” in their life.

Through all my diverse volunteering roles within Spectra, Chelsea and Westminster hospital and Positively UK,  I'm able to promote safe sexual health, do rapid HIV testing, volunteer as a mentor to trans people,  Cancer patients and survivors and fellow HIV+ peers.  I want to put my own health issues behind me and fulfil my potential continuing to help others.

To do this I have to fight for myself first. And then really raise awareness and make our health rights equal

I maintained a smile on my face through all battles, illnesses and difficulties faced.


Please help me maintain that smile and be the woman I was born to be.

(Some people have told me about technical difficulty to donate here. If that's the case, for alternatives to support me, feel free to contact me directly)


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Joanne Elizabeth Espada 
Hayes, Greater London, United Kingdom

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