Surgery referrals

Once consensus has been reached between you and two of your clinicians, they will refer you to a surgeon for chest or genital surgery. Surgery is provided by services external to the GIC. Waiting times for surgery after you have been referred by the GIC will depend on the waiting lists of individual surgical service providers. It is important to understand that two assessments for any desired surgery are required before a referral can be made by your clinicians.


Chest surgery

You will normally be required to have been living in your actual gender role for at least one year, and have been taking masculinising hormones for 6 months prior to assessing your suitability for a chest surgery referral.

Hysterectomy and salpingo oopherectomy

There are many reasons people may seek hysterectomy as part of their gender care. One of the medical reasons we refer people is that the risk of endometrial hyperplasia is increased when someone has been taking synthetic testosterone for 2 years. If someone does not wish to have hysterectomy it is advised that they have ultrasound tests every 2 years to monitor the risk.

In order to be assessed at the GIC for hysterectomy, we usually expect you to have lived officially in your actual gender role for at least a year. Your clinician may also request documentation showing that you are living and functioning in your actual gender role, examples of this may include work ID, copies of pay slips, evidence of voluntary work or study.

Genital surgery

A standard requirement will be for you to have lived officially in your actual gender role for at least a year before assessment of suitability for a genital surgery referral. Your clinician may also request documentation showing that you are living and functioning in your actual gender role, examples of this may include work ID, copies of pay slips, evidence of voluntary work or study.

Weight management

Some surgical service providers ask that you have a body mass index (BMI) of around 30 and/or a waistline of 102cm or less. This is for safety reasons and to achieve the best surgical results.

We refer people for surgery who have a higher than optimal BMI. In these circumstances we hope that people are able to reduce their BMI with support (e.g. your GP) if required while on the waiting list for surgery. If you require support with weight management this can be provided by your local services, please ask your GP. Weight management is not provided by the clinic.

After referral

People who are referred for surgery are discharged from the GIC to the care of the surgeons as it is assumed that their gender care is complete. If you want to have a follow up appointment at the GIC after receiving surgery, please ask your GP to write to us to arrange this. PLEASE NOTE THAT THIS SHOULD NOT BE A RE-REFERRAL BUT A LETTER TO US STATING YOU ARE A PREVIOUS PATIENT, as re-referral can mean significant waits for appointments.

Surgery waiting times

Surgery waiting times vary depending on the hospital.

See below for an example from Imperial College Healthcare NHS Trust.

> Surgery statistics for Charing Cross Hospital

> The St Peter's Andrology website