What do we know about NHS Masculinising Lower Surgery?
In Wages for Transition, Josie Giles describes the unpaid work trans people do to create their own and one anothers genders. i think about this as i create this information hub from research trans people have done into understanding the deliberately opaque machinations of the NHS.
The situation for lower surgeries in the UK is very bad. Get on the waiting list now and don't read on.
Mood Music
- Aquarela do Brasil - Geoff & Maria Muldaur
- Fallout - Albert Elms
- Inertia Creeps - Massive Attack
- It's In My Blood - Coil
Who does what in lower surgery?
Original research by scottish trans redditor Neat-Bill-9229 on who does what and where in UK lower surgeries. Expanded by me as and when i come across new information
New Victoria
- Hospital Overview
- Professor David Ralph
- Mr Don Lee - Phalloplasty + Meta stage 1 + 2.
- Mr Nim Christopher - Phalloplasty + metoidioplasty
- Mr Phillip Rubin - phalloplasty, plastic surgeon, can do MLD
- Mr (Oudai) Ali - Gynacology
- Professor Issac Manyonda - Gynacology
- Mr Chiriaco - UL, does stage 2 (glans & scrotum), relatively new (as of Jul 26) to working independently
Chelsea & Westminster
- Hospital overview
- Mr Miroslav Djordjevic - Metoidioplasty + Phalloplasty (tbc). Teaching new surgeons how to do metas.
- Professor Marlon Buncamper - from Ghent in Belgium, reported by TransActual to be training surgeons in phalloplasty; additional confirmation from a patient on reddit. (source)
- Miss Victoria Rose - phallo, according to reddit
- r Juan Tinajero - phallo, according to reddit
- Dr Tina Rashid - ??? according to reddit
- Mr Jeffery Ahmed - Gynaecology
- Mr Rufus Cartwright - Gynaecology
- Mr Giangiacomo Ollandini - phallo, meta, urology (special interest in Andrology and Sexual medicine, gender Dysphoria and infertility). Studied a Masters in Andrological Surgery and gender disorder Surgery.
- Miss Alexandra Zachou - Urology
- Mr Guiseppe Di Taranto - Plastic surgeon. [ETA, 24/11/23 - performs metoidioplasty] Carries out top surgery with LTC. Note on website + LTC - I hold a Substantive Consultant post within the prestigious Chelsea and Westminster Hospital, NHS Foundation Trust, in central London, where I perform oncologic and reconstructive procedures for general plastic surgery and Gender Affirmation Surgery — To perform metoidioplasty - not performing surgeries yet - Jul 26 (source)
- Mr Saahil Mehta - Gynaecology
- Mr Dominic Yue - Consultant Plastic surgeon. Nothing about gender.
Information
C&W are reluctant to do monsplasties and will say you are unable to get one. They use different meta techniques to NVH - they do a bifid scrotum, and they attempt to do everything as a single stage.
sourceC&W do a bifid scrotum, whereas NVH do their own variant on VY
(source; source)C&W have a BMI limit of 33, and depending on the type of surgery, it might be a limit of 27.
(source)The NHS don't offer redos, essentially, unless there is a medical reason. You can fight for it but it has to go up to a board who will decide.
(source)The NVH team do offer UL without v-nectomy. This is unusual internationally so worth noting!
An hour-long lecture by Mr Christopher, longest-standing surgeon at NVH, on their process. May 2020.
The NVH team cover RFF scars with a full-thickness graft from your buttocks.
Moving up the waiting list is weird and arbitrary. People with referrals from 2024 and 2025 are post Stage 1 and getting consultations, despite other reports they are still on COVID-era referrals.
(source)The three inflatable implants that NVH offer: Coloplast Titan, AMS 700 CX, and the Rigicon Infla 10 X (Jul 2025)
(source)St Peters Andrology in the UK estimate the cost of going private for phallo is between £70,000 and £100,000. stage 1 would be roughly £42,000 and you can then seek later stages through the NHS. It might also be closer to £40,000 if you choose a simpler kind of phallo (no vnectomy and no UL). Options in Europe are significantly cheaper. (2026)
(source)New Victoria Hospital estimate the cost of going private at Stage One - £22 - 28k; Stage Two - £11,436; Stage Three - £17,166.60. This doesn't include the fees for consultant and anaethetists. The estimate for consultants was £10,500 + £6000 + £3500 and anaethetist £2500 + £1250 + £1000. This would bring the total price between £75,352.60 and £81,352.60.
(source)You might be able to get private lower surgery through insurance provided by your employer, which is unusual in the UK. Some employers are listed here.
(source)the S2 Funding Route allows people who can't be seen in a timely manner by the NHS to be funded to go abroad. Community word on the ground is that since 2012, nobody has been heard of to get this for masculinising lower surgeries. There's no harm in trying and wasting their time so long as its not too much of a waste of yours. Here's the justification:
NHS England will determine whether: the same or equivalent treatment can be provided to you on the NHS within a time period that is medically justifiable (undue delay)
NHSE won a court case saying the GIC waits are valid and they are ‘doing all they can’.
(source)Information from a phallo consultation with Mr Christopher (Jul 2026)
- Self-pay first consultation is £375
- with Alt thigh he chooses the site on the day and recommends to do electrolysis afterwards because you'll just be hairless on an unused spot otherwise.
- You can get a combination of two different sites; so for urethral lengthening you can use a graft from your forearm but the girth from your thigh.
- Full forearm phallo gives you 3 nerves, full thigh gives you 1 and a combination of forearm and thigh gives you 2 nerves one from each.
- The skin to replace your forearm is taken from your butt so you get a bum tuck. Skin for your thigh is taken from the other thigh and mesh is used.
- If you use your stomach for the graft site then you won't get sensation at the end of your phallus due to the nerve hook up.
- Gaining weight affects your phallus if you have thigh because of the cell type. This works with weight loss as well.
Waiting List Detective Work
The NHS does not give up this information without a fight or clearly. It falls to the hard work of our community to give up their free time to wrangle it out of them.
Waitlist-to-join-the-waitlist numbers
FOI request - December 2025.The community does not currently know what the waiting list for NVH or C&W is, however someone has also done a FOI request on the GDNRSS waiting list i.e. the 'waiting list to join the waiting list'.
- Phalloplasty – 1,151
- Metoidioplasty – 180
- Unspecified - 267
- Total 1,598
Moving onto a real waiting list
FOI request - 27/11/2025Nobody has moved off the waiting-list-to-join-the-waiting-list since 2021.
It may assist you if we clarify that New Victoria Hospital has held its own waiting list since 2021 and it has not taken any new referrals from the separate waiting list held by the GDNRSS. No transfers have been made to the Chelsea and Westminster service from the GDNRSS because New Victoria Hospital made provider-to-provider transfers directly to Chelsea and Westminster from the NVH waiting list.
Community information
- All stage 1 patients around COVID time have been completed, lots of stage 3 patients are being discharged so mostly stage 2 remain
- Westminster and Chelsea did only 6 operations in the entirety of last year so they aren't speeding up the backlog too much. They also have a different method of two consultants working on you at once. I believe he said doing stage 1 and 2 at the same time. However they might be changing method soon as when complications occur it is harder to fix. It also slows down the process a lot because you have 2 consultants working on one person rather than 2 separate patients.
- Only contact the GDNRSS regarding wait lists because the hospital isn't accepting "new" patients until all COVID patients have been finished. They don't know anything until they are told. So no new NHS patients will be seen and they can't give you a date or time estimate.
Information about waiting times
Cribbed from an investigation by TransActual, based on community FOI requests
17th October 2021
survey suggests at least 3 years and 8 months for the surgical team to clear the current waiting list; 4 year wait if referred in 2021
3rd December 2021
Individuals waiting for stage 2 or 3 surgery have received a letter from New Victoria Hospital. They anticipate that these surgeries “will commence from March 2022 and will take around two years for all cases to be operated on.”
16th February 2022
FOI request says 1,944 people are on the waiting lists for NHS phalloplasty and metoidioplasty. Suggests waiting times for some people will be even longer than our forecast of 8 years.
12th March 2022
FOI response, says 967 people on waiting list for surgery, plus 1003 waiting for an appointment related to surgery (such as a first outpatient appointment or surgery review. In addition:
New Victoria Hospital has performed 30 masculinising genital surgery procedures between the service start date of 13 December 2021 and 22 February 2022. This represents an average of approximately 14.5 procedures per month.
10th October 2022
FOI request, 139 phalloplasty and metoidioplasty surgeries took place at New Victoria Hospital between 1st January 2022 and 30th June 2022. This equates to approximately 23 procedures a month.
NHS England’s indicative activity plan indicates an expectation of 472 procedures in the 2022/23 financial year, which equates to approximately 39 procedures a month.
Number of phalloplasty procedures performed at C+W to date
As of 2024, C&W also do phalloplasties
- Stage 1: 7
- Stage 2: <5
- Repair: 0
information
Wow! That sucks! I've got so much time to get really good at Tekken. Maybe if i'd gone back to medical school in 2015 instead of getting on a waiting list i'd actually have qualified as a surgical urologist faster than waiting for someone else to do it! Wow! Don't think about it!
take me anywhere but here