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Delays in gender affirming surgeries

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Delays in gender affirming surgeries

We are bringing a claim against NHS England and St Peter’s Andrology Centre in relation to NHS delays in providing trans men (used here as an inclusive umbrella term to also include individuals identifying as transgender and transexual) with gender affirming surgeries. 

About the claim

Leigh Day is bringing a claim on behalf of trans men in relation to significant delays in receiving phalloplasty and metoidioplasty surgeries. This includes delays in commencing the first stage of their surgery, delays in receiving a subsequent stage of a multistage surgery, or delays in receiving a repair. Many patients have been waiting in-between surgeries for years.

Those affected have been living with serious consequences including ambiguous genitalia, physical pain, and poor mental health. We have also heard how it has negatively impacted their personal relationships, work life, and led to increased gender dysphoria. We estimate that many thousands of individuals may be affected.


What is the latest?

We have sent a “letter before action” to NHS England and St Peter’s Andrology Centre. The letter sets out the factual background to the proposed claim and why we say the Defendants have acted unlawfully. 

This is the first step in any legal claim. The Defendants will now conduct their own investigations and provide a formal response to the claim. 


How much could my claim be worth?

Legal action can be used to hold people to account and to compensate for distress and injury, including the physical and psychiatric impacts caused by a breach of the law. It can also be used to attempt to recover expenses you have paid as a result of the breach (for example, private counselling or private surgery). While legal action can never put right what has happened to you, we hope to support those affected to be heard, and to prevent these failures from happening again.

Any compensation you may be entitled to will depend on your individual case and the impact it has had on your health, wellbeing and livelihood. However, at this stage, we estimate that in certain cases, you could be entitled to tens of thousands of pounds.

If you have undergone, or are awaiting, phalloplasty or metoidioplasty surgery and have experienced delays in your treatment plan, please contact us if you would like to consider instructing us in relation to a potential claim. Any enquiries are strictly confidential, and you are under no obligation to sign up to a claim with us.

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Delays in gender affirming surgeries - Matthew's story

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Delays in gender affirming surgery - Oliver's story

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Delays in gender affirming surgery - Harry's story

"Waiting for the repair is uncomfortable and it makes me feel insecure and incomplete"

How do I join the claim?

Registering your interest is quick and easy. To see if you are eligible, we require some basic information. Please fill out this expression of interest form.

Alternatively, you can call us on 020 3780 0210 or email us at surgerydelays@leighday.co.uk. We are happy to help answer any questions you may have by telephone or email.

Delays in gender affirming surgeries FAQs

Time limits apply to most legal claims. Generally, this is three years from the date you were injured for a personal injury claim and one year from the date of the interference with your human rights for a claim under the Human Rights Act. However, there are some important exceptions and determining a time limit is a complex matter, particularly in a case such as this.

We would encourage you to seek legal advice urgently if you are interested in pursuing a claim and get in touch even if the delays affecting you may have been longer than three years ago.

We are offering to fund your claim by a Conditional Fee Agreement (“CFA”) – also known as a “No Win, No Fee” agreement. If your case succeeds, then most of your legal costs will be paid by your opponent. However, Leigh Day is entitled to up to 25% (including VAT) of your damages which we will use to cover items such as any costs we cannot recover from the proposed Defendants, any non-recoverable insurance premium and our success fee.

Proceeding with cases under a CFA with a success fee enables our firm to take on important and complex cases such as this one where there is a risk we will not be paid if the case does not succeed.

If you lose, you do not pay us anything. This is explained in detail in our Client Care Letter.

Legal Aid – We may be able to apply for legal aid for you if you are financially eligible and the Legal Aid Agency is satisfied that your case meets the test for public funding.

Other options – You can also pay our fees as a private client. This could be a significant investment and is unlikely to be a realistic option for most clients.

You could receive compensation for the following:

  • Any injuries you have suffered as a result of the alleged negligence. This could include any physical and psychiatric injuries.

  • Any financial losses you have incurred directly as a result of the delays to your surgery. This might include medical treatment, such as surgery or counselling you have paid for privately, or unpaid time off from work.

  • A breach of your human rights.

In the UK, compensation awards can be modest. Figures for personal injuries are fixed by judges on a tariff basis and compensation for breaches of human rights are only awarded if the Court is satisfied that it is “just” to do so (which is not always the case even when a breach has been found). Large compensation claims often only involve complex financial loss claims for losses calculated many years into the future.

Each claim is unique, and the amount of compensation you may receive if your claim is successful depends on your own circumstances

Claim length can vary and depend on various factors. The largest contributor to claim length depends on how far the Defendants choose to fight the claims. They may settle things outright or continue to trial. They may even settle somewhere in the middle.

This is a complex and novel claim, and if fought all the way to trial, it will require expert input at different junctures. Defendant documents and medical records would also need careful review.

Generally, most cases go to trial within 18 months to two years, but in complex claims (such as this) that timetable may need to be extended.

It’s best to assume it may take several years to conclude your claim, though the Defendants may settle early. At all times, we will keep you updated and work quickly for you.

Few cases actually get as far as trial.

However, there is always a chance that you will have to go to court once you decide to commence litigation. We can guide you through the process if this becomes necessary. There are several things that can be done to help you feel more comfortable should you have to go to court.

Under the Data Protection Act 2018 patients have the right to copies of their own medical records. The records holder could be your GP, hospital, or any other healthcare provider who has provided you with medical treatment. Leigh Day will request your medical records on your behalf.

It is important that we are able to request and review all of your medical records. This includes your surgery records, as well as your GP records and any records from other healthcare professionals, such as counselling and gender dysphoria clinics. We need to review your medical records to establish the strength of your claim and to identify key dates, such as when limitation expires.

When you sign up to the claim, we will ask you to sign a medical consent form, and identify all of your medical providers, so we can request your medical records on your behalf.

We are happy to discuss any concerns you may have.

If you lose (that is, you don’t get any compensation or other remedies from the Defendants), then you do not have to pay us anything. We are investigating After the Event (ATE) insurance to protect you against the risk of losing and being exposed to the Defendants' legal costs.

It is our understanding that individuals need to be 18 years of age for NHS funded surgery but that you may be referred for the surgery at 17.

In the UK you need to be 18 or over to conduct your own litigation and anyone under the age of 18 will need a litigation friend to instruct a solicitor. Once you reach the age of majority (18 years) you will be able to take over the conduct of your matter. For further information please see our FAQs.

You can also pay our fees as a private client. This could be a significant investment and is unlikely to be a realistic option for most clients.

You may have other sources of funding your claim other than the funding package we are offering, such as legal expenses insurance. Many home insurance products include legal expenses insurance, either automatically or as an optional add-on. You should contact your insurers to check.

If you are a member of a trade union, you should check whether the union will fund you.

If you have such an alternative source of funding, then it may be cheaper for you to use it than the funding package we are offering. We are not offering to act via such legal expenses insurance/union funding, so if you wish to use it you may need to instruct another firm.

We may be able to apply for legal aid for you if you are financially eligible and the Legal Aid Agency is satisfied that your case meets the strict criteria for public funding. We are happy to discuss this option with you.

Leigh Day is one of the country's leading law firms for those who have been injured, had their human rights breached or have been discriminated against. We have particular experience working on issues affecting trans and nonbinary clients.

We are not a claims management company.

We are one of The Times top 100 law firms and is ranked at the highest levels for the majority of its practice areas in both the law sector’s independent legal directories, Chambers & Partners and Legal 500.

We have significant and expansive experience in relation to group claims and high-profile cases that attract significant media attention.

Contact the team by telephone on 02037800210 or send an email.

Contact the team

Kate Egerton

Senior associate solicitor

Kate Egerton is a senior associate solicitor in the human rights department.

Human rights Discrimination

Jessica Harrison


Jessica is a paralegal in the human rights team

Environment Discrimination Court of Protection Inquests Human rights