Lessons from Finland’s gender reaffirmation surgery services

Published: 10 Aug 2017

Author: Michael Ng
Lessons from Finland’s gender reaffirmation surgery services

Scotland must create a centralised gender reaffirmation surgery (GRS) service as soon as possible, according to Michael Ng, a plastic surgeon from Glasgow, who has recently spent three months in Helsinki, Finland, learning about what is required to create and maintain a successful regional GRS centre. Michael’s travels were enabled by a Winston Churchill Memorial Trust Travelling Fellowship Award, with funding for the final month of Michael’s stay overseas provided by the Royal College of Physicians and Surgeons Glasgow.

Proposals to streamline the process of changing gender were recently unveiled by Justine Greening, Minister for Women and Equalities. However, changes in legislation alone will not address the fact that the UK does not currently have a centralised surgical service for trans* patients, meaning that patients cannot undergo all core procedures under one roof, and instead must travel to a variety of locations. Not only does this lead to stress and anxiety for patients, but also, due to the increased number of hospital stays required, a greater cost to the NHS. Scottish patients must travel to England for surgery, meaning they may be separated from their support network at a time when they are most vulnerable.

Michael wanted to use his Fellowship to learn from the example of Finland, a country with a similar population size to Scotland, who legislated for a centralised GRS service in 2004. Under the guidance of Dr Sinikka Suominen and Dr Maija Kolehmainen, the lead surgeons of the GRS team in Helsinki, Michael gained an insight into the resources that are required to run an effective service, both in terms of facilities and personnel. He was impressed with the aftercare that was available to patients, with outcomes tracked from a surgical and psychosocial point of view for 10 years or more.

During his Fellowship Michael also received training to perform the most up-to-date surgical procedures, including the three flap phalloplasty (reconstruction of the genitals and urinary tract), a pioneering technique which does not seem to be subject to some of the complications which can arise with current practices.

“I believe the time has come for Scotland to provide a high-quality, sustainable and innovative surgical service to their trans* population. A centralised service is badly needed, but backing from government will be vital in ensuring its long-term success. A centre of excellence in the UK will enable more surgeons to receive training so that GRS techniques are widely available and accessible to all. During my time overseas, I have truly learnt from the best; Finland is a country of saunas, so their surgeons strive for perfection, knowing the results of their work will be very visible to the public!” – Michael Ng

Michael is currently in Ghent, Belgium, training with Professor Stan Monstrey, to widen his repertoire of surgical techniques. He has been engaging with NHS Grampian regarding a phased repatriation of GRS services, and will later attempt to launch a bid for the designation of national services.

Read Michael's report here

Notes to Editors

Trans* is used as an inclusive term for all persons who identity as transgender or non-gender conforming.

Contact: [email protected]

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Royal College of Physicians and Surgeons Glasgow