GRS is given a higher priority than FFS by the NHS. Do you agree? Which would you do first, if you had the choice?

FFS in my personal opinion is more important to me. Our face is on view to the world and what we spend the most time and attention on with make-up. The authorities seem to think that transwomen NEED/MUST HAVE a penetrable vagina, and if you don't, you aren't a transexual - get out! If you are a translesbian do you need penetration, constant dilation and potential infection. Removing the penis alone would be a practical option for many transexuals but it is not talked about or discussed openly (though some TS's have discussed it in their biographies). I don't even think its an option? I might be wrong and would happily be corrected!

I am not sure what a clinic in Malaga specializing in FFS has to do with the NHS? Or if we here are the right target group for facial surgery or gender reassignment surgery? Though some of our members are TS they are a small minority.

In my view if someone wants either or both types of surgery that should be their choice (age and basic health permitting); but only after they have lived full time as woman for at least 2 years - which I know is the case in the Netherlands. I do not know which rules apply in Spain or the UK.

And then there is the vexatious question of funding the surgery. Who should pay? The patient or the national health care system and/ or medical insurance?

The problem with it is where do you stop - I personally would say I don't need much in the way of ffs- on the other hand- my hair really needs attention - and I am not sure I would want some of the renowned nhs butchers working on the downstairs.

I personally feel I wouldn't change to vagina from penis if I were ts. I know how it feels & I can not get a uterous anyway.Face is important it should be a top priority.

I appreciate your personal replies, which are sincerely enlightening. Thank you! Julie, I agree that the person should indeed have the option of a vagina, or not!
A few years ago I was involved in helping a UK patient campaign against the NHS to receive funding for her FFS. We built up a good argument, but lost the battle unfortunately-- this patient had been suffering for decades already with her struggle to "pass" and 2 more years seemed an eternity. It is easier for some than others of course. Yes, it is a very personal decision whether to pursue surgery of any kind. For this UK patient, GRS certainly took second place, but it also was desireable. Yet for her, huge surgical expenses were prohibitive and she relied on the NHS for her transitional needs. Given her financial situation and obvious clinical need for FFS, our surgeons did not charge her any surgical fees (just hospital expenses) . In Spain, the situation is very similar to in the UK. Although I work for a FFS clinic, we are very interested in the public sector´s approach to the health issues of transwomen. Recently, at Sparkle, after discussions with many transwomen, myself and one of the surgeons began to develop a survey regarding this specific topic, which I must say we have gained some knowledge about. Many of our patients talk about this and other topics with us, so we thought maybe there was something we could do, despite the fact that it isn´t in our best interest for FFS to be included in the national health service!
We simply hope to develop a survey on the topic in order to present to local health authorities and here on transtastic my hope is to learn more about the transwomen´s point of view.
Since I already have several sincere responses from transwomen after only 1 day, I think this is a good place to get some quality feedback.
In regards to April-Mae´s comment, this is true--Where to stop? So may girls email me with long lists of procedures they think they need...I recommend asking for a minimal and optimal treatment plan from any FFS surgeon.
Thanks again for your participation in this topic.

I think there are two key approaches to transexualism.... one is the need to appear as a woman, while out in public, amongst ordinary people and to be accpeted as a female...... and the second is the need to be a sexually functioning female. The problem is that the link is not that obvious as it might seem. one does not automatically follow the other.... A great nyumber of T-grils want to look as close to their idea of a woman as possible and a lot of time, money and emotion, is spent trying to achive that. This is where any comsetic surgery that changes features and reduces male features seems to come in. The sexual side is a bit different!..... arousal and desire connects into different notions of gender and sex. I have various t-girl friends who all vary in their (some lucky!) female looks, some more female 'looking' than others but the sexual response is far more complex and involves being attracted to other trans girls, or gender girls, or men, etc. but that is a very indvidualistic repsonse....... in my case I respond sexually to men but I do not regard myself as gay nor do I want to remove my penis, but I would consider facial surgery to feminise my features more.... if I had the money and was younger!
I thyink the whole topic of transexualism is very complex and there is a huge rainbow variety of individualistic emotional and sexual needs, I guess this just makes a lot of gender re-assigment advice and counselling, more difficult and subtle. It is interesting that quite a lot of girls after transitioning decide to pull back and change their minds! I guess we all have different needs in our tran lives and as usually its best not to pigeon hole anyone but treat everyone you meet as unique!! and of course special!! which on the whole..... I think this website does better than most!!!
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i think it should be allowed on the NHS, they treat junkies and drunks don't they? so why not a TS who's need is greater than the likes of football hooligans who go around injuring themselves and others as well as the drunks and junkies, sorry for being so frank. love collette XXX.

Thank you again for your thoughtful and insightful replies. Yes, Andrea, we are beggining to see how complex the question is, and how so much depends on the individual. Many girls don´t need FFS, but really desire GRS, and vice versa. On both counts, it seems there is still some work to do to modify the national health services to become more sensitive to the nuances of BOTH surgeries, and keeping an open mind as to the what is appropriate for each INDIVIDUAL person instead of a blanket treatment for all transgender patients. I agree Collette, it seems sometimes that there is a bit of inequality in the priorities of national healths systems. You shouldn´t have to become a real social nuisance in order to get treatment!

well girl that is the way i see it, you have to an arse/thug to get treatment, which i think is very wrong, love collette XXX.

So many opinions. Can anyone see why we are the outcasts of civil rights? We do not even know ( & I more so than most ) what to call ourselfs. Are you a tv,ts,crossdresser,tg,etc? Next we talk about who feels what is more important. If I were a woman in a mans body traped & needing out of it, the choice is obvious to me. Grs. In my case I like being a woman in all ways but 1. Ffs is my obvious choice. I feel until we know a term we all can live with as a lable everyone is different. When we can lable our group,power in numbers. We haven't any political power because a ts,& tv do not associate their discriminations as the same because of the different labels. I being labeled gay annoys some gay males because I do it in female underware & false tits. Same thing done different. Reason? I don't fit his perception. Ts's usually feel the tv is not related & are why they are facing their challenges. I get more discrimination from ts's than anyone, ( pre-op anyway ). But do get it from others too. I'm on their side until that happens. Problem? Same war,different battle.

Thanks Eva, there are as many opinions and view as there are people in the world, which indeed makes it difficult to consolidate and progress, which is the objective of our survey. We appreciate your participation!
Please visit our Facebook page, where you can anonymously answer only 4 questions, helping us to better understand the needs of the male-to-female transitioning individual and develop in the future a better survey: https://www.facebook.com/facialfeminization