The number of breast removal operations performed by the NHS as part of gender-related treatment has risen by 52 per cent in two years, with taxpayers facing an estimated annual bill of £6.5mn for the procedures, according to newly disclosed figures.
A total of 1,115 mastectomies were carried out in England in the 2024-25 financial year, compared with 734 in 2022-23, an increase that brings fresh scrutiny to the scale, cost and long-term implications of gender-related healthcare.
The figures, obtained through freedom of information requests and reported by The Telegraph, show that the number of procedures increased to 904 in 2023-24 before reaching 1,115 the following year. A further 933 had been recorded in 2025-26 at the time of the data collection.
NHS England estimates the cost of each operation at approximately £5,800, putting the annual expenditure on these procedures at about £6.5mn at the 2024-25 volume.
The figures also reveal changes in other forms of gender-reassignment surgery. Operations to construct male genitalia, known as masculinising genital surgery, numbered 270 in 2022-23, rising to 357 in 2023-24 before falling to 241 in 2024-25. There have been 322 procedures recorded so far in 2025-26.
These operations cost an average of £32,000 per patient. By contrast, feminising genital procedures, which involve the construction of a vagina and cost approximately £10,000 each, have declined from 420 in 2022-23 to 364 so far in the current financial year.
Across the three categories, annual NHS expenditure on gender-reassignment surgery is estimated at approximately £21mn. No procedures in the categories covered by the data were performed on patients under 18.
The changing pattern of demand has also drawn attention to the age and demographic profile of people seeking treatment. An official review of adult gender services found that most patients accessing the clinics were aged between 18 and 25.
Data from the Gender Identity Development Service for young people, which closed in 2024 following the Cass review, indicated that approximately 70 per cent of referrals since 2017 involved people born female, with teenage girls accounting for the majority of that group.
The shift represents a reversal of the historical pattern in which most referrals to gender identity services came from people born male.
The figures have renewed debate over clinical safeguards, informed consent and the long-term consequences of irreversible procedures, particularly for younger adults. The financial cost is one dimension of a wider discussion about how the NHS should assess demand, allocate specialist resources and ensure patients receive appropriate support.
Helen Joyce, director of advocacy at the campaign group Sex Matters, criticised the rise in operations and raised concerns about the possibility of later regret.
“Given that we know the vast majority of elective mastectomies relating to gender identity are performed on girls who haven’t reached the crucial age of brain maturity at 25, the sharp rise in the number of these surgeries in recent years is a tragedy,” she said.
“These girls are at the peak age of being influenced by cultural and social activism, and often cannot grasp the regret that they may later feel.”
She added: “We know of detransitioners who have become mothers and grieve that they cannot breastfeed their babies.”
Her comments reflect the position of an advocacy organisation and should be distinguished from clinical findings about the outcomes of surgery across the wider patient population.
The latest figures provide a clearer picture of the scale and cost of NHS gender-related surgical treatment, but also raise questions that expenditure data alone cannot answer: how patients are assessed, what long-term outcomes they experience and how services balance timely access with careful clinical decision-making.
As demand and spending come under closer examination, the challenge for the NHS will be to ensure that decisions involving irreversible treatment are supported by robust evidence, appropriate safeguards and comprehensive follow-up care.
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