We, the undersigned, are appalled at the treatment FTM (female-to-male transgendered) men have received from the NHS in Scotland with regards to obtaining 'top surgery' (mastectomy) as part of their transition.

Top surgery is an integral part of transition, and is a deeply important step in the lives of FTM men. Without it, consequences range from severe depression to physical and mental pain, and social anxiety.

The necessity of wearing binders while waiting for top surgery to be carried out puts a great deal of stress on the body. It can lead to complications such as, but not limited to: sciatica, cervical radiculopathy, severe migraines, and torn muscles.

Many FTM patients successfully undergo the many stages of 'lower surgery' (metoidioplasty and phalloplasty), experiencing no issues with funding, however, many are refused funding for top surgery, despite prevailing medical opinion and agreed care pathways. To be refused top surgery at this stage is, we believe, cruel, irresponsible, and dangerous.

In addition, patients undergoing lower surgery whilst top surgery continues to be denied are forced to live with an anomalous physical appearance which, in itself, leads to anguish and distress, negating many of the positive benefits of this surgery.

For many FTM patients, no clear reason has ever been given as to why their funding has been denied, cut, or taken back after they were assessed by surgeons and informed that top surgery could go ahead. Some patients have even been given firm confirmation and a surgery date, only to have been told a matter of days before that the surgery would not be performed, due to funding issues.

We wish to bring to the attention of our Members of Parliament, Members of the Scottish Parliament, and NHS heads, the human cost of this funding issue. It means that our friends, husbands, partners, brothers, fathers, and sons are not being treated, and are suffering in silence. For large numbers of FTM patients, the wait for this urgent and necessary surgery has been ongoing for many years. The distress associated with such seemingly interminable delays cannot be overstated.

While we can certainly understand that a lack of competent surgeons may lead to long waiting lists, we do not accept that there can be any legitimate reason to simply refuse care. This is manifestly unjust.

We find it troubling that a surgery which is carried out as a matter of routine in other parts of the UK is being refused to Scottish patients. We are sure you will agree that every Scottish patient is equally deserving of proper care as his counterpart in England, Wales, and Northern Ireland.

We challenge those in authority to comply with the Standards of Care and professional advice. Provide top surgery to FTM patients in Scotland, and allow them to live their lives fully, happily, and with dignity.