Beard Removal on the NHS: A Hairy Issue

Men who declare themselves to be 'transwomen' get laser-hair removal funded by the NHS – they don't even have to 'get the snip' first – in fact, they don't have to at all (most 'transwomen' keep their penises). The treatment received by 'transwomen' is a cut above that offered to women who desire hair-removal (e.g. for facial hair caused by PCOS).

An NHS Senior Consultant speaks out on this unfair situation – remaining anonymous – public discussion of this hairy issue runs the risk of being accused of 'transphobia'. Let's not allow this to become the perm.


Article by an anonymous NHS Senior Consultant

Laser hair removal is the best way of removing hair (depilation). For some, this is minor cosmetic surgery, one quick zap for a persistent chin hair, costing £40 or so at a private clinic. But women with common conditions like Polycystic Ovary Syndrome (PCOS), grow male-pattern facial and body hair making them feel uncomfortable and unpresentable. And for women, unpresentable often means unemployable and causes difficulties in relationships. Of course we OBJECT to, and resist, the pressure to shave our legs, armpits etc, but persistent facial hair in a beard/moustache pattern is something most women would dread. PCOS is only suffered by women – we have the ovaries!

‘That will get treated by the NHS, won’t it? That’s a physical problem, caused by no fault or choice of the sufferer, that’s what the NHS is for, isn’t it?’ I hear you say. But no. Patients will get plucking, shaving, waxing, depilatory creams on the NHS. But PCOS hairiness can persist, and laser treatment is then the best option. Although not permanent, it is long-lasting and reduces the amount of hair by 50%, often making the difference between a woman feeling ok to leave the house or not.

What are the NHS guidelines on this? Well, you may get lucky. But you may not. ‘Laser removal of facial hair may be available on the NHS in some parts of the UK.’ Clinicians must request funding from the local Clinical Commissioning Group (CCG) for each individual case. Only half are even willing to consider applications, and the hairiness has to be severe.

‘But that is so unfair!’ you rightly say. A physical condition, suffered exclusively by women, entirely unchosen by the sufferer, and a post-code lottery as to whether a sufferer has to live with a beard or not. Unbelievable. But true.

‘Well,’ you then say, ‘in these days of austerity and NHS cuts, only top priorities can get funding. Some things we just have to live with. It’s unfair when only women pay the price, but I expect there are conditions men suffer where they do not get the full treatment either.’

The exact opposite is true. There is a condition experienced only by men which requires facial hair removal, one with no physical symptoms whatsoever, and indeed the only condition in the entire NHS where drug treatment, surgical treatment AND laser hair removal are all granted as of right, if the ‘patient’ tells the right story. There are even websites to tell you what to say – Google it. A man who chooses and applies to ‘transition’ into a woman to ease his bad feelings about being male gets the full range hair removal in any area of the UK as of right!

How much does beard removal cost? A man who transitioned, now known as Caitlyn Jenner, writes about it in her recent autobiography ‘The Secrets of My Life’. Jenner says that beard removal takes on average 30 three-hour sessions over two years and costs upwards of $30,000 (pages 152, 163).

So a woman with a painful health condition which is (a) entirely physical (with distressing mental health consequences), (b) clearly diagnosable by medical tests, (c) unaffected by fashion (d) unchosen and (e) subject to a postcode lottery

… gets worse treatment (and in half of the country no treatment) than a man whose condition is (a) not physically painful (b) diagnosable only by vague, fakeable mental symptoms, (c) something of a fashion, popular only in the past 10 years, (d) a choice often made without trying recommended talking therapies first, and (e) the only accepted health condition diagnosed solely on the stated feelings of the patient!

As an NHS professional long involved in administrating such funding decisions, I find this unfair. William Beveridge, founder of the NHS, said there should be ‘bread for all…before cake for anybody’. He would have been horrified at this inequity – it’s exactly what the NHS was meant to end. Treatment of physical disease was what he had in mind as ‘bread’. I think he would have categorised mental health conditions with no physical symptoms as ‘cake’, and cake is something you provide for yourself. It’s a treat, not a necessity.

I cannot disclose my name for fear of losing my job for ‘transphobia’. I do not hate trans people and believe they should have the same rights as anyone else. This does not mean that they should have everything they say they want. I believe that all medical treatments, particularly those funded by an overstretched NHS, should be subject to rigorous testing, critical thinking and proper prioritisation.

Written by an anonymous NHS Senior Consultant

TransgenderHannah Harrison