Some transwomen decide that they want to have surgery to permanently alter their anatomy, however not all trans feminine people choose to have surgery.
All referrals are done via the gender identity clinic and the surgery and immediate follow-up care is handled by the Gender Dysphoria National Referral Support Service (GDNRSS).
Patients may be referred to the district nurse or GP if they require wound care in the days following the operation. Patients will remain under the care of the GDNRSS for a year, after which time any ongoing care will be discharged back to the GP.
A vaginoplasty is an operation which aims to remove the penis and testes and create a vagina, which is either sexually functioning or not. While there have been several different types of procedures in the past, most vaginoplasty operations are now carried out in a standard way.
The Nottingham Centre for Transgender Health can make recommendations for surgery for those who are suited to this type of operation.
To find out more about the surgery services the NHS provide, you can read the service specification on the NHS England website.