title: The case for bilateral mastectomy and male chest contouring for the female-to-male transsexual.
abstract: BACKGROUND
  In the UK, funding for a bilateral mastectomy (BLM) and associated chest recontouring for female-to-male transsexuals (trans men) has been rejected by some funding authorities on a number of unsustainable grounds.
  
  
  METHODS
  As funding is increasingly an important area for both surgeons and referrers, we undertook a review of the small amount of literature pertaining to this issue and considered it in light of our clinical experience of this group.
  
  
  RESULTS
  The literature showed that BLM is necessary for trans men to live safely and effectively in their reassigned gender role, and further that it acts as a prophylaxis against distress, ameliorates extant distress as well as providing improved quality of life and global functioning for this patient group.
authors.affiliation: West London Mental Health NHS Trust Gender Identity Clinic, London, UK. christina.richards@wlmht.nhs.uk
authors.forename: C
authors.initials: C
authors.lastname: Richards
authors.forename: J
authors.initials: J
authors.lastname: Barrett
mesh_terms: D002755:Choice Behavior; D005260:Female; D061889:Healthcare Financing; D006801:Humans; D008408:Mastectomy / Q000191:economics / Q000379:methods* / Q000523:psychology; D011788:Quality of Life; D057830:Gender-Affirming Surgery / Q000191:economics / Q000379:methods* / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control; D014189:Transsexualism / Q000191:economics / Q000523:psychology / Q000601:surgery*