Fertility experts in the U.K. are advising the National Health Service to provide free egg storage for women who are physically transitioning to look like men so that it's still possible for them to have children biologically related to them after they become sterile.
To advance so called healthcare "equality," transgender individuals would be given the opportunity to freeze their eggs, embryos and ovarian tissues so "there is still the opportunity for trans folk to have a child who is biologically related to them, through pregnancy or surrogacy."
This comes at a bad time, however, as the NHS is already strapped for cash and has told doctors to cancel thousands of non-emergency operations this month because of funding issues and the number of people seeking treatment for the flu at emergency rooms during the winter, The Times reports.
As more people in the U.K. are opting to have gender reassignment surgeries since the NHS first began offering the procedures in 1999, The Telegraph reports that many NHS Clinical Commissioning Groups do not fund fertility preservation for transgender individuals who might undergo sex reassignment procedures that could render them sterile.
On Thursday, the British Fertility Society published guidelines on fertility preservation.
The guidelines were released at the Fertility 2018 meeting in Liverpool. Input for the guidelines was received from experts at a variety of hospitals and universities throughout the U.K.
"The number of people coming forward with gender dysphoria has increased rapidly over the past decade. But the consistent provision of NHS funding for fertility preservation for this group has yet to catch up," Dr. James Barrett, the lead clinician of the NHS' Gender Identity Clinic, said in a statement. "My clinic sees around half of the patients being referred for difficulties with gender identity in the U.K. and although we do discuss future fertility with them, they are not always able to self-fund for the necessary procedures and ongoing storage of material."
Barrett added that "infertility is a real disease."
"[I]t is hugely frustrating that the whole NHS is not always able to help our patients with that part of their lives," Barrett added.
The Daily Mail reports that the cost of freezing eggs to have a baby later in life with a surrogate mother is approximately $6,770 (£5,000). The storage costs add up to about $400 per year (£300).
The process is available for free in Scotland and Wales. However, the various commissioning groups in the U.K. have different policies on the matter.
"In reality, the provision of fertility preservation treatment is patchy, with local CCGs (Clinical Commissioning Groups) deciding on the availability of funds to enable people to take advantage of the latest clinical developments," the British Fertility Society report explains.
Barrett told The Telegraph that the way the system works right now, one of his patients with gender dysphoria could get approval to have eggs frozen and stored, while another might not get approval simply because of where she lives.
"They could be on opposite sides of the same street," Barrett said. "And that doesn't feel very sensible."
As The Independent notes, it is not always possible for transgender individuals to give birth.
Yet, the British Fertility Society recommendations come after headlines in December reported that a transgender man who is biologically female gave birth to a baby.
According to The Telegraph, there were 202 sex change operation that occurred in the U.K. in 2017, costing the NHS about $12 million (£9 million).
Critics of the guidance argue that the NHS should be focusing on more important types of healthcare rather than spending much needed funding to store eggs and embryos for people who are choosing to change their gender.
"The cash-strapped NHS should be concentrating on offering good basic healthcare to women or helping them beat their cancer, and not get side-tracked with these kinds of novelties," Josephine Quintavalle, co-founder of the group Comment on Reproductive Ethics, told The Telegraph. "Egg freezing is an invasive procedure and the outcomes are far from clear."
British news outlets reported last year that the NHS had already begun freezing the sperm and eggs of transgender individuals seeking reassignment.
According to The Telegraph, the NHS froze sperm for boys as young as 12, and eggs from girls as young as 16, before starting them on hormone treatments.
Anglican Bishop Michael Nazir-Ali, told The Daily Mail in September that he opposes such a scheme at the NHS.
"The NHS is about treating people who are ill — that's what we pay our taxes for," Nazir-Ali, said. "It is not to aid people's various wishes about what they want to do with their bodies or their futures."
"With increasing pressure on the NHS and so many essential services not being delivered, where are these funds for fertility treatment coming from?" Nazir-Ali added.