Scotland's NHS has spent more than £1 million in just seven months on gender reassignment surgery for people in England. It referred Scots for 86 operations south of the Border, including male to female surgery, female to male ops, and chest reconstruction.
The new figures bring the total number of gender ops referred to surgeons in England by NHS Scotland to almost 1,700 in the last 10 years. This includes at least 46 instances when youngsters under the age of 18 applied for and secured funding to have specialist chest reconstruction.
The amount spent on providing the service for transgender Scots in the last 10 years was £9,492,953, with £1,070,336 spent between April 1 and October 31 of this year alone. A snapshot shows the standard cost for chest reconstruction was £5,804 last year, while it was £10,737 for male to female surgery. Female to male genital surgery was said to cost £20,750.
NHS Scotland said patients under 18 can be referred to surgical providers in England for consultation, but operations are not undertaken until they turn 18. The figures were provided by the National Services Division.
Currently, Scottish patients are sent to England as there are no specialist 'gender surgeons' north of the Border.
Harry Potter author JK Rowling has previously voiced concerns over young women 'wishing to transition' only to regret having 'altered their bodies irrevocably'.
A spokesman for campaign group For Women Scotland said: 'The money would be better spent in mental health services, helping people to reconcile with their bodies rather than chasing the impossible delusion that their sex can be changed.'
The news comes after the landmark Cass Report warned children questioning their gender had been 'let down by a lack of research' and 'remarkably weak' evidence on medical interventions.
In March, NHS Lothian and NHS Greater Glasgow deferred starting new patients on puberty hormone suppressants and gender-affirming hormones. Then, in May, NHS Lothian paused all referrals to surgery and assessment appointments so as to allow for 'extensive reviews'. Restrictions were subsequently lifted.
Scottish Conservative equalities spokesperson Tess White MSP said: 'The number of under-18s referred for specialist procedures is especially concerning. And at a time when NHS waiting lists in Scotland are sky-high, taxpayers will ask why such significant sums were spent funding these procedures in NHS England.'
Susan Buchanan, Director of National Services Directorate at NHS National Services Scotland (NSS) said: 'All patients referred for surgery are carefully assessed by healthcare professionals considering individual patient needs and circumstances.'
The Scottish Government said not all patients who are referred proceed to surgery following their consultation.