Trans woman facing six years on NHS waiting list left with an ‘unethical’ choice to make

Maya Osa has decided to pay for hormone replacement therapy (HRT) out of her savings

Maya (right) and her partner El Shute, 28, live in Bristol (PA)

A trans woman seeking gender affirmation surgery who was told she could wait up to six years on an NHS waiting list or fork out more than £18,000 has said the “unethical” choice has left her feeling “trapped” inside her body.

Maya Osa, 24, a community event organiser from Southampton, began her transition to becoming a woman after a shopkeeper made a mistake and called her Madam during the Covid pandemic, in 2020, as she was wearing a mask and had long hair.

She decided to change her pronouns and name to be more feminine before contacting her GP to discuss hormone treatments and, later, gender affirmation surgery.

Maya was shocked to discover the NHS waiting list could take up to six years and decided to pay for hormone replacement therapy (HRT) out of her savings.

While she has seen incredible results, including having a rounder face, growing breasts and thicker thighs, she still feels uncomfortable about her body.

To remedy the “horrible” situation she has decided to have vaginoplasty, a surgical procedure to construct a vagina.

However, she does not have the funds to pay privately for the procedure – which costs more than £18,000 – and so has launched a fundraiser on GoFundMe to help her feel comfortable in her body.

“I either have to wait until my 30s to be seen and finally have the body I want or I spend an insane amount of money,” Maya told PA Real Life.

“It just feels so unethical the amount of money and time you have to wait to get treatment as a trans person.

“It’s horrible, it really is.”

Maya, who lives with her partner El Shute, 28, in Bristol, is hoping to raise awareness about how difficult it is for people to access trans health treatments.

“Being trans is really hard,” she said.

“Why do we keep attacking trans people as if it’s not already hard enough being trans?

“That stuff in the media can make you feel really isolated and like you’re at risk when you see so many people hating on trans people.”

Maya decided to pay for hormone replacement therapy out of her savings (PA)

Maya grew up in a large south Asian family in Southampton and often spent time playing with 12 cousins.

From an early age she felt more comfortable spending time with girls and would sneak into her parents’ bedroom to apply make-up and lipstick.

“I’ve always felt that I did not belong in the body that I was born in,” she said.

“I just preferred being with the girls and felt like I was one of them.

“When I was younger I would sneak into my mum or my aunt or my nan’s room while they were downstairs and I would, like, put on some lipstick and then rub it off.”

It was not until June 2020, at the start of the Covid pandemic, when she visited a charity shop in Bristol and was addressed as Madam that she was prompted to begin her transition.

“I had grown my hair out and even though I had facial hair at the time, it was hidden by my mask,” said Maya.

“The lady at the counter misgendered me and called me Madam and I was like, ‘Oh, I kind of like that’.

“I was like, ‘OK, maybe this is something I want and maybe I should lean into this because it feels nice’.

“It was absolutely a realisation moment.”

This is when the penny dropped for Maya who began identifying as a trans woman.

She asked her friends to start using female pronouns she/her/hers and experimented with different names to see which one she felt more comfortable with.

“I officially changed my name and surname in January 2021 because it was quite gendered,” she said.

A month later, in February 2021, Maya spoke to a GP about being referred to the Sheffield Gender Identity Clinic to discuss feminising hormone treatment and gender affirmation surgery on the NHS.

But when she began researching online she was shocked to discover the waiting list for an appointment at a gender dysphoria clinic on the NHS could take years.

“I was like, ‘Oh my god, these waiting lists are, like, three, four, five years long, just to get your first appointment,” she said.

“And then you might have to wait another years for a second appointment.”

Hormone treatments, known as hormone replacement therapy (HRT) or gender-affirming hormone therapy (GAHT), can help people who suffer from gender dysphoria, a mismatch between someone’s biological sex and gender identity, by changing their physical appearance.

Trans women who feel dysphoric can also have gender affirmation surgery (GAS), which refers to a series of procedures including a penectomy (surgical removal of external male genitalia), an orchiectomy (surgical removal of the testes), a vaginoplasty (surgical creation of a vagina), a feminising genitoplasty (creation of internal female genitalia), and implants to create breasts.

Maya began HRT at the end of 2021 and has spent just under £1,000 over two years in appointment fees (Collect/PA Real Life) (PA)

Feeling confident that this is what she wanted, Maya decided to tell her parents, who she describes as “strict Muslims”, in May 2021.

Maya, who said she felt trapped in her own body, began exploring private options and contacted the Gender Care clinic online.

She began HRT at the end of 2021 and after paying almost £1,000 in appointment fees over two years the results began to show.

“Your emotions and physical appearance change so much – it feels like you are going through a second puberty,” she said.

“What I’ve noticed is that my face is so much rounder which makes me feel good.

“I’ve got fuller cheeks and the obvious one is that I’ve got boobs now.

“My thighs are also thicker, so like it changes your body shape to a more feminine kind of look.”

Maya was told that she could have to wait six years for her gender affirmation surgery on the NHS ( )

In November 2023, Maya decided she wanted GAS and contacted the Gender Clinic at Brighton Hospital.

She was told the procedure would cost around £18,600 plus additional consultation fees.

“I knew it would be in the five figures and that’s why I was so deterred from looking into it,” she said.

“I was already dealing with a lot but now that I’ve been on hormones for two years and the dysphoria for my genitals has become so strong, I do really want it.

“It’s incredibly frustrating and there have been so many times were I’ve cried about this.

“Feeling uncomfortable in my body is not a good feeling and not being able to do anything about it because I have to wait for so long or because I don’t have the funds makes me feel trapped.”

To help her speed up the process, Maya has launched a fundraiser on GoFundMe for £13,000, which has so far received £940 in donations.

“I’m so, so grateful for everyone who has donated,” she said.

“I obviously don’t have any support from my parents, so it’s the only way I can go about it.

“I’m so immensely grateful to have the support.”