FA-2025-000058 - [2025] EWHC 2685 (Fam)

Dr. Pasterski’s report dated 29^th January 2020

Dr. Pasterski is a Gender Identity Specialist and Clinical Psychologist at the Harley Street Gender Clinic. Her report sets out a diagnosis of gender dysphoria. This is the first report on which the Applicant relied for the purposes of his application. The report recorded (“Background”) that “[W], who was assigned female at birth, is aged 21 years old and presently living full-time in the male social gender role” and that:

“Practically speaking, [W] has transitioned to the male social gender role full-time. He changed his name by deed poll in April 2016 and has lived full-time since then. He is known in all contexts as male and as [W], including on his UK driving license, UK passport, with his university and with his GP surgery.

With respect to taking steps toward physical gender change, [W] wears a binder, has started with testosterone therapy and generally presents as masculine. In future, he plans to undertake gender confirming genitoplasty. [W] wishes now to move forward with bilateral mastectomy with the view to achieving a more naturally masculine appearance and sense of self.”

Dr. Pasterski also stated (“Opinion”):

“[W]’s presentation is consistent with a diagnosis of gender dysphoria (302.85) / female to male transsexualism (F64.0) according to DSM-5 and ICD-10-CM criteria. …

It is my opinion that [W] has met the guidance criteria for gender confirming surgery outlined by the World Professional Association for Transgender Health (WPATH): (1) [W] has a persistent and well-documented history of gender dysphoria, present for longer than two years; (2) [W] possesses the capacity to consent to treatment; (3) [W] is of the age of majority for the United Kingdom; and (4) [W] reported no disqualifying health concerns and presented with no disqualifying psychiatric history. In sum, I support [W] in going forward with bilateral mastectomy under your care.”

She recommended that the Applicant should proceed with his consultation regarding bilateral mastectomy. He underwent that procedure soon after, in February 2020.