A transgender paedophile has sued the NHS for refusing her reassignment surgery after she transitioned from male to female while in prison.

The 60-year-old, known only as KK for legal reasons, is serving an indefinite sentence for public protection for making indecent photographs of children, and also has a previous conviction for sexual activity with a young girl.

She has been in prison for over a decade and has been living as a woman for the last eight years, The High Court heard.

The prisoner claims the Tavistock and Portman NHS Foundation Trust has unlawfully adopted a "de facto policy" of refusing to refer serving prisoners with gender dysphoria for gender reassignment surgery (GRS).

But the trust argues that the reason KK was not referred was because "the treating clinicians at a world-class clinic for gender dysphoria did not consider it clinically appropriate to refer her for surgery".

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On Thursday, KK's barrister David Lock QC told a judge in London that the refusal to refer his client was "solely based on the fact that the claimant has lived as a woman in prison for the last eight years as opposed to living outside of prison".

He submitted that the trust refused to make the referral over "concerns that there was a possibility that the claimant may not wish to continue to live as a woman following her release from prison".

Mr Lock concluded that KK "was forced to endure her present level of distress by being denied otherwise clinically appropriate medical treatment because of the minority chance that she would later express regret at having had GRS".

In written submissions, Jenni Richards QC, for the trust, argued that the court should not interfere in a decision involving "the application of clinical expertise in a developing area of medical practice".

She said the number of patients affected by gender dysphoria was relatively small, adding: "The number of patients affected who are in prison is smaller still.

"The number of prisoners who are imprisoned as a result of sexual offences, which further complicates the clinical picture, will be still smaller."

Ms Richards said GRS is "major, irreversible surgery which may destroy existing parts of a patient's body, personality and sexuality".

She argued that "the fact that the claimant's real life experience (as a woman) has been acquired in prison ... is relevant to the determination of whether surgery is an appropriate intervention for her, at this stage and in her present circumstances".

Mr Justice Supperstone, who is hearing the case, is expected to reserve his judgment.