TITS4TATS is Billy Slicks’ creative response to the alarming state of trans healthcare in the UK. The London-based artist trades tattoos for donations to dozens of surgery fundraising pages.

The idea for the project took shape earlier this year, during the first COVID-19 lockdown. Billy tells me that, during that time, they were “seeing friends whose fundraisers weren’t going anywhere, who were struggling”. 

Although the NHS (National Health Service) has a legal obligation to provide specialist care within 18 weeks of a referral from a general practitioner, many trans patients wait years for a first appointment. The coronavirus pandemic has further increased waiting times and stalled medical transitions that were underway. 

Without government support, many of the UK’s trans people have been left with no choice but to turn to private healthcare. This has resulted in an ever-rising number of fundraisers to cover prohibitively high private treatment fees, with top surgery (the removal of female breasts) costing up to £7,000.

Unable to donate to these fundraisers personally, Billy began thinking of other ways to help. Having been tattooing their friends for years, they created an Instagram page to share previous work and new designs and launched TITS4TATS – a new platform that, just six months on, is supporting dozens of trans people who are crowdfunding online for gender-affirming surgeries. 

A few people have already met their goals. “It’s obviously not all down to me, but it’s nice to see that progress on people and know that something’s happening,” Billy says. The project now includes a fundraiser for the artist’s own surgery. They didn’t have a fundraiser when it started, Billy explains. “It wasn’t for me.”

I first met Billy in September, when I was a TITS4TATS client visiting their old studio – a sunlit cubicle in a north London warehouse space shared between artists. The brick partition wall was strewn with the tattooist’s signature designs: shirtless cowboys with spurs, cigarettes and surgery scars; angels holding “trans rights” banners; and squatting devils taking dumps labelled “TERFs” – a jab at anti-trans ‘feminists’.

“The drawings I do are very childish,” Billy admits – but they’re also political. They hope that portraits of cowboys with top surgery scars help to normalise trans culture. “That’s my existence, that’s all that I know and what I’ll do.” They add: “It’s a beautiful thing that’s mine that I can share with other people […] It’s actually kind of magic.”

Tattooing has been instrumental in helping Billy and their clients feel more comfortable in their bodies, they reflect: “It means a lot to me because of what it’s done for me and how I feel it can really affect other people in a positive way.”

Their work also helps fill a gap in what was once a creatively rigid and cismale-dominated industry. “I don’t want to go into a shop and have to get traditional work – which I actually do have on my body because I wanted tattoos. I’ve got some really shit tattoos from, like, men,” Billy grins.

The tattoo industry can also feel unsafe for queer clients, Billy says. “We’re forgetting that this is one of the most intimate things that you can do with a stranger, beyond sex and surgeries and all of these things that are completely invasive.” 

Billy wants TITS4TATS to grow beyond tattooing. They speak passionately about plans for a community-led “social creative space” with classes and workshops run by London’s LGBTIQ creatives.

Through the project, Billy has met many clients who describe feeling alienated: “I meet people who are trans who don’t really have any queer friends, people who are queer who are less inclined to really express themselves or feel attached to our community because they’re very estranged from it.” 

Having close LGBTIQ friends has been pivotal for Billy. “My surroundings are very queer now, which is very comfortable and has really helped me with myself,” they explain. “Everyone around me can understand who I am. Honestly, I have never felt more myself than I have in the past year with the group of friends I have.”

Billy hopes to bring a vital and affirming sense of community to others. As LGBTIQ people, “we’ve all got the same background, which is essentially being rejected from society, not feeling normal,” the artist explains. They want to break down boundaries and help London’s LGBTIQ people connect with each other. 

“I want us to be as safe in ourselves as cis people were growing up,” they tell me, adding that crowdfunding for healthcare expenses shouldn’t be necessary. Yet it remains a critical lifeline for many trans people, Billy says. “It can be better than this”, but for now, “we can only tackle this together.”