Gender Reassignment Surgery Before and After Transformations
Gender reassignment surgery, also known as genital reassignment surgery or gender confirmation surgery, alters a person’s body to match their identified gender. It is a major undertaking and many patients must undergo a lengthy psychological evaluation before undergoing surgery.
Surgical procedures may include mastectomy, breast reconstruction and a “neoclitoris” (to allow sensation) for women; removal of the uterus and ovaries for female-to-male patients; facial feminization surgery; and cosmetic changes to the chest and genitals.
Before
The first step in gender reassignment surgery is often a period of transition. This includes learning about the process, seeking out support and making lifestyle changes. It can also include mental health therapy and hormones.
Gender reassignment surgery, also called gender confirmation surgery, makes surgical changes to the body that align with your preferred gender. It can include feminizing surgery, such as breast augmentation or use of your own body fat to create breast shape, facial feminization, and genital reconfiguration (or bottom surgery) such as vaginoplasty.
For transgender women, vaginoplasty includes creating a new inner vaginal canal and vulva by using tissue from your penis or scrotum. In addition to vaginoplasty, female-to-male genital surgeries may involve orchiectomy, removal of the testicles, and creating a scrotum. These procedures are typically performed after a person has been on testosterone for about a year. They may also need a urethral extension or penile prosthesis. It is important that you follow your team’s discharge instructions carefully.
After
Gender reassignment surgery, also known as sex reassignment surgery or gender confirmation surgery, is a set of surgical procedures that change your body’s appearance and genitals to match your self-identified gender. The procedure helps alleviate the distress that can occur when your sex assigned at birth doesn’t match your gender identity.
Gender reassignment surgery isn’t right for everyone. You need to be stable and emotionally healthy before you undergo it. And you should have a medical or social transition plan, including hormone therapy, to help you come to terms with your new identity.
Surgery may include facial feminisation or masculinisation (liposuction, cheek implants or a tracheal shave to shorten the voice), breast augmentation with implant surgery, and bottom surgery (phalloplasty, metoidioplasty or scrotoplasty). It’s important that you have all the support you need during this time, especially if you have family and friends who do not agree with your decision.
Preparation
Gender reassignment surgery, also known as gender affirmation surgery or genital confirmation surgery, is a surgical series of procedures to match the person’s desired sex. It can be accompanied by hormone therapy, which can suppress secondary characteristics such as body hair and voice tone and puberty blockers, and a period of living as the opposite sex.
The first step in preparing for a surgery is getting a letter from your psychiatrist or therapist saying you are mentally healthy and ready to undergo gender confirmation surgery. Then you will need a letter from your doctor giving you medical clearance.
Depending on your chosen surgical procedure, you may need additional tests and consultations with specialists. These include a plastic surgeon, urologist and gynecologist. You will also need a letter from your GP saying you are fit to have the surgery you want. Procedures addressing pelvic and gonadal anatomy (phalloplasty, scrotum shortening, hysterectomy and/or ovariectomy) have been shown in multiple studies to help align the experienced physical anatomy with the person’s gender identity and alleviate gender dysphoria.
Recovery
Many transgender people have surgery to help their bodies match their gender identity. The surgery is often part of a bigger transition process called gender affirmation, which can also include social changes (living as the desired gender role, coming out to family and friends and changing pronoun use), hormone therapy and other medical interventions like puberty blockers.
A person who is male-to-female may choose to have genital surgery to construct a vagina and clitoris from scrotal skin and to remove the testicles and prostate gland (penectomy and orchiectomy). Biological men can also undergo facial feminization surgery to change the shape of their lips, eyes or nose.
Gender reassignment surgery can have complications, such as bleeding or scarring. It is important to take time to recover at home. This includes limiting physical strain, particularly when urinating. For the first month or two, you’ll need a catheter in your urethra to prevent infection and keep urine away from the penis.
