Sex Change Surgery

      Sex Change Surgery, also known as sex reassignment surgery (SRS), is the procedure by which a person changes his/her physical appearance and the function or mechanism of his/her sexual genitals are modified into the genitals of the opposite sex, depending on the individual’s sex identity.

Genital surgical sex reassignment and non-genital surgical sex reassignment are the two types of surgeries that allow a person to change its gender.

• Genital surgical sex reassignment: consists of the surgery of the genitals which is done in order to alter the morphology to assimilate the physical appearance of the other sex.

• Non-genital surgical sex reassignment: involves the procedures that do not have to do with the genitalia. Instead, they are related to the fact of effecting a more masculine or feminine appearance.

After the sex reassignment surgery, a hormonal sex reassignment is done, consisting of, on one hand, the administration of androgen to genotype females, and on the other hand, estrogen or progesterone to genotype males. This provides somatic changes that will make a person look like the gender they want to become. When the person is between the ages of 18 and 21, they usually undergo the operation. The earlier they submit to the surgery, the easier they will adjust themselves to their sexual identity.

The series of operations for transmen, female to male, are different from the series for transwomen, male to female. While for the first ones the surgery involves the action of construction of a penis, for the transwomen, the procedure has to do with the construction of a vagina. However, they both need non-genital surgical procedures, such as breast augmentation and facial feminization surgery for transwomen; and hysterectomy, mastectomy, and chest reconstruction, for transmen.

Breast augmentation is done in transwomen in order to enlarge their breast and assimilate to a woman’s body, making this procedure one of the most popular among transsexuals. Facial feminization surgery is another non-genital procedure for transwomen that consists of the elimination or reduction of the cross-gender-related deformities of the facial bones, mainly produced by late-pubertal testosterone masculinization. As to transmen, a mastectomy is the removal of the breasts, whereas a hysterectomy is the surgical removal of the uterus, taking away the person’s possibility to bear children and changing the hormonal ways in a considerable way. Some transmen rather get this surgery together with the hormone replacement therapy in the prime stages of their gender transition; nevertheless, other rather wait after they had had the genital surgical sex reassignment procedure.

Women or men that have hepatitis C or HIV (Human Immunodeficiency Virus) may not have the same possibilities to find a doctor who is willing to do the sexual reassignment surgery, mainly due to the potential complications that could happen. Despite the fact that professionals think it is not ethical to deny those who are HIV positive or have hepatitis C the surgical and hormonal procedures, there are some doctors that charge a more expensive fee for them. Those who suffer diabetes, obesity or an abnormal blood clotting are in the same position as those with HIV or hepatitis C, primarily because the anesthetic risk and the potential complications after the surgery. It is require for the patients with overweight to lose some weight before the surgery, and for those who smoke, do not do it for a certain amount of time before and after they undergo the procedure.

After the surgery is done, the expectations rely on the type of surgery that has been performed. Pain and nausea are the most normal consequences. However, after the recovery time, these will disappear.

Legal recognition that is provided to transgender or transsexuals widely varies from country to country. A small amount of countries allow a change of gender on the birth certificate, extending legal recognition. However, in other countries, the sex reassignment surgeries are required in order to achieve legal recognition.

• Male to female gender reassignment surgery

      The transgender surgery’s objective consists of the alteration of a man’s appearance in order to resemble to a woman, becoming attractive as well as functional. For this to happen, the creation of a clitoris, a vagina and a feminine vulva, and a labiaplasty, (conjugation of the labial axis to the anterior midline) are necessary.

Another useful and optional procedure is the orchiectomy, performed for men who want to extinguish the increase of testosterone and attain a degree of feminization.

• Female to male gender reassignment surgery

      The procedures that are involved are a metoidioplasty, insertion of testicular implants into labia and penile implantation. The first one, the metoidioplasty, it consists of the enlargement of the clitoris, and when this is provided with testosterone, the clitoral head might look like a teen glans penis, allowing an erection. The temporary consequences after the surgery may include swelling and loss of sensation. In the second procedure, testicular implants are inserted into the labia, and in order to prepare the labia, a tissue expander might be needed. The last procedure, as its name implies, consists of the implantation of a penis prosthesis that has the capacity to penetrate.