Sex Reassignment Surgery (SRS), also known as gender-affirming surgery, is a transformative procedure designed to help individuals align their physical characteristics with their gender identity.
Whether you are considering Male-to-Female (MTF) or Female-to-Male (FTM) surgery, Gender Affirmation plays a crucial role in the lives of many transgender individuals, offering not just a physical transformation but a sense of emotional and psychological well-being.
Our team of experienced surgeons understands the profound impact of this decision and is committed to providing the highest standard of care throughout the process.
What is Sex Reassignment Surgery?
Sex Reassignment Surgery (Gender Affirmation) is a medical procedure designed to change a person’s physical sex characteristics to match their gender identity. It can include several different types of surgeries based on the individual’s transition goals. For example:
- Male-to-Female (MTF) Surgery: This involves procedures like vaginoplasty (creating a neovagina), breast augmentation, and facial feminization.
- Female-to-Male (FTM) Surgery: This involves procedures such as phalloplasty (construction of a neophallus), metoidioplasty, and chest reconstruction (top surgery).
Eligibility and Requirements for Sex Reassignment Surgery
Before undergoing Gender Affirmation, individuals must meet certain medical, psychological, and legal criteria. Here’s what our specialists consider when determining whether someone is ready for surgery:
Medical Criteria for Gender Affirmation
- Documented Gender Dysphoria: A formal diagnosis of gender dysphoria from a licensed mental health professional.
- Age Requirements: In most countries, including Thailand, the patient must be at least 18 years old to undergo Gender Affirmation surgery. However, patients aged 18-20 may require parental consent.
- Physical and Mental Health: The patient must be in good physical and mental health. Any significant medical or mental health issues must be well-managed before surgery.
Psychiatric Evaluation
Our team requires that candidates have lived in their gender role for at least 12 continuous months before surgery. Additionally, a licensed psychiatrist must confirm that the patient is mentally prepared for the life changes post-surgery and understands the implications of the procedure.
Hormonal Therapy Requirement
We ensure that all MTF patients have undergone at least 12 continuous months of hormone replacement therapy (HRT) to achieve the desired physical changes before surgery. This helps prepare the body and mind for the changes that will occur during and after surgery.
Types of Sex Reassignment Surgery Procedures
Male-to-Female (MTF) Surgery
Vaginoplasty (Neovagina Creation): This is one of the most common MTF surgeries. The procedure involves the creation of a neovagina, typically through penile inversion or the use of skin grafts from the scrotum or other areas. The goal is to create a functional, aesthetically pleasing vagina with sufficient depth, allowing for sexual pleasure and easier sexual function.
Clitoral Construction: Our surgeons pay close attention to maintaining sensation in the clitoral area. We preserve the neurovascular bundle to ensure that the newly constructed clitoris has sensitivity.
Labia Reconstruction: Using the available tissue from the penis or scrotum, we create labia minora and labia majora that resemble the natural female anatomy.
Breast Augmentation (if necessary): While hormone therapy helps develop breast tissue, some MTF patients opt for breast augmentation to achieve a more feminine appearance.
Female-to-Male (FTM) Surgery
Phalloplasty (Neophallus Construction): This procedure creates a fully functional neophallus using tissue from other parts of the body, such as the forearm or abdomen. The first stage involves constructing the urethra and connecting it to the neophallus. Subsequent stages may involve the creation of a functional erectile device, testicular implants, and penile implants.
Metoidioplasty: For patients who have developed a small, functional penis through hormone therapy, metoidioplasty is an option. It involves creating a neophallus using the existing genital tissue, resulting in a smaller but functional erection.
Chest Reconstruction (Top Surgery): FTM patients typically undergo chest reconstruction to remove breast tissue and create a more masculine chest. This procedure can be performed as part of the gender-affirming surgery process or separately, depending on the patient’s preferences.
Preoperative Preparation for Sex Reassignment Surgery
Proper preparation for Gender Affirmation surgery is crucial to ensure a smooth surgical process and optimal recovery.
Medical Evaluation
Prior to surgery, our surgeons will evaluate your overall health through lab tests, imaging, and physical exams. We also assess the mental health readiness for surgery, ensuring that you understand the long-term implications of Gender Affirmation surgery.
Hormonal Therapy Guidelines
Patients must continue their hormone therapy regimen up until a certain point before surgery. We typically ask our MTF patients to stop taking hormones for 3-6 weeks before surgery to minimize the risk of blood clotting.
Lifestyle Adjustments
To reduce surgical risks, patients must:
- Stop smoking at least 2-3 weeks before surgery to minimize complications related to healing.
- Avoid taking aspirin and other blood thinners in the weeks leading up to surgery to reduce the risk of bleeding.
Dietary Instructions
In the days leading up to surgery, we recommend that patients follow a soft or residue-free diet to prepare their digestive system. The day before surgery, a liquid diet is necessary to prevent complications during surgery.
See Also: Labiaplasty in Turkey
The Surgical Process: What Happens During Gender Affirmation surgery?
Surgical Steps for MTF Surgery
- Step 1: Preparing the Flap: For vaginoplasty, our surgeons begin by preparing a flap of skin from the penis or scrotum. The flaps are carefully designed to create the neovagina, ensuring adequate depth (typically 5-6 inches) and functional capability.
- Step 2: Creation of the Neovagina: Using meticulous techniques, we create the vaginal cavity, ensuring it is both functional and aesthetically aligned with the patient’s gender identity.
- Step 3: Clitoral and Labial Reconstruction: The next step is the creation of the clitoris and labia. Our surgeons use the available tissue to construct a sensitive clitoris and create labia minora and labia majora to match the natural female anatomy.
Surgical Steps for FTM Surgery
- Step 1: Urethral Reconstruction: For phalloplasty, the first step is the reconstruction of the urethra, which is essential for urination.
- Step 2: Neophallus Construction: Our specialists use tissue from the forearm, abdomen, or another area to construct the neophallus. After this, the urethra is connected, and testicular implants are placed.
- Step 3: Penile Implant: In later stages of phalloplasty, our surgeons may place a penile implant to allow for erectile function.
Postoperative Care After Sex Reassignment Surgery
MTF Postoperative Care
- Dilation: To maintain vaginal depth, patients must begin dilation shortly after surgery. This process typically involves using a dilator for 20-30 minutes twice a day, for up to six months.
- Wound Care: We provide detailed instructions on how to care for your surgical sites to minimize infection and promote healing.
FTM Postoperative Care
- Phalloplasty Recovery: After surgery, patients may need to use a catheter to urinate until the new urethra is fully healed. Testicular implants are monitored for proper positioning.
- Chest Reconstruction Care: After top surgery, patients need to avoid heavy lifting and follow wound care instructions to promote proper scarring and healing.
Risks and Complications of Sex Reassignment Surgery
While Gender Affirmation surgery is generally safe, there are some risks and complications to consider. These may include:
- Infection: As with any surgery, there is a risk of infection at the incision sites.
- Bleeding: There may be risks of excessive bleeding, especially if pre-surgery guidelines are not followed.
- Complications with Urinary Function: FTM patients may face issues with urination post-surgery, especially after phalloplasty.
- Scarring: While our surgeons strive to minimize scarring, some patients may experience visible scars, especially if tissue rejection or healing issues arise.
See Also: Hymenoplasty Surgery
