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Gender confirmation surgery

Posted in Gender confirmation surgery

What is gender confirmation surgery?

Gender confirmation surgery, also known as transgender, gender reassignment, or sex reassignment surgery, is a topic that is becoming increasingly mainstream in the United States.  From the recent coverage of Bruce Jenner’s transition, to Laverne Cox being on the cover of Time magazine, transgender topics and gender confirmation surgery are more prevalent in the news.  Although there are no firm numbers, it is estimated that approximately 700,000 transgender persons are living in the United States.  Of these, however, only about 30 percent undergo the process of gender transformation.  But what exactly is gender confirmation surgery?  And how does a transgender person begin the process of transformation to the opposite sex?

Gender identity disorder

gender confirmation surgery

Gender identity disorder is a medical condition in which the person  manifests, with constant and persistent conviction, the desire to live as a  member of the opposite sex and progressively take steps to live in the  opposite sex role full-time.  People who wish to change their sex  are referred to as suffering from gender dysphoria, or unhappiness with  one’s gender.  According to the World Professional Association for  Transgender Health (WPATH), the first step is usually meeting with a  mental health professional to diagnose gender identity disorder.  Two  referral letters from independent mental health professionals, along with  the diagnosis of gender identity disorder, are necessary in order for the  transgender person to begin hormone therapy.  The transgender person must have the capacity to make a fully informed decision, give consent for treatment, and be above 18 years of age.   If there are any significant mental health or medical concerns, these must be well controlled.  Further, the transgender person must live for twelve months in a gender role that is congruent with their gender identity.

Gender confirmation surgery

Once a transgender person has undergone the required amount of therapy and their doctor has decided they meet the right requirements, they are then able to get a note that they can take to a plastic surgeon to perform gender confirmation surgery. Transgender patients may then go through a number of gender confirmation surgeries on their face, body, and genitalia to reflect outside how they feel on the inside.  For male to female individuals, gender confirmation surgery on the genitalia may include penectomy (removal of the penis), orchidectomy (removal of the testicles), vaginoplasty (creation of a vagina), and clitoroplasty (creation of a clitoris).  Body gender confirmation surgery usually consists of breast augmentation utilizing breast implants, abdominoplasty, and buttock augmentation using fat transfer.  Facial cosmetic gender confirmation surgery may include rhinoplasty, lip augmentation, upper lip shortening, reduction of the Adam’s apple, vocal cord shortening, and hair transplants.   For female to male transgender individuals, gender confirmation genital reconstruction procedures may include phalloplasty (creation of a penis), scrotoplasty (creation of a scrotum), hysterectomy, and an oophorectomy (removal of the ovaries).  Gender confirmation surgery on the body include mastectomies and chest wall contouring.  Facial gender confirmation surgery may include rhinoplasty, jaw reshaping, cheek augmentation, and chin implants.

Although the success of treatment depends in part on the technical success of gender confirmation surgery, perhaps more crucial is the mental health support and psychological adjustment of the transgender person after gender confirmation surgery.  Mental health care may need to be continued after gender confirmation surgery and the transgender patient should continue to get support from family, friends, employers and the medical profession.

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