Some people are born male and some are born female. While there are some people who are transgender, whose gender identity does not match their assigned sex. Sex change surgery, also known as gender reassignment surgery (GRS) or sex reassignment surgery (SRS) is there to help these people. This is a surgical procedure which changes the sex of a person. It changes a transgender person’s physical appearance according to there identified gender. It treats gender dysphoria in these people. This includes both feminization and masculinization surgeries. In masculinization surgery, there are two domains:
- Top surgery
- Bottom surgery.
In top surgery, mastectomy is performed to remove the breasts and give your chest a more male-like contour. Bottom surgery involves increasing the length of the clitoris which is called metoidioplasty, production of a penis and scrotum which are known as phalloplasty and scrotoplasty respectively and removal of the uterus that is a hysterectomy. This surgery is not for everyone. A number of things are considered before opting for surgery. However, normal people with assigned gender can also go for this if they want to.
Before the operation, your assigned sex does not correspond to your gender identity. You suffer from gender dysphoria. You feel uncomfortable in your skin. However; after the surgery, you are a person of your desired sex. You are converted from a female to a male.
Anesthesia is given to ensure that the patient does not suffer from pain during the surgery. Top and bottom surgeries are performed differently.
Mastectomy: It is performed in two ways. In one method, an incision is given around the areola and excessive fat and breast tissue are removed through it. The skin is left as it is for a year. It retracts in this period of time. This method leaves prominent scars. In the other method, excess skin is also removed along with the tissue and fat. This leaves fewer scars. After this, male-like the contour of the chest is obtained.
In the other step, female reproductive organs which are present inside your body are removed.
Hysterectomy: Total Hysterectomy is the removal of uterus and cervix. Another surgery, bilateral salpingo-oophorectomy (BSO) is performed to remove fallopian tubes. In this way, the entire female reproductive system is eliminated from the body.
After this, procedures for the construction of male reproductive organs begin. They include,
- Metoidioplasty: Androgenic hormones are given to increase the length of the clitoris. Length is increased to almost 1.6 to 2 inches.
- Phalloplasty: It is performed to create a penis or to increase the length of it. It can be done in 4 ways. All of these work on the same principle. A flap of skin is taken from a donor site of the body such as arm or abdomen to make a penis out if it. It is joined to the urethra. This is the most complicated step of GRS. An erectile prosthesis is inserted into the penis to achieve an erection.
- Scrotoplasty: Scrotum is produced from labia majora and prosthetic testes are inserted into it.
Length of Stay in Destination
It is a long procedure involving a number of surgeries. There is top surgery and bottom surgery, with the Mastectomy taking 2-3 hours and the bottom surgery 8-10 hours. You should plan to stay local for at least 14 days after your top surgery, during which time, your health conditions are monitored regularly and your stitches are removed after 10-14 days. The recovery time for bottom surgery is much greater, requiring up to a 10-night stay in the hospital and potentially 6 weeks local as regular check-ups will be required.
You will have to take several weeks off work. After 2 months, you can begin light activity and can go back to office work. You can start strenuous activity 3-4 months after bottom surgery. Pain killers are given in this period to deal with moderate pain. Scars take some time to fade away. It can take years after the surgery to settle both physically and psychologically.
Following points should be considered to look after you post-surgery:
- Go for regular check-ups.
- Take your medicines as and when prescribed by the doctor.
- Live with someone who takes care of you while you recover.
- Abstain from sexual activity till allowed by your doctor.
- Do not take a bath or shower with bandages intact. It can cause infection.
- Avoid strenuous exercise in the early few days after surgery.
- Do not lift heavy objects; it puts pressure on your stitches.
- Avoid excessive movement. Take a rest.
According to a study, 97% of the people who went through this surgery found its results satisfactory. You need to be sure before opting for it, as it is a lifetime decision. GRS is mainly for the treatment of dysphoric and transgender people.
Alternatives to a Sex Change Operation (FtoM) procedures
The following are some alternatives to sex reassignment surgery:
- Hormone replacement therapy: this therapy aids in changing your secondary sex characteristics according to your desired sex. In the case of female to male sex change, testosterone is given. This induces hair growth and coarseness of voice. It reduces breasts growth and changes in fat distribution in your body. It also stops menstruation.
- Altering physical appearance: you can alter your physical appearance, your dressing, your hair, your makeup in accordance with your desired sex. Do regular exercises to build up muscle mass which will make you look like a male.
- Psychological counseling: it will make you handle your personality. Gender reassignment surgery cannot be reversed. Therefore, you should make your decision wisely.
- Cosmetic surgery: it is a wide field covering a number of domains. It can alter your facial features, your body fat, your waist, your stomach, your chest to transform you into your desired gender. You can go for liposuction, mastectomy, Botox, fillers, Rhinoplasty, etc.
All of the methods, mentioned above are not permanent but are helpful. For permanent change, you have to go for sex reassignment surgery.
For an in-depth analysis of Sex Change Operation (FtoM) surgery, watch this long video
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