What Is Gender Affirming Surgery?
Gender-affirming surgery, also known as gender reassignment surgery, refers to a range of medical procedures that an individual might choose to undergo to align their physical body more closely with their gender identity.
These procedures include:
Vaginoplasty
Facial Feminization Surgery (FFS)
Breast Augmentation
Tracheal Shave
Mastectomy
Hysterectomy
Phalloplasty
Metoidioplasty
How Does Gender Affirming Surgery Work?
The first step is to meet with a mental health professional for an evaluation, to ensure that you’re making an informed decision and to meet the World Professional Association for Transgender Health (WPATH) standards of care.
The next step is to set up a consultation with a surgeon who specializes in gender affirming surgeries to discuss surgical options, outcomes and risks. At Passport Surgical Partners, we facilitate this process for you.
Many trans individuals undergo hormone therapy before surgery. This can help develop secondary sexual characteristics, such as breast growth or facial hair.
Gender affirming surgery can be either:
Female-to-male (FTM) surgery
Male-to-female (MTF) surgery
Gender Affirming Surgery: Female-to-Male
For many trans men and non-binary individuals, undergoing female-to-male (FTM) surgeries can be an essential step in aligning their physical appearance with their gender identity.
Surgical procedures can drastically enhance one's sense of self and alleviate feelings associated with gender dysphoria.
The most common female-to-male procedures are:
1. Top Surgery (Mastectomy)
Top surgery, also known as a mastectomy, is the removal of breast tissue to achieve a male-contoured chest. There are two main techniques used for this surgery and the technique chosen depends on chest size.
The double incision method, suitable for those with larger chests, involves two horizontal incisions and the repositioning of the nipple. Conversely, the keyhole technique is tailored for those with smaller chests and entails incisions made around the areolas.
For many transgender men, top surgery can be an essential step towards aligning physical appearance with gender identity.
2. Bottom Surgery
At the heart of this transformative journey lies bottom surgery — a collective term for procedures that modify female genitalia to resemble male anatomy.
The most common bottom procedures are:
Hysterectomy: This procedure is conducted to remove the uterus. It can also include the excision of the ovaries and fallopian tubes.
Vaginectomy: This surgery is conducted to close the vaginal canal.
Phalloplasty: This intricate procedure is conducted to create a penis by taking tissue grafts from various parts of the body, such as the forearm, thigh, or abdomen.
Metoidioplasty: This procedure is conducted to enhance the enlarged clitoris to form a small penis, after testosterone therapy has enlarged the clitoris.
Scrotoplasty: This surgery is conducted to form the scrotum using labial tissue. Testicular implants can also be added during this procedure.
3. Other FTM Procedures
In addition to primary transition surgeries, there are other procedures that further aid in the masculinization process.
Facial surgery, for example, can involve modifications such as chin or jaw reshaping to achieve a more masculine profile, while voice surgery, including interventions like thyroplasty, aims to deepen the voice, aligning it more closely with male vocal characteristics.
Gender Affirming Surgery: Male-to-Female
For numerous trans men and non-binary individuals, male to female surgeries often serve as a crucial step towards aligning their physical presence with their gender identity. The most common male-to-female procedures are:
Top Surgery (Breast Augmentation)
Top surgery for MTF individuals typically involves breast augmentation to achieve a female-contoured chest. Silicone or saline implants are typically used, but in some cases, fat grafting can be used to enhance breast size and shape.
Bottom Surgery
Central to this transformative process is bottom surgery — the process of modifying male genitalia to mirror female anatomy.
The most common bottom procedures are:
Orchiectomy: This procedure is conducted to remove the testicles, reducing the production of testosterone.
Penectomy: This surgery is conducted to remove the penis.
Vaginoplasty: This intricate procedure is conducted to craft a vaginal canal. Skin from the penis and scrotum is typically used to create the vaginal lining.
Labiaplasty: This surgery is conducted to construct the labia, providing a more typical female genital appearance.
Clitoroplasty: Often part of the vaginoplasty, this procedure is conducted to create a clitoris from the glans of the penis, aiming to maintain sensation.
Other MTF Procedures
Beyond the primary transition surgeries, there are several other procedures that can aid in feminization.
Facial feminization surgery (FFS) can include modifications such as forehead contouring, jaw and chin reshaping, rhinoplasty, and tracheal shave, to create a more feminine facial profile.
Voice surgery, such as cricothyroid approximation, aims to elevate voice pitch, to make the voice sound more feminine by adjusting the tension and length of the vocal cords.
Gender Affirming Surgery Recovery Process
The recovery process after gender affirming surgeries varies based on the procedures performed, your overall health, and any complications that might arise.
Here’s a general overview of what recovery might look like for both female to male and male to female procedures:
Top Surgery Recovery
FTM (Chest Masculinization):
Immediate post-op: You will likely wear a compression bandage or vest to minimize swelling and support healing.
Duration: You can typically return to light activities within 2-3 weeks, but strenuous physical activity should be avoided for 6-8 weeks.
Other considerations: You may experience numbness around the surgical site, which typically improves over time.
MTF (Breast Augmentation):
Immediate post-op: You will wear a surgical bra to support the new implants.
Duration: You can resume light activities within a week, but strenuous activities and heavy lifting should be avoided for up to six weeks.
Other considerations: You might experience changes in nipple sensation.
Bottom Surgery Recovery
FTM:
Phalloplasty/Metoidioplasty: Your initial recovery can take 6-8 weeks, while you will need to avoid strenuous activities for up to three months. Complete healing can take several months, and more than one procedure might be needed.
Hysterectomy: Your recovery can range from 2-6 weeks, depending on the surgical approach (laparoscopic vs. traditional).
Vaginectomy: As this procedure often accompanies other surgeries like phalloplasty, your recovery timelines will be interlinked.
MTF:
Vaginoplasty: You can expect to stay in the hospital for around one week, with 6-8 weeks recommended before returning to most daily activities. You will also need to dilate the neovagina on a daily basis to maintain depth and width.
Orchiectomy: You can resume light activities within a week or two, but full recovery might take a few weeks longer.
Penectomy: This is typically performed alongside vaginoplasty, so your recovery timeline will be similar.
Gender Reassignment Surgery Risks
Gender reassignment surgery comes with significant risks. Potential risks include:
Scarring: Surgical procedures often leave scars, which can vary in visibility.
Infection: Surgery can pose the risk of infection at the surgical site or internally.
Complications with sensation: Surgery can lead to temporary or permanent loss of or change in sensation — especially in the nipples or surgically constructed genitals.
Aesthetic concerns: Aesthetic concerns include asymmetry, dissatisfaction with appearance, or unsatisfactory cosmetic results.
Complications from graft sites: If tissue is taken from one area of the body to be used in another, both sites can have complications. This includes poor graft take, scarring or complications at the donor site.
Urinary and bowel complications: Gender reassignment procedures can lead to issues like fistulas, strictures, or other urinary and bowel problems.
Implant-related Issues (for MTF breast augmentation): The procedure can lead to various issues including rupture, displacement or capsular contracture.
Blood clots or thromboembolic events: Surgery and reduced mobility post-surgery can increase the risk of blood clots.
Anesthetic risks: As with any surgery that requires anesthesia, there's a potential for complications such as allergic reactions or breathing difficulties.
Need for revision surgeries: Sometimes, a secondary procedure might be necessary to address complications or improve results.
It’s important to fully understand potential risks about gender reassignment surgery and have realistic expectations about recovery time.
Schedule a Consultation for Gender Affirming Surgery at Passport Surgical Partners
Contemplating gender reassignment surgery can come with hope and anticipation, along with apprehension and multiple questions.
At Passport Surgical Partners, we serve as your trusted liaisons, connecting you with renowned medical facilities and adept surgeons who are skilled in transgender surgical procedures.
We manage every detail of your surgical experience, from your pre-op consultations to post-op care. We coordinate accommodations, transportation, local excursions, and even personal guides to help make your experience as seamless as possible.
Traveling after surgery, especially flying, can be a worry. We will make sure that you only fly home when your surgeon gives you the green light, confirming it’s safe. Yes, you can fly after surgery! But remember, even when you’re cleared to go home, you might still have some dressings and perhaps bruising.
Our collaboration extends to the most proficient surgeons in Latin America, who are experts in:
Transgender facial feminization or masculinization procedures
Top surgeries, including breast augmentation or mastectomy
Comprehensive bottom surgeries and body contouring
Contact our team to find out more details about surgeries or accommodation.
