What Is Gender Affirming Surgery?
Gender affirming surgery, also known as gender confirmation surgery or sex reassignment surgery, encompasses a range of medical procedures that transgender and non-binary individuals may undergo to align their physical bodies with their gender identity.
These surgeries can be broadly categorized into:
Top surgery (altering chest or breast tissue)
Bottom surgery (altering genitalia)
Facial surgery
Facial surgery, in the context of gender affirmation, includes procedures like facial feminization or masculinization, which are tailored to alter the facial features to be more aligned with the individual's gender identity.
When To Consider Gender Affirming Surgery?
Gender affirming surgery is a significant step for many transgender and non-binary individuals seeking to align their physical appearance with their gender identity.
Deciding when to pursue these surgeries is a highly personal and complex process, often involving deep introspection, medical consultations, and mental health support.
Here are some key situations where an individual might consider gender affirming surgery:
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If you’ve been experiencing long-standing, significant discomfort with your assigned gender at birth, you might be interested in gender affirming surgery.
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If you have a thorough understanding of the surgical procedures, risks, benefits, and potential outcomes, you will be more comfortable with your decision.
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If you’re in a mentally and emotionally stable place to make such a life-changing decision, you should consider this type of surgery.
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If you’re considering gender affirming surgery, being in good overall health to undergo surgery and manage post-surgical care is essential.
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You should research about meeting the age and legal requirements for surgery, which may vary by region and medical facility.
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It’s important to have a supportive network of friends, family, or a community that can provide you with emotional and practical support.
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Before deciding to undergo this procedure, you should get comprehensive consultation and recommendations from qualified healthcare professionals, including mental health providers.
Male to Female Bottom Surgeries
Male-to-female bottom surgery includes a range of specialized surgical procedures designed to transform the male genitalia into female genitalia, aligning an individual's physical anatomy with their gender identity.
The most common bottom surgeries include:
1. Orchiectomy
An orchiectomy involves the surgical removal of the testicles. It's a relatively straightforward procedure that reduces the production of testosterone, a key aspect of the male to female transition. This surgery can be performed as a standalone procedure or in conjunction with vaginoplasty.
2. Penectomy
Penectomy is the surgical removal of the penis. It's typically performed as part of a comprehensive gender confirmation surgery, often with the construction of neovagina (vaginoplasty).
3. Vaginoplasty
Vaginoplasty involves creating a vagina and vulva, including the labia and, often, a clitoris. Tissue from the penis and scrotum is typically used to construct the vaginal canal and external genitalia. The goal is to create genitalia that function and appear more typically feminine, allowing for sexual intercourse and providing a sense of gender congruence.
4. Clitoroplasty
This procedure involves creating a clitoris, often using tissue from the glans of the penis. The aim is to create a sensate structure that enhances sexual pleasure.
5. Labioplasty
Labiaplasty involves the construction or refinement of the labia minora and majora. The procedure aims to create aesthetically pleasing and functional female external genitalia.
Female to male Bottom Surgeries
Female-to-male bottom surgeries involve various surgical techniques to reconstruct the female genitalia into male genitalia, facilitating the physical transition for transgender men in accordance with their gender identity.
Here are the most common female to male bottom surgeries:
1. Hysterectomy
Hysterectomy is a foundational procedure in the gender-affirming surgery process for transgender men and some non-binary individuals. It involves the surgical removal of the uterus, marking a significant milestone in their transition process.
Opting for a hysterectomy goes beyond aligning one's physical body with their gender identity; it also offers several practical advantages.
These include ceasing menstruation, lowering the risk of certain cancers, and preparing the body for further gender-affirming surgeries, such as phalloplasty or metoidioplasty.
It's a crucial step, and if you're considering this procedure, it's important to discuss the implications, potential risks, and fertility impacts with your healthcare provider.
To support this journey, PSP is actively developing partnerships with hospitals in Latin America to provide these critical gynecological procedures.
2. Vaginectomy
A thigh lift is a cosmetic surgery that aims to remove excess skin and fat from the thighs. This procedure is ideal for individuals who have lost a significant amount of weight and are left with sagging skin, or for those who want more aesthetically pleasing thigh contours.
The surgery results in smoother, tighter skin and better-proportioned contours of the thighs and lower body.
3. Metoidioplasty
Metoidioplasty creates a neophallus from an enlarged clitoris, which is a result of testosterone therapy. The procedure allows for standing urination and preserves erogenous sensation, making it a preferred choice for some due to the functionality and sensation retention.
4. Scrotoplasty
Laser Lipo 360, also known as 360-degree liposuction, is a cosmetic procedure that uses laser technology to remove fat and contour the body. It typically targets multiple areas such as the abdomen, waist, flanks, and back, providing a more comprehensive and circumferential body reshaping.
This procedure is less invasive than traditional liposuction and may result in quicker recovery times.
5. Urethroplasty
Post-bariatric surgery, or post-weight loss surgery, involves removing excess skin and tissue after significant weight loss. This type of surgery can include various procedures like tummy tuck, arm lift, thigh lift, and breast lift, tailored to the individual's needs.
The goal is to improve body contours and address issues such as skin irritation and hygiene problems caused by excess skin.
6. Phalloplasty
Calf implants are a cosmetic procedure aimed at enhancing the size and shape of the calf muscles.
This surgery is chosen by individuals seeking more muscular or balanced lower leg contours, often due to underdeveloped muscles that cannot be improved through exercise alone. Implants are inserted to create a more aesthetically pleasing leg shape.
Other Gender Affirming Surgeries
In addition to male-to-female and female-to-male bottom surgeries, there are some other gender-affirming surgeries such as:
1. Facial Feminization Surgery (FFS)
Facial feminization surgery, or FFS, is a set of surgical procedures intended to alter masculine facial features to make them more closely resemble a traditionally feminine appearance. This can include procedures such as brow lift, rhinoplasty, cheek augmentation, lip augmentation, jaw and chin recontouring, and tracheal shaving.
The aim is to soften and feminize facial features, aligning them more closely with the individual's gender identity. The specific procedures involved in FFS are tailored to each individual's unique facial structure and desired outcomes.
2. Chest Masculinization
Chest masculinization surgery, also known as top surgery, is a procedure performed to remove breast tissue to create a more masculine chest contour. This surgery often involves techniques like subcutaneous mastectomy or breast reduction.
The goal is to flatten the chest, often including resizing and repositioning the nipples and areolas to achieve a natural, male-typical chest appearance. This surgery is a critical component of the physical transition for many transgender men and non-binary individuals seeking a more masculine chest appearance.
3. Breast Augmentation with Body Contouring for Transgender Women
Breast augmentation combined with body contouring for transgender women is a surgical approach that enhances the size and shape of the breasts while also modifying body contours to achieve a more typically feminine silhouette.
Breast augmentation usually involves the use of implants or fat transfer to increase breast size and improve shape. Body contouring may include procedures like liposuction or fat grafting to redistribute body fat, creating curves in areas such as the hips and buttocks.
How to Prepare for Gender Affirming Surgery?
Preparing for gender-affirming surgery is a journey that involves deep personal reflection and careful preparation.
Here's an overview of the key steps involved:
Psychological Evaluation
Why it's important: This step ensures your mental well-being and readiness for surgery. It's a space to explore your feelings, understand the implications of surgery, and confirm that any mental health conditions are being appropriately managed.
What's required: You'll usually need one or more supportive letters from a mental health professional who understands transgender healthcare. These letters will affirm your gender dysphoria's persistence and your readiness for surgery. This process is as much about support as it is about evaluation.
Hormone Therapy
Why it's important: Hormone therapy aligns your physical characteristics more closely with your gender identity. For many, this is also a step towards preparing for surgery.
What's required: Often, there's a requirement to have undergone hormone therapy for atypically around 12 months before surgery. However, this varies and may not apply to all surgeries or individuals. This period is as much a part of your transition as the surgery itself.
Real-Life Experience
Why it's important: Living full-time in your affirmed gender role is a way to ensure your comfort and readiness for the permanent changes the surgery will bring. This experience is crucial for confirming the stability of your gender identity and your resilience in facing the transformative journey ahead.
What's required: Though not mandatory in all cases, if required, you may be requested to live in your affirmed gender role for around 12 months. Remember, this time is valuable for your growth and confidence in your identity.
Permanent Hair Removal
Why it's important: For surgeries like vaginoplasty, removing hair from the surgical area is crucial to prevent complications post-surgery.
What's required: You may need to complete several sessions of electrolysis or laser hair removal. This process should be started well in advance to ensure permanent results are achieved by the time of your surgery.
Benefits of Gender Affirming Surgery
Gender affirming surgery offers a range of psychological, emotional, and physical benefits for transgender individuals.
These benefits include:
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Surgery helps align an individual's physical body with their gender identity, which is crucial for overall well-being and self-perception.
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Many transgender people experience gender dysphoria; a distressing disconnection between their gender identity and physical body. Gender affirming surgery can significantly reduce or eliminate this distress.
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The alignment of physical appearance and gender identity can lead to improvements in mental health, reducing symptoms of depression, anxiety, and other mental health issues related to gender dysphoria.
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Undergoing gender affirming surgery often boosts self-esteem and confidence, as individuals feel more comfortable and authentic in their own skin.
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Many individuals report an overall improvement in the quality of life post-surgery, as they can live more freely and authentically.
How Long Does It Take to Recover After a Gender Affirming Procedure?
Recovery times following gender-affirming procedures vary, depending on the type and complexity of the surgery performed.
Here are the recovery periods for specific procedures:
Orchiectomy
Initial recovery period: 1-2 weeks for initial wound healing; limited physical activity recommended.
Full recovery: Complete healing and resumption of normal activities typically occur within 4-6 weeks.
Penectomy
Initial recovery period: About 2-3 weeks for initial healing; significant care is needed to manage pain and prevent infection.
Full recovery: Full recovery and adaptation can take several months.
Vaginoplasty
Initial recovery period: Initial healing takes about 6-8 weeks; patients may need assistance during the early stages.
Full recovery: Complete healing, including the ability to resume sexual activities, can take up to 1 year.
Clitoroplasty
Initial recovery period: Around 2-4 weeks for initial healing; patients are advised to be gentle in the area.
Full recovery: Full sensitivity and healing may take a few months.
Labioplasty
Initial recovery period: 4-6 weeks for initial healing; activities should be limited during this period.
Full recovery: Full recovery and stabilization of results can take up to 6 months.
Vaginectomy
Initial recovery period: Approximately 4-6 weeks for initial healing.
Full recovery: Complete healing may take several months.
Metoidioplasty
Initial recovery period: Around 4-6 weeks for initial healing.
Full recovery: Full recovery and achieving results can take up to 6-12 months.
Scrotoplasty
Initial recovery period: 4-6 weeks for initial wound healing.
Full recovery: Complete healing and final results may take several months. Full recovery and acclimation to the prosthesis typically occur within 2-3 months.
Urethroplasty
Initial recovery period: Typically, 2-4 weeks for initial healing.
Full recovery: Full recovery and normalization of urinary function can take several months.
Phalloplasty
Initial recovery period: 6-8 weeks for initial healing; this is a complex surgery requiring careful post-operative care.
Full recovery: Complete recovery, including full functionality and sensation, can take up to a year or more.
Facial Feminization Surgery (FFS)
Initial recovery period: 2-3 weeks for initial swelling and bruising to subside.
Full recovery: Complete healing and final results can take several months to a year, depending on the extent of the procedures.
Chest Masculinization
Initial recovery period: About 2-4 weeks for initial healing; limited physical activity during this period.
Full recovery: Full recovery and final results are typically seen within 3-6 months.
Breast Augmentation with Body Contouring
Initial recovery period: 4-6 weeks for initial recovery from surgery.
Full recovery: Final results and full recovery can take several months, especially if extensive body contouring is involved.
FAQs About Gender Affirming Surgery
If we haven’t answered all your questions, here are some of the most common questions and concerns regarding these transformative procedures.
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The level of pain experienced during bottom surgery (gender-affirming genital surgery) can vary greatly among individuals. Most surgeries are performed under general anesthesia, so there's no pain during the procedure itself.
Postoperatively, patients often experience discomfort and soreness in the surgical area, which is typically managed with prescribed pain medications. The intensity of pain depends on the specific procedure, individual pain tolerance, and adherence to post-operative care instructions.
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It is generally uncommon to undergo both top and bottom surgeries (gender-affirming surgeries) simultaneously.
These surgeries are complex and can be physically demanding, requiring significant recovery time. Performing them together would increase the risk of complications and extend the recovery period.
Some of our doctors in Colombia do both at the same time, with one surgeon doing the bottom and the other doing the top. It is a much longer recovery, but essentially doable. It depends on the surgical team. Please wordsmith.
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In many Latin American countries, the legal age for medical consent is 18. This means individuals can independently decide to undergo gender affirming surgery once they reach this age. In several countries, minors under the age of 18 can undergo gender affirming surgery with the consent of their parents or legal guardians.
Schedule a Consultation for Gender Affirming Surgery at Passport Surgical Partners
We understand that contemplating gender affirming surgery can evoke a mix of hope, anxiety, and countless questions.
At Passport Surgical Partners, we act as intermediaries to connect you to esteemed medical facilities and expert surgeons where you can feel confident about the surgery you’re undergoing and the recovery process.
We will coordinate your surgical procedure, along with your pre-op & post-op care, hotels, drivers, excursions, and local guides.
Once you are medically cleared for travel by your surgeon, it is safe to fly home. However, you may still be navigating through the initial stages of recovery, which might include managing dressings and bruising which will subside over time.
We partner with the best surgeons in Latin America that specialize in:
Cosmetic dentistry
Breast procedures
Body procedures
Hair transplant procedures
Bariatric surgeries
