Gender reassignment surgery (male-to-female)

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Sex reassignment surgery from male to female includes surgeries which will shape a male body into a body with the appearance of and, as far as possible, the functioning of a female body.

Prior to any surgeries, transgendered or transsexual people usually undergo hormone therapy.

Lili Elbe was the first known recipient of male-to-female sex reassignment surgery in Germany in 1930. She was the subject of five surgeries- penectomy and orchidectomy, one intended to transplant ovaries, one to remove the ovaries after transplant rejection, and vaginoplasty. Tragically, she died three months after her fifth operation.

Christine Jorgensen was likely the most famous recipient of sex reassignment surgery, having her surgery done in Denmark in late 1952 and being outed right afterwards. She was a very strong advocate for the rights of transsexual people.

Another famous person to undergo male-to-female sex reassignment surgery was Renee Richards. She transitioned and had surgery in the mid-1970s, and successfully fought to have transsexual people recognized in their new sex.

The first male-to-female surgeries in the United States took place in 1966 at the Johns Hopkins University Medical Center.

Contents

[edit] Genital reassignment surgery

Primary GRS male-to-female (MTF) procedures fall under one of two categories: penile inversion or (less commonly) colovaginoplasty. Sex reassignment surgery can be completed in either a single surgery or two surgeries, depending on the surgeon's technique.

For changing anatomical sex from male to female, the testicles are removed and the penis is usually inverted to form a vagina (vaginoplasty), or, if additional depth or self-lubrication are desired, a section of colon may be grafted in (colovaginoplasty). For additional vaginal depth, pubic hairs are removed from scrotal tissues via electrolysis prior to the SRS procedure which is then incorporated by the surgeon to extend the vaginal shaft where penile tissues alone were found insufficient. If either technique performed involved two surgeries, the second surgery is a minor surgery called labiaplasty.

A third, crudest form of reassignment is where the penile tissue is removed altogether (penectomy) and vagina tissue created from grafts.

Possible complications to this surgery, regardless of the type of vaginoplasty performed, include:

  • Post operation infection (as with any surgical procedure)
  • Blood loss
  • Deep vein thrombosis (preventable with compression stockings and/or drugs)
  • Vaginal stricture, and urethral stricture (the narrowing of either opening)
  • Pubic hairs in undesirable places, most commonly inside the neovagina (when using a penile inversion technique) and/or (uncommonly) on the neolabia minora (if the hairs were not adequately cleared either prior to surgery, or as the result of the surgeon scraping off the follicle)
  • Necrosis (death) of the neolabia and/or the neoclitoris tissues from the lack of blood supply or the result of a major infection
  • Rectovaginal fistula (a hole connecting the neovagina and the colon, this is rare)

Any technique of vaginoplasty performed will require vaginal dilation of the patient for the rest of her life with a set of vaginal stents. In the case of penile inversion, this is due to the skin used for surgery, being treated by the body as an artificial void, with the body's response being an attempt to fill the void by contracting length-wise and narrowing at the new opening. In the case of colovaginoplasty, the body's only attempt at "wound repair" is the narrowing of the new opening.

Dilation is started several days after surgery, when the temporary packing inserted during surgery is removed. After several weeks of several dilations per day, the patients will eventually be able to cut down to one dilation per week. It is important to note that sexual intercourse does not count as a dilation- the body requires the hard presence of the stents to keep the vagina from losing depth.

[edit] Breast augmentation

Breast augmentation is the enlargement of breasts, which can be necessary if hormone therapy did not yield satisfactory results.

[edit] Facial feminization surgery

Occasionally these basic procedures are complemented further with feminizing cosmetic surgeries or procedures that modify bone or cartilage structures, typically in the jaw, brow, forehead, nose and cheek areas (facial feminization surgery or FFS).

[edit] Voice surgery

Some MTF individuals may elect to have voice surgery altering the range or pitch of the person's vocal chords. Estrogens by themselves are not able to alter their voice range or pitch. Voice lessons are available to train the MTF to practice feminization of their speech.

[edit] Tracheal shaves

Tracheal shaves are also sometimes used to reduce the cartilage in the area of the throat to conform to more feminine dimensions, to greatly reduce the appearance of an Adam's Apple.

[edit] See also

[edit] References

[edit] Discuss

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