However, the meaning of "sex reassignment surgery" has been clarified by the medical subspecialty organization, the World Professional Association for Transgender Health WPATH , to include any of a larger number of surgical procedures performed as part of a medical treatment for "gender dysphoria" or "transsexualism". According to WPATH, medically necessary sex reassignment surgeries include "complete hysterectomy, bilateral mastectomy, chest reconstruction or augmentation Please help improve this section by adding citations to reliable sources.
Unsourced material may be challenged and removed. October Learn how and when to remove this template message The array of medically indicated surgeries differs between trans women male to female and trans men female to male.
For trans women, genital reconstruction usually involves the surgical construction of a vagina , by means of penile inversion or the sigmoid colon neovagina technique; or, more recently, non-penile inversion techniques that provide greater resemblance to the genitals of cisgender women.
For trans men, genital reconstruction may involve construction of a penis through either phalloplasty or metoidioplasty. For both trans women and trans men, genital surgery may also involve other medically necessary ancillary procedures, such as orchiectomy , penectomy , mastectomy or vaginectomy.
Penile inversion vaginoplasty is one of the most common procedures performed in the United States. It is a relatively safe procedure. These require additional surgery to fix and are often fixed by colorectal surgeons. For trans men, these may include mastectomy removal of the breasts and chest reconstruction the shaping of a male-contoured chest , or hysterectomy and bilateral salpingo-oophorectomy removal of ovaries and Fallopian tubes.
For some trans women, facial feminization surgery , hair implants, and breast augmentation are also aesthetic components of their surgical treatment. Medical considerations[ edit ] People with HIV or hepatitis C may have difficulty finding a surgeon able to perform successful surgery.
Many surgeons operate in small private clinics that cannot treat potential complications in these populations. Some surgeons charge higher fees for HIV and hepatitis C-positive patients; other medical professionals assert that it is unethical to deny surgical or hormonal treatments to transgender people solely on the basis of their HIV or hepatitis status.
The conditions do increase the anesthetic risk and the rate of post-operative complications. Surgeons may require overweight patients to reduce their weight before surgery, any patients to refrain from hormone replacement before surgery, and smoking patients to refrain from smoking before and after surgery.
Surgeons commonly stipulate the latter regardless of the type of operation. Potential future advances[ edit ] See also: Further in the future, stem cell biotechnology may also make this possible, with no need for anti-rejection drugs. Standards of care[ edit ] See also: Legal aspects of transgenderism Sex reassignment surgery can be difficult to obtain, due to a combination of financial barriers and lack of providers.
An increasing number of surgeons are now training to perform such surgeries. For many individuals, these may require a minimum duration of psychological evaluation and living as a member of the target gender full-time, sometimes called the real life experience RLE sometimes mistakenly referred to as the real life test RLT before genital reconstruction or other sex reassignment surgeries are permitted. Standards of Care usually give certain very specific "minimum" requirements as guidelines for progressing with treatment for transsexualism, including accessing cross-gender hormone replacement or many surgical interventions.
Alternative local standards of care exist, such as in the Netherlands, Germany, and Italy. Most surgeons require two letters of recommendation for sex reassignment surgery. At least one of these letters must be from a mental health professional experienced in diagnosing gender identity disorder, who has known the patient for over a year. Letters must state that sex reassignment surgery is the correct course of treatment for the patient.
In some jurisdictions legal gender change is prohibited in any circumstances, even after genital or other surgery or treatment. Quality of life and physical health[ edit ] Patients of sex reassignment surgery may experience changes in their physical health and quality of life, the side effects of sex steroid treatment. Hence, transgender people should be well informed of these risks before choosing to undergo SRS.
For instance, trans men obtained a higher self-perceived health score than women because they had a higher level of testosterone than them. Trans women who had undergone face feminization surgery have reported higher satisfaction in different aspects of their quality of life, including their general physical health. However, these are counted upon the procedures and surgical tricks which are used to preserve the sensitivity. Considering the importance of genital sensitivity in helping transsexual individuals to avoid unnecessary harm or injuries to the genitals, allowing trans men to obtain an erection and perform the insertion of the erect penile prosthesis after phalloplasty ,  the ability for transsexual to experience erogenous and tactile sensitivity in their reconstructed genitals is one of the essential objectives surgeons want to achieve in SRS.
Psychological and social consequences[ edit ] After sex reassignment surgery, transsexuals people who underwent cross-sex hormone therapy and sex reassignment surgery tend to be less gender dysphoric.
They also normally function well both socially and psychologically. Anxiety, depression and hostility levels were lower after sex reassignment surgery. In these studies, most of the patients have reported being very happy with the results and very few of the patients have expressed regret for undergoing sex reassignment surgery. Persistent regret can occur after sex reassignment surgery.
Regret may be due to unresolved gender dysphoria, or a weak and fluctuating sense of identity, and may even lead to suicide. Social support can help them to relate to their minority identity, ascertain their trans identity and reduce minority stress.
Hence, they were frigid and not enthusiastic about engaging in sexual activity. In consequence, transsexuals individuals who have undergone SRS are more satisfied with their bodies and experienced less stress when participating in sexual activity.
The female-to-male transgender individuals reported that they had been experiencing intensified and stronger excitements while male-to-female individuals have been encountering longer and more gentle feelings.
Moreover, trans men also had a lower sexual satisfaction with their sexual life than trans women.