Gender Reassignment Surgery

Transsexualism is a definition for opposite sexual orientation, when a person self-identifies as a member of the gender opposite to the one assigned to him/her at birth – man wants to be a woman and woman wants to be a man. It is not possible to treat these individuals through re-education or medically. The therapy is based on psychotherapy, which is followed by other medical and eventually surgical procedures.

Transsexualism is an inverse inborn sexual orientation, which prevalence is limited to split thousand of male and female population. These people have permanent sorrowful feeling of opposite sex than to which they are forced by their biological anatomical equipment. They are unsatisfied with their genitals and they wish to have anatomical signs of opposite gender and also desire a sexual role of the opposite gender. The etiology of trassexualism is not clear. This disease probably originates in the prenatal phases of life and is irreversible. Therefore transsexualism presents lifelong problem of the individual.

Transsexual therapy involves long-lasting treatment that takes several years, which is usually initiated and managed by the sexologist eventually psychologist and finally a surgeon:

  1. It is based on psychotherapy. It is important to have a support when organizing life in opposite gender role.

  2. As soon as the diagnosis of this disease is set, the program for treatment is determined by transsexual committee and the name and surname can be changed to a sexually neutral.

  3. Hormone therapy should cause such changes so that secondary sexual characteristics resemble the desired gender (androgens in women and anti-androgens with combination of estrogens in men). The results of hormone therapy are less satisfying for men. Facial hair and typically man’s hair need usually even electric depilation.

  4. Surgical procedures aim to a change of anatomical sex. It means castration for men and breasts removal by plastic surgeons and the removal of womb and ovaries. After undertaking these changes and after approval of medical committee it is possible to ask for a change of registered gender.

  5. Plastic surgeries. Many transsexual men and women are satisfied with correction of secondary sexual characteristics and they do not undergo the genital reassignment surgery because of the inability to form a perfect appearance and function.

Sex reassignment surgery from male to female

  1. surgery – breast augmentation (if the patient requires it because the breasts enlarge in a satisfactory manner after the hormone therapy)

  2. surgery – the reshaping of male genitals into female genitalia is a one-shot procedure that consists of following separate procedures:

  • The testicles and follicles are removed.

  • A subcutaneous amputation of penis except a small part of the glans of the penis. This part serves for clitoris reconstruction, which is fully supplied with nerve endings.

  • Preservation of the urethra.

  • Forming a vagina from the skin of penis with the appearance of tube that is supplied by subcutaneous pedicle. Another technique is to form a vagina from a section of colon. Because of the vulnerability of delicate mucosa and secretion, the colon is used less for reconstruction.

  • The creation of labia from scrotal tissue.

Sex reassignment surgery from male to female

  1. The removal of breasts with preservation of the areolas and nipples.

  2. The removal of womb and ovaries.

  3. The creation of penis and eventually urethra.

  4. The creation of scrotum.

This text has been created with kind assistance of prof. Jiri Vesely, M.D. PhD.

Updated: 2007-11-12

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