Transgender 101

Sex Reassignment Surgery

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     Sex Reassignment Surgery, commonly referred to as the "sex change", has been scrutinized a lot over the fifty years of it's existence. The term "sex change" is actually a misnomer. There is currently no way to change someone's sex. What this surgery does is alter the physical body to appear like that of the opposite sex. Like the surgery is named, it's a reassignment, not a change.

Male-to-Female

     There are quite a few procedures that go into the M2F sex reassignment surgery. Here they are in order:

orchiectomy - removal of the testicles
penectomy   - removal of parts of the penis
vaginoplasty - inversion of the penis to create the neovagina
clitoroplasty  - creation of the clitoris
labiaplasty -    formation of the labia

     These obviously don't include any other surgeries that might be done such as breast augmentation or facial feminization surgery. Typically SRS is considered elective or too experimental by insurance companies and is not covered at all despite the fact that it's been around for 50 years. It has also shown to be the only successful treatment in treating severe gender dysphoria.

     Follow-up studies have been done to determine if the patients were satisfied. The results showed that 70% of the patients were satisfied with the outcome. Some would argue that 70% is not a high enough success rate and that restrictions should be increased or modified to raise that level to 100%.

     One of the most common questions is "Will there be sensation afterwards?" The answer to that is typically yes. Surgeons don't touch the nerve trunks unless they absolutely have to. So, in most surgeries, there is sensation and capability of orgasm. Of course, every surgeon, no matter how good or experienced, can have a bad day. So mistakes do happen. However, about 95% of the surgeries are successful in maintaining sensation.

For a list of SRS surgeons, visit gender.org's SRS page.

Female-to-Male

     There are also a slew of procedures done for the f2m sex reassignment surgery:

Hysterectomy - removal of the uterus
salpingo-oophorectomy - removal of the ovaries and fallopian tubes
vaginectomy - removal of the vagina
metoidioplasty - a version of creating the penis and scrotum
scrotoplasty - creation of the scrotum
urethroplasty - urethra construction
placement of testicular prosthesis
phalloplasty - creation of the neopenis

     A metoidioplasty is an alternative to a full phalloplasty in which the labia are joined together to become the scrotum and fitted with testicular prosthesis. The enlarged clitoris is what becomes the neopenis. A phalloplasty is a much more involved and difficult surgery to do. It's up to the F2M to decide on which surgery they want. However, many F2Ms don't even opt for SRS simply because the results are not that promising. There needs to be a pump or prosthesis of sorts to get an erection, and many report no sensation afterwards.

     Compared to M2F surgeries, these are much more expensive as well. For a list of M2F surgeons, visit the sex change indigo pages.