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Also known as Gender Reassignment or Sex Change Surgery, involves the surgical procedures required to change a person’s sexual characteristics from one gender to the other. The term Transgender can be used to refer to such a person. The procedure can be used to transition a person from Male to Female and from Female to Male. M to F procedure involves reshaping of male genitals to appear and function as female genitalia (including a vaginoplasty), hair removal therapy, hormone replacement, facial feminization surgery, and Breast Augmentation.
Hormone treatment is started one year prior to surgery and continues after, where estrogen helps to reshape the body’s contours and stimulates the growth of labia majora. At least one therapist will be required to assess a patient’s psychological wellbeing before the go-ahead can be given.
The decision to have a breast augmentation should be an informed one that takes into account the potential risks and side effects. You should also have realistic expectations about the results of breast implant surgery to avoid disappointment. Find out about the procedure, the recovery period and any possible complications - ask your doctor or surgeon if you are unsure about anything.
Clinically speaking, sex change operation is known as “Genitoplasty Procedure”. This type of procedure can be performed to transition an individual from female to male and from male to female.
It is very important to understand that before you undergo surgery, you will need to first transition. Gender transition is a lengthy process that requires a lot of patience and resilience. In addition, it will be of great help if you have a strong support system to back you up in times of difficulty. It’s also essential that you have a therapist to not just help you with your emotional wellbeing before and after the transition, you will also need a letter of recommendation from your therapist before your surgery.
Transitioning from male to female will involve penectomy (removal of the penis), orchiectomy (removal of testes), vaginoplasty (creation of a vagina), and feminizing genitoplasty (creation of female genitalia). During the surgery, you will be induced with a general anesthetic.
You must start hormone treatment a year prior to your surgery to help reshape your body contours and stimulate the growth of your labia majora. Hormone treatment will be continued even after your sex-change operation.
There are popular MTF sex reassignment surgery techniques which you can choose from, two of which are: sex reassignment surgery with skin graft technique - the most popular SRS procedure, vaginal depth is up to 13-15cm (5-6 in). Another is sex reassignment surgery with colon graft - suitable for people with less scrotal skin and those who prefer a lubricated vagina and is considered as the most expensive procedure.
There are other procedures that you can undergo to fully transition from male to female. These may include; breast implants, facial feminization surgery (FFS), and another procedure would be to minimize the appearance of your Adam’s apple, etc. All procedures to help one fully transition will vary on the individual’s need and of course, their budget.
Prerequisites to Surgery
Popular MTF Sex Reassignment Surgery (SRS) Techniques
1. SRS with Penile Skin Inversion
2. SRS with Scrotal Skin Graft
A lot of patients prefer having surgery overseas since it is far less expensive and most countries, like Malaysia, have a very high success rate in terms of plastic surgery and gender reassignment surgery.
Recovery after surgery will be a long and painful process. It will also require several follow up procedures as well as constant monitoring so you will have to stay a little bit longer at the hospital until you are ready to be discharged. Generally, allow for a minimum of 3 weeks stay in Malaysia after your surgery, this will allow for the removal of stitches and a few weeks of follow up visits with the surgeon.
Smoking before and after the surgery is highly discouraged and avoid smoking for at least two weeks to reduce risks of non-healing.
Most people are able to return to work in about 4-6 weeks after a sex change operation. Furthermore, you can resume strenuous work and exercise after 2 months. It is vital that you strictly follow all medication instructions during your recovery period.
Social support is very important before and after the surgery, especially the support that comes from your family and loved ones. You have to be socially and emotionally stable before you undergo the operation. This is why it is required that you have proper counseling to help you with your emotional wellbeing. You have to prepare yourself mentally, before, during and after transition because it can be quite overwhelming and stressful.
It is also important that you maintain a regular check-up with your local doctor to monitor the progress of your healing and avoid complications.
The success rate for a sex change is very high nowadays, given technological advancements and the greater experience of surgeons. Gender reassignment surgery from male to female has a higher success rate than female to male; this is why more male transgender people opt for a sex change.
However, given the nature and complexities of this type of surgery, you also have to be aware of its complications, for example, there is always a possible risk of infection, severe pain, given the intrusive nature of the surgeries and the potential for blood clotting and scarring.
Possible side effects may also include a decreased sexual sensation and ability to orgasm, fistula (opening between rectum and vagina), narrowing of vagina and hair growth in the vagina from the grafted tissue and the partial death of tissue used to create the new vagina.
There is no alternative to a sex-change operation. Undergoing gender reassignment surgery will require a lot of time, energy, patience, and of course money. A vast majority of people who experience gender dysphoria never really surgically alter their appearance. Instead, they use creams and hormonal pills to alter their bodily appearance. Estrogens (female hormones) will help develop the breast, widen the hips, help lose facial hair and slightly increase voice pitch.