Sex Change And Surgery

What is 'sex reassignment surgery'?

Sex reassignment surgery for a transwoman is usually Vaginoplasty. It's a plastic surgery that sort of reconfigures the tissue and nerves of male genitalia to approximate female genitalia as closely as possible. A common misconception is that they remove or cut off genitalia. And, they don't, they reconfigure the existing genitalia, so that you still have genitalia, but it is in a new configuration or form. For transmen the surgical options are a lot more limited; but, there are Phalloplasties when they create a penis for the transmen. And there are Metoidioplasties where they sort of use existing structures to approximate a penis as well as possible.

Do all transgender people want to change their biological sex?

All transgender people don't necessarily want to change their biological sex. Some are just comfortable living in the gender role socially. They can blend into society and be happy without ever taking a hormone pill or having any medical interventions whatsoever. And others just have it up to the level they're comfortable in doing. Especially for “F-to-M”, or female-to-male transsexuals, the genital surgery is not very advanced still, so many of them take some medical steps, but they do not have genital surgery. But they still feel very confident, in all of these cases, that they are their chosen gender, and they are comfortable and happy living that way.

How much does it cost to change your biological sex?

The costs involved in changing your sex and gender are vast, and they are spread out over a long time. It's a misconception that you can plink down some cash at some hospital, walk in, and walk out the opposite gender. It doesn't happen that way. The cost for genital surgery, which is where most outsiders seem to focus, for trans-women can be anywhere from, right now in 2008, anywhere from ten to fifteen thousand dollars, all the way up to twenty thousand dollars or more. For trans-men, it is actually a lot more expensive for genital surgery, and unfortunately, the results are often not as satisfying.

Does medical insurance cover sex reassignment surgery?

Insurance very rarely covers surgery for transpeople because most outsiders don't understand transpeople; they are repulsed by the idea and they are not even willing to consider the mental and sexual pain that we endure, just like someone with scoliosis or a club foot, or having a portwine stain on their face or something. Those people endure a lot of social stigma. Although they could so function under those circumstances, insurance does cover those situations. We are making progress though and some companies do cover the surgery, and socialized medicine in England and Canada will cover this.

What hormones does a male-to-female have to take during transition?

Usually take some form of estrogen during transition. And they usually take a testosterone blocker before they have genital surgery to block out whatever testosterone might be in their system. There are all different kinds of estrogen. From the little blue pills that your mom might take after menopause, to injections of Estrodol. There are basically different strengths and origins. But your doctor will help you decide on which of those are for you.

What hormones does a female-to-male have to take during transition?

Female-to-male transsexuals take some variant of testosterone, and they often try to block the estrogen. Testosterone is almost always injected, although there are some gels that you can apply. And the results, especially from testosterone, are pretty dramatic.

What is 'vaginoplasty'?

A vaginoplasty is the general surgery that a lot of male to female transsexuals have when they use the tissue of the penis and they invert it to create a vagina and the other structures of the female sexual anatomy, and they maintain the nerves and everything, so, most transwomen who, you know, go to a good surgeon still retain sexual function and sensation, and it's quiet an advanced surgery at this point, their results are really good from the surgery.

What is 'phalloplasty'?

Phalloplasty is the surgery that some female-to-male transsexuals have, or even men who somehow are injured or did not develop a penis which happens occasionally. A phalloplasty is a surgery when they take some skin from another part of the body, often from the thigh or the forearm and they fashion a penis with that skin, and put it on to the body, and sometimes they'll put underlying structures that allow some sexual function, such as an erection in the same way that men who are impotent will sometimes have a little pump or something in there. It's basically just a surgery that creates a penis for female-to-male transsexuals.

Can anyone have sex reassignment surgery?

Anyone can have a vaginoplasty or a phalloplasty. Actually, those surgeries are not limited to the transsexual community. There a some women who are actually born with conditions of having a shallow vagina or even vaginal agenesis where they do not develop a vaginal cavity - so anyone can have a vaginoplasty. Some men due to congenital conditions or a female to male transsexual will have a phalloplasty. So anyone can have that surgery. It is important to note that having that surgery-in my mind at least- does not make you a woman or a man. In my mind you are already a woman or a man and you are just correcting your body. Just as a woman born with vaginal agenesis is already a woman, whether she has a vagina or not. The surgery just sort of makes her life easier.

What is the transition process a transgender person goes through to change their biological sex?

The transition process for a transgender person to change biological sex is very complicated because your dealing with gender issues which are complicated social issues, legal issues and your also dealing with mythical issues that are very complex so basically you got a through a phase of self-realization with you understand that you probably are transsexual and you want to take steps to begin living enroll that you are more countable in then you start doing a lot of research and finding support for your self then a lot of people will begin the essential process where they start going out as there new gender or expiring that then a lot of people will begin miracle inventions in a earful hormones all the way out to surgery and a lot of people somewhere in that process undergo to legal steps such as simply legally changing their names your social security documentation and people can switch up that order some people do only some of those steps but biological sex is an overview of the most of the steps.

What does it mean if someone has 'transitioned'?

The term transitioned is sort of a catch all term and a lot of people will have different definitions of this term, but basically it's used to mean that someone has made the majority of the journey over from their assigned birth gender to their target gender. It doesn't necessarily mean they've had genital surgery or whatever, but for all intents and purposes that person is living as their target gender.

What is a 'gender identity disorder'?

Gender identity disorder is a classification in the DSM for the diagnostic and statistical manual, which is used by the psych community to identify mental issues. And it describes the situation when someone is uncomfortable with their assigned gender to the point that it is impacting their life negatively. And gender identity disorder is usually considered to be cured by transition. Whether that is just social transition or whether it is full social, medical and legal transition.

What is 'gender dysphoria'?

Gender dysphoria is the core symptom of gender identity disorder and dysphoria means basically, literally, sort of an unhappiness. It is the opposite of euphoria, and gender dysphoria just describes a situation when you are unhappy with your assigned gender. Used in the medical context, it means that you are unhappy with your assigned gender to the point that it's negatively impacting your function in society.

What are the 'HBIGDA Transgender Standards of Care'?

The Harry Benjamin International Gender Disphoria Association is a collective of medical and psychatric professionals who have come together to study and put out a concensus on issues of gender identity, and how it's dealt with in the medical community. It's named after Dr. Harry Benjamin, an eye doctor who was quite a pioneer in transgender and transexual medicine. "HBIGDA" is now referred to as "WPATH," and it sets out a standard of care that doctors use to treat transgendered people.