In the last decade, gender reassignment surgery has become a common phenomenon. Although modern society is still biased towards transsexuals, many still decide to embark on this difficult path of transformation from a man to a woman and vice versa. What will a person who wants to change their gender have to face? How is the operation of changing gender from male to female? What are the risks? "Popular about health" will help to understand these issues.

Where to start a man who wants to become a woman?

The gender transition process is quite complicated. It is necessary to go through, as they say, all the circles of hell. It all starts, of course, with making a conscious decision. If a guy has been experiencing discomfort in his body since childhood and suffers because of his gender, then he has a chance to change everything. However, the decision should not be made on emotions, because of resentment towards the partner or other circumstances. The next stage of reincarnation is a visit to a psychiatrist.

A man needs to register with this doctor and be observed by him for at least a year. The psychiatrist conducts many conversations with the patient, prescribes necessary tests to find out if there really are no other ways to solve the patient's problem. If the medical commission establishes the fact that the guy is really a transsexual, then he will eventually be issued an appropriate certificate. It also states that no other mental abnormalities were found in the patient. This means that the decision was made consciously. The next step is hormone therapy.

Taking hormones as part of the transformation of a man into a woman

After receiving the conclusion of a psychiatrist, a man must be tested for hormones. Based on their results, it will be seen what dosage of hormones should be prescribed to the patient. Hormone therapy is a long process, taking pills before surgery is carried out for 9 months. It is impossible to skip or change the dosage, the doctor should adjust the doses, based on the results of the tests (they are taken every one and a half to two months).

What changes occur to a man as a result of taking female hormones? The features of his face gradually soften, acquiring femininity, the body also changes - the hair on the face, legs, arms disappears, the figure is slightly rounded. What hormones should a man take? Most often it is estrogen. Sometimes the doctor considers it necessary to include progestogens in the course of hormone therapy. Hormone intake is stopped at least one month before the planned date of the operation. After surgery, it is necessary to take female hormones for life. And how the operation itself proceeds, you will learn further.

operation from man to woman

From the point of view of anatomy and surgery, it is easier to turn from a guy into a girl. The operation is performed in a hospital and lasts from 5 to 8 hours (depending on the complexity). What exactly does a surgeon do? First, he removes the male testicles. The future vagina and clitoris are formed from the tissue of the penis, the scrotum is used to form the labia.

If this tissue is not enough, then a section of the sigmoid colon or skin taken from the man's forearm is used.

In parallel, the surgeon will have to perform other plastic surgeries - mammoplasty (breast augmentation) and face correction. The surgeon must work with the patient's cheekbones, nose, if necessary. Such operations are successfully performed in Russia and other countries. Most of these transformations are done in Thailand. In this country, they are loyal to transsexuals. There are about 15 thousand of them. The cost of a sex change operation from a man to a woman in sunny Thailand is almost three times lower than in other countries.

Who should not undergo gender reassignment surgery??

The following factors serve as grounds for refusing to carry out such an operation:

1. Age up to 18 years.

2. Absence of a psychiatrist's report or detected mental abnormalities.

3. Homosexuality.

4. HIV, AIDS, hepatitis.

5. Diseases of the liver, heart.

6. Others possible problems with health, in which surgical interventions are contraindicated.

What are the predictions for a successful outcome of sex reassignment surgery??

Any operation is associated with the risk of infection, this must be understood from the outset. Heart problems may arise during the introduction of anesthesia, and it should not be ruled out that the transplanted tissues may not take root well. It is also important to mention the nuance that after the operation, the patient's life expectancy is reduced. Hormone intake plays an important role in this regard. However, in almost 80 percent of cases, the outcome is favorable.

In addition to the risks of harming health, the patient will face many psychological problems. He will certainly face misunderstanding among his entourage, relatives, it is also worth mentally preparing for this. After changing gender, a man who has turned into a woman needs to go through many procedures with identity documents.

Sex change from a man to a woman is a long and complex process that requires patience, awareness, and willingness to make sacrifices for the sake of your well-being. It is very important to weigh everything many times before making a decision, because there will be no turning back.

When a person of one sex feels like a person of the opposite sex, this is called transsexualism. Such a state is not a sexual perversion, and differs significantly from homosexuality, lesbianism, transvestism, etc.

I want to change gender from female to male, how do I do that?

During embryonic development, a certain violation occurs in a person, in which the brain and body are formed in different ways - as if they relate to opposite sexes. Imagine that you are a man in your sense of self, and your body is the body of a woman, completely inconsistent with your idea of ​​yourself. Or, on the contrary, you are a woman, by the whim of nature “squeezed” into the body of a man. It is easy to understand how like people it's hard to live in the world. And it is not surprising that many of them strive to bring their body into a state corresponding to their sense of self.

Modern medicine allows many of them to do this.

What you need to know about gender reassignment

Such a patient first of all needs to make a final decision about what he wants. change sex. It is not simple. He must be prepared for the fact that after such a decision he will lose his relatives, friends, work, and will start completely new life. Not everyone is ready to accept a person after sex change. Probably, some of these people are more lucky - after the operation, their environment does not turn away from them. But many have to endure the rupture of all social ties.

In addition to various social problems, which arise in this case - a change of documents, the reaction of others, a possible change of job, etc. - money is needed - in most countries such a procedure is not included in medical insurance. Although, there are exceptions. For example, Brazilian citizens wishing to change sex can do it for free.

Sex-change operation

Then the medical events begin.
First of all, a general examination to determine whether, for health reasons, it is possible to start sex change. It is clear that serious chronic diseases can complicate or even make such a procedure impossible.
Then a psychiatric examination is carried out to make sure that the patient applying for a sex change is mentally healthy and his desire is not a symptom of a mental disorder. In addition, it is necessary to be sure that the patient's psyche is able to cope with all psychological problems associated with sex change.

After that, they begin taking hormones of the sex in which the patient wants to switch. To change the sex from male to female, estrogens are taken, and vice versa - testosterone.
Only at the last stage, surgical correction of the external genital organs is carried out. Exist various options such a correction, and its success depends both on the age and condition of the patient, and on the skill of the surgeon. One of the famous sex reassignment surgery centers is located in Thailand.
In Israel, a plastic surgeon performs similar operations. Dr. Chaim Kaplan in the hospital Tel HaShomer in Tel Aviv.

Dana International

One successful example of a transgender woman after a gender reassignment was the popular Israeli singer Dana International. Dana was born a boy, then her name was Yaron Cohen. Since childhood, she felt like a girl, at the age of 15 she realized that she wanted to change gender from male to female, and a few years later she fulfilled her desire by undergoing a corresponding operation in London.
As you know, Dana in 1998, after sex change won first place in the Eurovision Song Contest. And now she remains a popular singer in Israel - although, probably, her life does not consist of joys and successes alone.
Although according to statistics, the majority of patients after sex change satisfied with their choice, the surgical procedure itself and the subsequent permanent treatment with sex hormones is not easy and is associated with many complications.
A lot of material about transsexualism, sex reassignment operations, impressions of people who have undergone such operations are on the site http://transsexuals.ru/

Sex change in Israel

In Israel, gender reassignment surgery is performed only on citizens of the country.

In the conditions of Israel, a patient who has decided on sex change, you need to start with a visit to the family doctor. The doctor should give a direction for general tests, as well as for a consultation with a psychiatrist. After the tests and the conclusion of the psychiatrist have been received, and there are no obstacles from the point of view of the psyche and health, you can ask for a referral to the consultation of the department where gender reassignment operations are performed.

It makes no sense for foreign citizens to apply for such an operation in Israel - it is better to look for a clinic in Thailand or Europe, where they accept tourists with this problem for treatment.

Pictured is Dana International after winning the Eurovision Song Contest.

Gender change is a rather serious issue and is not shown to everyone.

During puberty, problems with self-identification may still arise, but by about 25 years such thoughts disappear. Only a small percentage of people in a conscious and mature age adhere to the desire to change their gender.

As a rule, such desires come from childhood. Boys, being at kindergarten age, begin to try on mother's dresses, shoes with heels. Girls, in turn, are absorbed in their interest in typical male activities: football, boxing, etc. Having matured, such people begin to understand that their outer shell - the body does not reflect the inner world and true desires.

Gender reassignment: the process of change

The first step to gender reassignment is to visit a psychiatrist who can make sure that such an operation is necessary. Further, the medical specialist will issue a conclusion that general state a person is normal and he really is a transsexual.

In the case when a sex change is an absolute necessity for a normal existence, doctors prescribe a course of taking hormonal drugs. In the case of women, there is a restructuring menstrual cycle, which subsequently disappears completely. Further, hair growth intensifies, gradually the female voice acquires lower male notes. As for men, during hormone therapy, their facial features become more feminine.

According to doctors, gender reassignment from women to men is much more difficult and the number of successful operations is much lower. The main reason for the problem is that it is incredibly difficult to replace female genitals with male ones. When it is much easier to make a semblance of a vagina from the male genitalia. For this procedure, part of the male penis and the scrotum are used, from which the labia is recreated. When the sex reassignment operation is completely successful and all procedures are performed with the highest quality, even gynecologists cannot suspect a sex change during examination. On average, the duration of operations of this nature is from 7 to 12 hours.

Sex reassignment and hormone therapy

Taking hormonal drugs when changing sex is an integral part of the path to change. Transsexual women are prescribed the use of estrogens, as well as antiandrogens, which will reduce the level of sex hormones in the body. At the same time, other female sex hormones can be prescribed, for example, progestogens, which are analogous to gestagens.

Reception of hormonal preparations begins at least 9 months in advance, and 4 weeks before the sex reassignment procedure, the use is stopped.

During the period of hormone therapy, it is necessary to check the level of hormones every month, for this a blood test is performed. For men who decide to become a woman, the level of testosterone is very important, which should approach a minimum during hormone treatment.

Sex change: the transformation of a man into a woman

As mentioned above, men more often decide to change their sex, feeling like a woman and trying to quickly discard the male shell. Male sex reassignment surgery will include the following:

• reproduction of the vagina and labia using scrotum tissue;
• breast augmentation using implants;
• facial plastic surgery to give a more feminine look.

It is worth noting that the preparation for the sex change operation is quite long. It is necessary to spend at least 3-4 years at receptions with psychotherapists and psychologists in order to be allowed to make such a reincarnation, as well as to realize it and adapt to future changes.

Sex change: from woman to man

It should be said right away that this procedure is difficult, both psychologically and physically. In order to perform an operation to change the sex of a woman into a man, it is necessary to carry out a series of manipulations:

• breast removal;
• complete removal of the pelvic organs (uterus, ovaries, fallopian tubes).

As in the case of men, a woman will also need long-term preparation, communication with psychotherapists, and adaptation measures.

A rather large difficulty lies in the creation of male genital organs. Phalloplasty is a very complex procedure and not always successful. Besides, maximum length The penis after surgery cannot be longer than 9 cm.

Today, Thailand is considered the leader in such operations. The surgeons of this country have vast experience in gender reassignment operations, in particular from male to female. In Thailand, such operations are widespread among the local population, do not require long-term preparation as in other wounds, and the price is almost 3 times lower than in Europe.

Sex change, or scientifically - a transgender transition, is a rather serious decision that must be fully conscious. A person must be 100% sure that there is no other way out, and this is his only way to get rid of the constant feeling of gender non-identity. A female-to-male gender reassignment operation will deprive her of her ability to ever have children, so it is worth considering other options for solving this problem.

Transgender transition, or to put it more plain language gender reassignment is a serious step in a person's life. It is necessary to think over it with special care, first of all, because it will not be possible to return the removed genitals back. But when moving from the female category to the male, there are some nuances.

What is female to male gender reassignment surgery

FtM sex reassignment is the surgical removal of female sexual characteristics and the reconstruction of male and human tissues. Such surgery is usually carried out in several stages and requires serious preparation.

concept

When compared with a similar procedure for turning a man into a woman, this one is more difficult to perform and requires a number of preparatory operations and other manipulations. It generally consists of three items:

• Removal of mammary glands ();
• Removal of female genital organs;
• Creation of the most natural likeness of the male genital organ.

It is the creation of male genital organs that is referred to as the most complex manipulations, which do not always end with a positive outcome.

In this case, the maximum length of the penis will be no more than 9 cm. For transsexuals, this can later create many problems and psychological complexes.

Kinds

Such a transformation of the genital organs is done in one of two ways:

1. Metoidioplasty, in which hormonal therapy produces more than 6 cm, after which an operative change is already carried out appearance. With this type of intervention, the final length of the penis will be no more than 5 cm, there will be no penetrating ability, but the sensitivity of the erogenous areas will remain. This type of intervention gives the least number of postoperative complications and is performed in one go.
2. will give a full penis from an aesthetic point of view with adequate dimensions. He will have a sufficient degree of sensitivity and penetrating power, allowing you to perform a full-fledged sexual intercourse. In the process, a special erectile prosthesis is placed in the vagina. But this operation is long, extremely complicated and requires tissue transplantation.

Indications

The indication for a transgender transition is transsexuality, which is confirmed by a qualified specialist.

Contraindications

Contraindications are:

• Lack of transsexuality;
• Systemic pathologies of a severe type;
• Severe mental disorders;
• Age up to 18 years;
• Elderly age;
• Desire to have a child;
• Homosexuality;
• Antisocial lifestyle;

This type of surgical intervention is not performed in the presence of pressure from relatives, friends and relatives of the patient.

Comparison with similar methods

Since this type of gender change is much more difficult, the number of operations with a positive outcome is much lower than with. This is due to the fact that it is much easier to transform the penis and scrotum into female genital organs than female into male.

It is worth noting that, unlike the MtF transformation, this operation has much more side effects and complications. At the same time, a sex change often ends with the fact that the opportunity to have sexual intercourse is lost forever, as well as the opportunity to have children. Accordingly, this noticeably adds psychological complexes.

It is worth noting that if you do not remove the female genital organs, but create male ones, then the function of childbearing is preserved. To do this, it will be enough just to stop drinking hormones. In the case of a transition from a man to a woman, there is no such possibility.

Holding

The operation requires serious preparation, which takes an average of 2 to 3 years. The operation itself is carried out in several stages, and the direct reconstruction of the male genital organ is carried out for 7-12 hours.

Necessary analyzes and activities

Preparation is required for a long time for such a responsible operation. Therefore, the patient will have to:

• Long-term and very close interaction with a psychiatrist, sexologist, endocrinologist for a long period of time (up to 2 years).
• The psychiatrist must issue a certificate of form F64.0, which indicates that the patient is transgender and needs surgery and further change of documents.
• A year before surgery, you need to take hormones, and a month before surgery, the reception stops.
• Get your hormone levels checked regularly.
• Lead a healthy lifestyle, take strengthening drugs.
• Conduct an interview with the head of the commission, who will issue permission for gender reassignment surgery. He will issue a referral to several paid psychiatric tests, the outcome of which will determine the further outcome of the preparation.
• After obtaining permission, clinics are monitored, then a consultation with the surgeon is carried out, the cost of the procedure and the postoperative hospital are determined.
• In 2 weeks, the necessary tests are given ( ; ; ; , hepatitis B and C, ; ), and other required types of examination.
• For 8 hours before the operation, it is forbidden to drink and eat.
• Before the operation, depilation of the pubic area (breast - depending on the type of intervention) is performed.

It is important to understand that doctors in some cases perceive transsexuality as a mental disorder, since there is no single answer to this question. Therefore, the doctor, at his discretion, may require from you a year's experience of living as a man. It is also worth understanding that the rehabilitation period after the operation will be difficult and require long-term treatment, hospitalization and recovery.

Algorithm

The operation can be carried out simultaneously with the implementation of all stages in one run, and may require a phased execution. Depends largely on the decision of the surgeon and the condition of the patient. To change sex, carry out:

• Removal of mammary glands with correction;
• Ovariectomy - removal of the fallopian tubes and ovaries;
• Vaginectomy - removal of the vagina;
• Colpocleisis - closing the entrance to the vagina;
• Hysterectomy with removal of the uterus;
• Reconstruction of the female genital organs into male one of the proposed types - either metoidioplasty or phalloplasty. In the process, the urethra, the penis itself and artificial testicles or testicles with a scrotum are created.

Possibility of combining with other types of plastics

In parallel, they can be carried out to remove excess fat from areas that make the body more rounded and feminine, as well. The latter will increase the volume of some areas, for example, the chin, calf muscles and much more, in order to recreate a male silhouette.

This video will tell about the case in relation to male sex reassignment surgery:

Rehabilitation

In the process of rehabilitation, the patient will have to face many difficulties and limitations:

• The loads are completely limited in the period after the operation;
• The first 8 days at least need to be spent in a hospital;
• Sexual life is impossible until the tissues are completely healed;
• Frequent visits to the doctor are required;
• After the operation, antibiotics, hormonal, pain medications are necessarily used;
• Produced pedantic care for the seams;
• Smoking and alcohol cessation is respected;
• The food is complete and no frills.

It is important to understand that the period of rehabilitation to the greatest extent depends on two factors - the professionalism of the doctor, as well as on the individual characteristics of the body. Therefore, a long healing process and the development of some complications often occur precisely because of the body's reaction to such a serious intervention by the surgeon. It is also worth mentioning life after the operation, which few people talk about. After the operation, you will have to face:

• Difficulties in paperwork;
• Probable hostility from the inner circle, relatives, friends and even spouses;
• Purely male diseases are acquired;
• Over the years, kidney and liver problems will develop due to hormone therapy;
• The functions of the lost female cannot be fully restored after the removal of the genitals;
• Postoperative adaptation is carried out with the help of a psychotherapist.

Result after surgery

Possibility of complications

Problems after surgery almost always develop. But which ones - will depend on how the body reacts to the intervention. These can be general surgical complications:

• Poor tissue survival and healing;
• Rejection of implants;
• bleeding;
• Lack of sensitivity in some areas;
• Complications after anesthesia on the heart and lungs.

Psychological complications most often occur when the patient is uncomfortable being a man. As a result of such a deviation, he will want to return the female sexual characteristics back. It should be noted that in this case, most often this phenomenon develops with an insufficient level of examination. It must be understood that if the patient before the operation behaved hysterically, depressively, and so on, then after surgical manipulations, these manifestations only worsen in most cases.

You still need to take care of your health...

Sex change plastic surgery

Having made plastic surgery to change sex, a person radically changes his life. But why do people decide on such an operation? How difficult is this plastic surgery?

The history of the operation

Dr. Harry Benjamin

Vaginoplasty- this is a change of sex from male to female, or vice versa. The first operations of this kind began to be carried out in Europe in the 50s of the 20th century. At that time, skin grafted from the thighs and buttocks was used to create vaginas. Operations had many shortcomings. They left behind numerous scars, the skin could not take root. In addition, sensitive tissue was removed, which led to difficulties in obtaining sexual pleasure, the inability to experience an orgasm.

The new technology of vaginoplasty, on the basis of which operations are carried out today, was developed by Georges Bourault in the 60s of the last century. It involves the formation of female genital organs from the skin of the scrotum and penis. This technology has several important advantages: vaginoplasty for men is carried out in one stage, the minimum number of scars, additional painful skin grafting operations are not required, and the ability to sexual satisfaction is preserved.

This technology was discovered by Buro only in 1973. Dr. Harry Benjamin, who was an American physician, a pioneer in the study of transsexuality, after the discovery of this surgical technique, began to systematically refer his patients to Dr. Buro. To date, it has been significantly improved both in terms of preserving the sensitivity of tissues and in terms of aesthetics. In 1978, a community of surgeons specializing in plastic surgery of intimate organs was founded in America.

Indications and contraindications for plastic surgery

Plastic surgery of the genital organs is performed according to the following indications:

Sex change from male to female

• transsexualism;
• Year of hormone therapy prior to surgery;
• Two years of observation by a psychiatrist;
• Obtaining a certificate with the appropriate diagnosis.

Contraindications to gender reassignment:

• No transsexualism detected;
• mental illness;
• Homosexuality;
• Alcoholism;
• Minority;
• Elderly age;
• genetic diseases;
• Drug addiction and other possible individual indications.

Demand for these operations

Each country has its own statistics on plastic surgery of intimate organs:

• America. There is one case of transsexualism in men and 0.25 in women per 100,000 people;
• Singapore. There are 35 cases of transsexualism per 100,000 people;
• England. For 10 years, 853 operations were performed in men, 12 in women;
• Thailand. It still ranks first in such operations.

World statistics: there are 1-2 cases of transsexualism per 100,000 population.

An interesting fact: if in Western countries plastic surgery of the genital organs is in great demand for men, then in Russia for 1 case of transsexualism in a man there are 3-4 cases of transsexualism in women.

Cost of gender reassignment surgery

After female to male reassignment surgery

The price of gender reassignment varies depending on the country:

• Thailand. This country is the most developed in terms of plastic surgery of the genital organs. This is already a separate area of ​​tourism with all the amenities: a luxury hotel, consultations with the best doctors, surgery and rehabilitation procedures. Estimated price of gender reassignment in Thailand is 7-10 thousand dollars;
• Russia. The cost of psychiatric consultations is about 15,000 rubles, and the cost of surgery is 550,000 rubles. In Russia, relative to other countries, there is a lack of both specialized training and equipment, which is why people usually choose to travel abroad for a sex change;
• America. The price of the main stage of the operation is 40 thousand dollars. The cost of breast removal is $4,000, penis shaping is $7,000, vaginal closure or urethra enlargement is about $4,000;
• Austria. All stages of sex change will cost 13-20 thousand dollars.

Before plastic surgery of intimate organs, it is necessary to carry out hormone therapy during a year.

Stages of the operation and its features

Before the operation, you must:

Stages of sex change in men

• Orchiectomy. The testicles are removed, as a result of which the production of testosterone in the body is reduced;
• Feminizing vaginoplasty. There are several technologies for this operation. Most often, female genital organs are created from the tissues of the penis. It is possible to use a vagina made of silicone or other fillers;
• with implantation of breast prostheses.

Model Lea T is a former male

• Removal of the Adam's apple;
• Plastic waist;

Stages of sex change in women

• Mastectomy. The mammary glands are removed. The nipple, at the same time, is preserved;
• . Creation of the penis from the tissues of the labia or body tissues;
• Uterus removal.

Possible additional operations:

• Muscle building,;

After operation

Rehabilitation after plastic surgery for sex change includes:

Before and after gender reassignment to female

• Daily douching of the vagina;
• Weekly lubrication of the vagina with Levomekol ointment;
• Daily lubrication of the seams with Solcoseryl ointment;
• Taking probiotics to restore the microflora of the gastrointestinal tract;
• Daily stretching of the vagina with fingers.

• You can have sex 1.5 months after discharge. Be sure to use special lubricants and condoms;
• For three weeks after leaving the hospital, you can not sit. Gradually develop motor activity, sit down, you can only from the fifth week after discharge;
• For 6 months after discharge, it is not allowed to squat. Physical activity should also be avoided.

Possible risks

Possible complications after gender reassignment:

12-year-old Leo is preparing to become a boy

• Inability to get sexual satisfaction;
• Loss of sensitivity in intimate places;
• necrosis of tissues in intimate places;
• Narrowing of the vagina, hair growth in it;
• Prolapse of the walls of the vagina;
• Insufficient aesthetics of the formed genitals.

Most complications after sex change are promptly identified and corrected. If the genitals do not look aesthetically pleasing, additional operations are performed.

Reasons for visiting the clinic after discharge:

Repeated operations are carried out in the following cases:

• Death of tissues of intimate organs;
• Fistula between vagina and rectum;
• Severe narrowing of the urethra;
• Noticeable scars.

It must be said that most people who have changed their sex are quite satisfied with their sex life. The ability to orgasm and sexual arousal, in most cases, is preserved.

Most transsexuals note that their sex life has become better and better. However, the risk of loss of tissue sensitivity and inability to experience sexual satisfaction remains.