Male-to-female (MTF) gender reassignment surgery

The decision to change sex to female — is a very personal and important step. During this period, it is important to have support, the opportunity to calmly ask the doctor all questions and receive professional medical care.

At the Oxford Medical clinic, consultations of specialized specialists, necessary examinations and surgical interventions in a modern inpatient department are available. Consultations are conducted by plastic and genital surgeons with more than 20 years of experience, who specialize in such operations.

In our medical center, you can calmly discuss your expectations, learn about the possibilities of modern surgery, the specifics of preparation and rehabilitation. Also, in the clinic you can undergo all the main stages of transgender transition from man to woman. Sign up for a consultation by phone or through the online appointment form on the website.

MTF (Male-to-Female) — is a medical term used to denote the transition from male sex to female. For some people, such a transformation from man to woman includes hormone therapy and surgical interventions aimed at forming female sex characteristics and a more feminine appearance.

MTF surgery is not limited to one intervention. The operation plan is formed individually — taking into account the person’s wishes, the results of hormone therapy, anatomical features and general health condition. That is why preparation for MTF transition usually takes place in stages and includes consultations with different specialists.

The plan of MTF transition may include several different surgical stages. The scope of interventions depends on anatomical features and on which changes are most important for the person.

One of the key areas is genital surgery. Such interventions may include:

• orchiectomy — removal of the testicles;
• penectomy — removal of penile tissues;
• vaginoplasty — formation of the vagina and external female genital organs;
• clitoroplasty — creation of the clitoris with preservation of tissue sensitivity;
• labioplasty — formation of the labia minora and labia majora;
• urethroplasty — correction of the urethra in accordance with female anatomy.

For some patients, operations on the chest are an important component of transition. In such cases, mammoplasty may be performed — breast augmentation with implants to form more feminine body contours. Sometimes correction of the breast shape after hormone therapy may also be performed.

A separate area is feminization of appearance. At the patient’s request, operations may be performed to soften masculine facial features and form more feminine proportions. These may include correction of the shape of the nose, eyelids, chin, jaw, or reduction of the prominence of the Adam’s apple.

Specialists of Oxford Medical note: it is important to understand that not all patients undergo the same scope of operations. For some, one or two stages are enough, others choose a more comprehensive transformation of the body from man to woman. That is why the transition plan is always formed individually after consultation.

The main indication for MTF surgery is a persistent feeling of mismatch between a person’s gender identity and the male sex characteristics of the body. For many patients, the surgical stage becomes an important part of the transition and helps them feel more comfortable in their own body.

Before the operation, the patient undergoes consultations with specialists, examination and preparation. Doctors assess the general state of health, the results of hormone therapy, the presence of chronic diseases and possible risks associated with anesthesia and surgical intervention.

Absolute contraindications may include:

• severe blood clotting disorders;
• decompensated cardiovascular diseases;
• severe conditions in which performing an operation or anesthesia is dangerous to the patient’s life.

In some cases, the operation may be temporarily postponed. This may be related to an exacerbation of chronic diseases, acute inflammatory processes, active infections or conditions that require additional treatment or stabilization before surgical intervention.

Doctors of «Oxford Medical» recommend openly discussing with specialists all questions that are of concern before the operation, as well as the specifics of the state of health and hormone therapy. This helps to go through preparation more calmly, better understand the future stages of transition and make the operation as safe as possible.

Preparation for MTF transition usually takes place in stages. It may include consultations with specialists, hormone therapy, examination and preparation for surgical intervention. The scope of preparation depends on the individual transition plan, state of health and type of operation.

One of the important stages is hormone therapy. It helps gradually form more feminine features of appearance, affects the condition of the skin, distribution of fatty tissue, hair growth and other secondary sex characteristics. Hormone therapy also has significance for preparing tissues for the future operative intervention.

Before the operation, the patient may be recommended:

• consultation with a surgeon;
• consultation with an endocrinologist;
• consultation with an anesthesiologist;
• consultation with a psychiatrist or psychotherapist;
• laboratory tests;
• ECG;
• fluorography or X-ray of the chest organs;
• ultrasound of the prostate;
• additional examinations according to indications.

A few weeks before the operation, the doctor may recommend temporarily limiting smoking, alcohol or adjusting the intake of certain medications. This helps reduce the risk of postoperative complications and improve the recovery process.

Doctors of «Oxford Medical» recommend not trying to go through all stages as quickly as possible. Calm staged preparation helps to better adapt to changes, more easily undergo the operation and more comfortably go through the recovery period.

The surgical stage of MTF transition is always planned individually. For some patients, it may consist of one intervention, but more often it takes place gradually — with several separate operations and recovery periods between them. The sequence and scope of interventions depend on the individual transition plan, state of health and desired result.

Most sex reassignment operations are performed under general anesthesia in the conditions of a surgical inpatient department. The duration of the intervention depends on its complexity and scope. For example, reconstructive operations on the genitals require especially careful work with tissues and may last several hours.

Each surgical stage usually includes:

• preoperative preparation and hospitalization;
• consultation with an anesthesiologist;
• performing the operation;
• postoperative observation in the inpatient department;
• dressings, control of healing and rehabilitation.

In the Oxford Medical medical center, operations are performed in a modern high-tech inpatient department equipped with expert-class equipment. For the safety of patients, intensive care wards and round-the-clock medical observation in the early postoperative period are provided.

After the operation, patients stay in comfortable single or double hotel-type wards with everything necessary for recovery. In the inpatient department, postoperative care, monitoring of well-being, high-quality and tasty nutrition and constant support of medical personnel are provided.

After MTF surgery, recovery takes place gradually and may last from several weeks to several months — depending on the scope of the intervention and the individual characteristics of the body. In the first days after the operation, the patient stays in the inpatient department under the supervision of medical personnel. Doctors monitor well-being, the healing process and the condition of postoperative sutures.

After discharge, the patient receives detailed recommendations on care, hygiene, physical activity and taking medications. After reconstructive interventions on the genitals, it is especially important to follow the rules of postoperative care and undergo follow-up examinations in a timely manner.

In the first weeks after the operation, swelling, discomfort, increased tissue sensitivity or a feeling of tightness in the intervention area may persist. Such manifestations gradually decrease as healing progresses. The final result of the operation is assessed after the main recovery period is completed and postoperative swelling decreases.

During the rehabilitation period, doctors usually recommend:

• avoiding intense physical exertion and sports activities;
• not lifting heavy objects;
• temporarily giving up the sauna, swimming pool and hot baths;
• following recommendations on intimate hygiene;
• not independently stopping the intake of prescribed medications or hormone therapy;
• regularly undergoing postoperative examinations.

After MTF surgery, hormone therapy usually continues further under the supervision of an endocrinologist. During this period, it is important for the patient to follow recommendations on taking medications and regularly monitor the state of health.

For some patients, psychological adaptation to changes in the body and a new stage of life is also an important stage after the operation. If necessary, a person may seek support from a psychotherapist or another specialist.

Doctors of «Oxford Medical» recommend not remaining alone with questions or worries during recovery. Timely consultation with a specialist helps to go through rehabilitation more calmly and feel more confident after the operation.

After MTF transition, some changes in the body become irreversible, so it is important to discuss in advance with a specialist the features of the further lifestyle and medical observation. After reconstructive operations on the genitals, tissue sensitivity, features of intimate hygiene and sexual life may change.

After transition, the patient usually needs to continue to be under the supervision of an endocrinologist and regularly monitor the hormonal background.

The issue of fertility requires separate attention. Some stages of transition, in particular hormone therapy and reconstructive interventions, may affect the possibility of having biological children. That is why it is advisable to discuss this issue even before the start of the surgical stage.

Our doctors recommend openly discussing with a specialist even before the operation possible changes after transition, features of recovery and further medical support. This helps to go through all stages of transition more calmly and better prepare for future changes.

The cost of MTF transition depends on the scope of surgical interventions, the duration of stay in the inpatient department and the specifics of postoperative recovery. At the «Oxford Medical» clinic, the transition plan is formed individually — after consultation with a specialist and assessment of the patient’s state of health. That is why the final price is determined personally.

You can preliminarily familiarize yourself with the prices for medical services here. To make an appointment for a consultation, leave a request through the online appointment form on the website or contact the clinic’s contact center at a time convenient for you.

The information is for informational purposes and does not replace a doctor’s consultation.

Sources:

• World Professional Association for Transgender Health
• Endocrine Society
• US National Library of Medicine