Gender reassignment surgery

Gender transition — is an important and very personal stage in a person's life. During this period, it is important to have support, the opportunity to calmly ask all questions to the doctor, and receive professional medical care.

At the «Oxford Medical» clinic, you can undergo consultations with specialists, necessary examinations, and surgical treatment in a modern surgical inpatient department. We have a team of experienced doctors who specialize in sex reassignment surgeries. In particular, consultations are conducted by a genital surgeon with more than 20 years of experience, who underwent training and internships in leading clinics of Europe.

If you are considering the possibility of surgical treatment or want to learn more about the stages of gender transition, we invite you to schedule a consultation with an «Oxford Medical» specialist. You can schedule an appointment by phone or through the online appointment form on the website.

Most often, for such interventions the terms surgical sex correction, gender-affirmative surgery, or SRS (Sex Reassignment Surgery — surgery for changing sex characteristics) are used.

Modern transgender surgery covers two main types of surgical interventions:

• Male-to-Female (MTF) — sex change from male to female. Such operations may include vaginoplasty, clitoroplasty, breast augmentation, as well as separate interventions for feminization of the face and body.
• Female-to-Male (FTM) — sex change from female to male. Such interventions may include mastectomy, metoidioplasty, phalloplasty, and other reconstructive interventions for masculinization of appearance.

Specialists of «Oxford Medical» note: it is important to understand that gender-transforming surgery does not always include all these operations. The correction plan is selected individually — depending on the patient's wishes, anatomical features, and health condition.

The scope of surgical interventions during transgender transition is determined individually. For some patients, one surgical stage is sufficient, while others undergo several sequential operations to gradually achieve the desired result.

Modern gender-transforming surgery may include operations:

• on the genital organs;
• on the chest — breast augmentation or mastectomy;
• for correction of facial features;
• for changing body contours.

Before the start of the surgical stage, the doctor discusses in detail with the patient the possible techniques, preparation features, expected result, and further rehabilitation. This helps to form realistic expectations and draw up an optimal plan of surgical interventions.

The main indication is persistent gender dysphoria — a condition in which a person feels a mismatch between their own gender identity and the sex characteristics of the body. The decision about surgical intervention must be conscious, voluntary, and made after consultations with specialists and the necessary preparation.

Before the operation, the doctor evaluates the patient’s general state of health, examination results, the presence of concomitant diseases, and possible risks of surgical intervention.

Absolute contraindications may include:

• severe blood clotting disorders;
• decompensated cardiovascular diseases;
• severe conditions that do not allow surgical intervention and anesthesia to be performed safely.

The operation may also be temporarily postponed in such conditions:

• oncological diseases;
• uncontrolled chronic diseases;
• active infectious diseases, in particular HIV and viral hepatitis;
• exacerbation of mental disorders;
• acute inflammatory processes in the body.

That is why before surgical intervention it is important for the patient to undergo consultations with specialists and a full set of examinations.

An important part of gender transition is hormone therapy, which helps to gradually change secondary sex characteristics in accordance with a person’s gender identity. In most cases, it is hormone therapy that is one of the key stages of preparation for surgical intervention, since it affects the condition of tissues, the features of the future operation, and the further result.

Hormone therapy is prescribed and monitored by an endocrinologist. The doctor evaluates the hormonal status, the patient’s general state of health, possible contraindications, and, if necessary, adjusts the therapy regimen.

Before the start of the surgical stage, the patient undergoes consultations with specialists, examinations, and the necessary preoperative preparation. The following may be recommended:

• consultation with a plastic surgeon;
• consultation with a genital surgeon;
• consultation with a psychiatrist or psychotherapist;
• consultation with an anesthesiologist;
• laboratory blood and urine tests;
• coagulogram;
• ultrasound of the pelvic organs;
• electrocardiogram (ECG);
• fluorography or X-ray of the chest organs;

Immediately before the operation, it is also necessary to take tests, the list of which is determined individually depending on the type of intervention and the general state of health. Several weeks before hospitalization, the doctor may recommend temporarily limiting smoking, alcohol, the use of certain medications, or adjusting hormone therapy. This helps reduce the risk of bleeding, thrombosis, and other postoperative complications.

Our doctors recommend not postponing the consultation, even if you are only beginning to think about the surgical stage of transition. A detailed discussion of all stages of preparation, the possibilities of modern surgery, and the features of rehabilitation helps to feel more confident and make a decision calmly and consciously.

SRS (Sex Reassignment Surgery) — is a general name for surgical interventions aimed at the reconstruction of sex characteristics in accordance with a person’s gender identity. Such operations belong to complex reconstructive interventions. Their feature lies not only in the aesthetic change of external sex characteristics, but also in the correction of functional aspects — urination, tissue sensitivity, anatomical symmetry, and the patient’s further quality of life.

The plan of surgical intervention is always formed individually. The doctor evaluates anatomical features, the results of hormone therapy, the general state of health, and the expected result. In some cases, the surgical stage may involve several sequential operations with an interval of several months.

It is important to understand that genital surgery requires not only high-quality performance of the intervention itself, but also proper rehabilitation and regular medical observation after the intervention. That is why it is important for the patient to follow the doctor’s recommendations at all stages of recovery.

Our doctors recommend discussing in detail with the specialist not only the desired result, but also the features of the postoperative period, possible limitations, and stages of recovery. This helps to form realistic expectations and better prepare for changes.

Most sex reassignment surgeries are performed under general anesthesia. The scope and technique of the intervention are determined individually — depending on the type of transition.

The main stages may include:

• hospitalization of the patient and preoperative preparation;
• consultation with an anesthesiologist before the intervention;
• reconstruction of external sex characteristics;
• postoperative observation in the inpatient department;
• further rehabilitation and follow-up examinations.

The surgical stage may include changing the genital organs, correction of the chest, or other reconstructive interventions according to the individual transition plan. Some interventions are performed in stages, with an interval of several months, which allows the body to recover gradually and reduces the risk of postoperative complications.

At the «Oxford Medical» medical center, surgical interventions are performed in a modern high-tech inpatient department equipped with expert-class equipment. The operating rooms are equipped with everything necessary for the safe performance of complex reconstructive operations and anesthesiological support. The clinic also has intensive care wards, which makes it possible to provide round-the-clock medical monitoring and patient safety in the early postoperative period.

After the operation is completed, the patient stays under the supervision of medical staff in the inpatient department. For comfortable recovery, the clinic provides single and double hotel-type wards with functional beds, separate bathrooms, air conditioning, Wi-Fi, and buttons for calling medical staff. Patients are provided with full nutrition, postoperative care, and constant medical support.

Before discharge, the doctor provides individual recommendations regarding care, physical activity, hygiene, taking medications, and further follow-up examinations. Following these recommendations is an important part of successful recovery.

The duration of the operation depends on the type of intervention and its complexity. For example, interventions on the chest usually last 2–4 hours, while complex reconstructive interventions on the genital organs may take 6–10 hours.

In most cases, trans transition takes place in several stages. First, the patient undergoes hormone therapy and preparation for surgery. Then separate surgical stages may be performed — for example, mastectomy or breast augmentation, reconstructive operations on the genital organs, and additional interventions for feminization or masculinization of appearance.

Between separate operations, a break from several months to a year is usually needed. This is necessary for full healing of tissues, recovery of the body, and assessment of the result of the previous stage.

In general, gender transition may last from one to several years — depending on the scope of operations, the individual transition plan, and the features of the patient’s recovery.

In the first days after the operation, the patient stays under the supervision of doctors in the inpatient department. Medical staff monitor well-being, the healing process, the condition of postoperative sutures, and the functioning of drains, if they are installed.

After discharge, it is important for the patient to follow the doctor’s recommendations regarding:

• treatment of postoperative sutures;
• taking prescribed medications;
• limiting physical activity;
• intimate hygiene;
• wearing compression underwear or bandages if necessary;
• attending follow-up examinations.

In the first weeks after the operation, swelling, discomfort, increased sensitivity, or temporary decreased tissue sensitivity may persist. This is a normal part of the healing process. The final result of the operation is usually assessed after several months, when the tissues fully recover and the postoperative swelling decreases.

After reconstructive operations on the genital organs, rehabilitation may be longer and require more careful care. In such cases, the doctor explains in detail the rules of hygiene, limitations of physical activity, the timing of return to intimate life, and the features of further observation.

During the recovery period, it is important for the patient to avoid:

• intensive physical activity;
• lifting heavy objects;
• overheating of the body;
• visiting the sauna, swimming pool, and hot baths;
• independent discontinuation of prescribed medications.

After the operation, continuation of hormone therapy and regular observation by specialists may also be recommended. For some patients, psychological support and adaptation to changes after the surgical stage of transition are an important component of recovery.

Doctors of «Oxford Medical» recommend paying close attention to any changes in well-being after the operation. If severe pain, bleeding, increased body temperature, pronounced swelling, or other unusual symptoms appear, it is necessary to consult a doctor immediately.

The cost of sex reassignment surgery depends on the type of surgical intervention, its complexity, the number of stages, the duration of stay in the inpatient department, and the scope of necessary preoperative preparation. Anesthesiological support, postoperative observation, and features of rehabilitation may also affect the final cost.

At the «Oxford Medical» clinic, the price for sex reassignment surgery is formed individually — after consultation with a specialist, assessment of the patient’s health condition, and development of a personal transition plan. You can preliminarily familiarize yourself with the prices for medical services here. To schedule 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