Understanding Sex Reassignment Surgery
Sex reassignment surgery, or gender confirmation surgery, is a medical procedure that alters a person’s physical sex characteristics to align with their gender identity. This surgery can involve transgender operation changing male genitalia to female (vaginoplasty) or female genitalia to male (phalloplasty).
What Does Sex Reassignment Surgery Involve?
The approach to surgery differs depending on whether the transition is from male to female or female to male. However, in both cases, patients are typically required to stop hormonal treatments several weeks before the surgery.
Transition from Male to Female: Vaginoplasty
For male-to-female surgery, known as vaginoplasty, the procedure involves reshaping the existing genitalia to create a natural-looking and functional vagina. The surgeon begins by opening the penis and separating the cavernous bodies and neurovascular bundles. The excess skin is then used to form the vaginal walls, and the glans is repurposed to create a clitoris, which allows for sensation. The scrotal skin is used to form the labia, and a vaginal cavity is created between the bladder and the rectum. The urethra is shortened and repositioned in front of the newly created vagina. A dressing is applied to ensure that the vaginal skin remains in place during the healing process.
Transition from Female to Male: Phalloplasty
For female-to-male surgery, known as phalloplasty, the procedure involves constructing a penis using tissue grafts from other parts of the body, such as the abdomen, thighs, or arms. The newly constructed penis allows for standing urination and is sensitive to touch. However, to enable sexual intercourse, a penile prosthesis may need to be implanted. After the penis is shaped using the chosen tissues, it is positioned, and the veins and arteries are carefully sutured.
Nerves from the clitoris are connected to the newly formed penis to preserve sexual sensation. The clitoris itself is hidden inside the reconstructed penis. The urethra is extended using a skin graft from the inner vaginal wall. The labia majora are used to create a scrotum, into which silicone testicular implants are placed.