How Does Sex Change Work?
Sex change surgery also referred to as sex reassignment surgery is a series of surgery to change the physical appearance and genitals of a person suffering gender dysphoria. It is a condition where a person feels a mismatch between their biological sex and gender identity; a person who identifies as a female but was assigned male at birth or vice versa.
Sex change surgery is irreversible. Therefore, it is a decision that needs careful consideration. Let us try to understand how sex change work?
There are two types of sex change processes, male to female and female to male.
Male to Female surgery
This procedure is done in patients assigned male at birth who want to change to female; it includes:Genital Surgeries
- Penectomy- It is a process where the penis is removed. The penile skin is inverted and preserved to make the lining of a vagina. The urethra will be surgically reshaped to form a special urinary drainage passage called a perineal urethrostomy.
- Orchiectomy- Radical inguinal orchiectomy is generally preferred for a sex change; both testicles are removed through a tiny cut in the abdominal area right above the pubic area instead of the scrotum and the testicles are pulled out. It can take two weeks to two months to fully recover from an Orchiectomy.
- Vaginoplasty- As already mentioned in the Penectomy section, the inverted penile skin is used to create a new vagina. The skin is cut into the appropriate size. The skin flap is sometimes combined with a scrotal or urethral flap
Non-genital surgeries
- Breast Augmentation- To acquire a more feminine appearance, breast implants are used in the sex change process. Implants are embedded below the breast tissue; the implants are filled with either saline water or silicone.
- Gluteoplasty- This is an optional procedure wherein the buttcheeks are enhanced to have more volume and femininity. The tissues are taken from surrounding areas and repositioned into the buttocks.
- Hormone change- Feminizing hormone therapy is done in addition to surgeries to suppress the production of testosterone. Progesterone and estrogen hormones are injected to change hair growth, voice pitch to enhance the femininity of the person.
FEMALE to MALE SURGERY
It involves:- Genital Assignment- This procedure is done to create a penis. There are multiple ways this is achieved. There are two ways to achieve this, Phalloplasty and Metioplasty. In phalloplasty, a penis is constructed using graft from the arm, thigh or abdomen. The penis is large but it is hard to achieve a proper erection, so a penile implant are used to ensure the possibility of erection. In Metoidioplasty, the clitoris is enlarged using hormone replacement therapy. The clitoris is enlarged to a neopenis. Sexual sensation and erection are completely functional in this case.
- Hysterectomy-A hysterectomy is an operation to remove the uterus. This procedure leaves the ovaries intact, and should not induce menopause. In total hysterectomy, the surgeons will remove your cervix as well. In gender change surgery, Salpingo-Oophorectomy is also performed, where the ovaries and the fallopian tubes are also removed. Removing ovaries will require hormone replacement therapy.
- Male chest reconstruction- Opposite to breast implant, in a male chest reconstruction procedure, the breast tissues are removed from the chest. The nipples are also altered. The surgeon then contours the chest to a more masculine structure. However, if the person already had small breasts, they can administer hormones to reduce the size by lowering estrogen levels.
- Hormone therapy- To gain a masculine appearance, androgens are administered to masculinise the body. It results in the deepening of voice, growing of more pubic hair and armpit hair as well as facial hair. The hormones suppress menstruation and suppress estrogen levels.
