Gender reassignment facts
How common is gender reassignment surgery?
Why do they do gender reassignment surgery?
How long does it take to recover from gender reassignment?
Is male to female surgery painful?
Can you really change your gender?
Can gender dysphoria go away?
At what age can you change your gender?
A decision to undertake gender reassignment is made when an individual feel that his or her gender at birth does not match their gender identity. This is called ‘gender dysphoria’ and is a recognized medical condition.
Gender reassignment refers to individuals, whether staff, who either:
- Have undergone, intend to undergo or are currently undergoing gender reassignment (medical and surgical treatment to alter the body).
- Do not intend to undergo medical treatment but wish to live permanently in a different gender from their gender at birth.
‘Transition’ refers to the process and/or the period of time during which gender reassignment occurs (with or without medical intervention).
Not all people who undertake gender reassignment decide to undergo medical or surgical treatment to alter the body. However, some do and this process may take several years. Additionally, there is a process by which a person can obtain a Gender Recognition Certificate, which changes their legal gender.
Transitioning is often two-fold: a social transition, such as new clothing, a new name and new pronouns; and a medical transition, with treatments such as hormone therapy and surgical procedures. Depending on the needs and wants of each individual, transitioning may include both social and medical transitions; just one of the two; or for those who eschew gender completely, neither.
Read more about: Gender reassignment surgery male to female
How common is gender reassignment surgery?
The sex ratio for the entire world population is 101 males to 100 females (2018 est.). Depending upon which definition is used, between 0.018% and 1.7% of live births are intersex. Transgender women report bottom surgery at rates between 5–13% (7-9,32). Even more transgender women desire bottom surgery in the future: between 45–54% (7,9). Among non-binary people assigned male at birth, 1% have had vaginoplasty or labiaplasty, and 11% desire these in the future.
Why do they do gender reassignment surgery?
A person may wish to undergo this type of surgery if they are uncomfortable having a uterus, ovaries, or fallopian tubes, or if hormone therapy does not stop menstruation.
Read more about: Facial feminization surgery
How long does it take to recover from gender reassignment?
Bottom surgery recovery
Three to six days of hospitalization is required, followed by another 7-10 days of close outpatient supervision. After your procedure, expect to refrain from work or strenuous activity for roughly six weeks.
Vaginoplasty requires a catheter for about one week. Full metoidioplasty and phalloplasty require a catheter for up to three weeks, until the point at which you can purge the bulk of your urine through your urethra on your own.
After vaginoplasty, most people generally need to dilate regularly for the first year or two, by using a graduated series of hard plastic stents. After that, penetrative sexual activity is normally enough for upkeep. The neovagina develops microflora similar to a typical vagina, although the pH level leans much more alkaline.
Scars tend to either be hidden in the pubic hair, along the folds of the labia majora, or simply heal so well as to not be noticeable.
Read more about: Sex change photo
Breast surgery recovery
After breast surgery You will wear a special bra and leave the surgical dressings on for 3 days after surgery. After 3 days, you can take the gauze pads off. There will be adhesive tapes (“steri-strips”) along the incision line; leave these on. At this point you can shower, being careful not to soak the steri-strips (it’s OK if they get splashed with a bit of water, but don’t run water directly over them). After showering, gently pat the steri-strips dry. They will fall off on their own in 7–10 days. It is normal for the incisions to be red, but the redness shouldn’t go beyond the incision for more than 1–2 cm (if this happens, see a doctor right away, as it can be a sign of infection). It is also normal to see or feel the knot in the stitches at the end of the incision. The stitch knot is not a problem; it will either dissolve on its own or come to the surface of your skin, in which case a doctor or nurse can clip it free. A medium level of bruising and swelling is normal. Your breasts will probably feel sore and swollen for at least a month after surgery. If you have a large amount of swelling, see a doctor. Feelings of sharp shooting pain, burning pain, or general discomfort are common as part of the healing process and will eventually go away. Usually serious discomfort 6 passes 1–2 days after the surgery. Three to five days after surgery, you can start special breast massage exercises that your surgeon will show you. You can go back to your usual routine when you feel well enough to do so (i.e., normal movements don’t cause pain). This is typically 1–2 weeks but can take longer in some cases. You should avoid any activity that is vigorous enough to raise your heart rate for 3–4 weeks.
Facial surgery recovery
The aftercare instructions are different for different types of facial surgery and depend on the specific technique used. Talk with your surgeon before surgery to make sure you understand what to expect and what you need to do after you’ve been discharged from the hospital, and to talk about pain management options.
- Forehead surgery: Pain medication and antibiotics will be prescribed.
- Day after surgery: The dressing around the forehead can be removed. You can then gently wash your hair, taking care not to get any dressings used for nose/chin surgery wet (if you have had multiple surgeries done at the same time).
- Within 8 days after surgery: Sutures and staples used to close scalp incisions are usually taken out by the surgeon. Most people feel well enough to go back to work by this time (but vigorous activity should not be done until 2 weeks after surgery).
- Within 10–12 days after surgery: Swelling and bruising around the eyes typically goes away by this time.
- b) Cheek augmentation: Pain medication and antibiotics will be prescribed. You can clean your teeth as normal, being careful not to brush over the incision line if the implant was placed through your mouth.
- First 1–3 days after surgery: Temporary numbness and swelling may interfere with speaking, smiling, yawning and chewing. You should avoid foods that are hard to chew for the first few weeks.
- Within 2 weeks after surgery: Swelling has typically gone away by this time.
- c) Nose surgery: Pain medication will be prescribed. If you wear glasses, you will get special instructions as the nasal pads that rest your glasses on your nose can’t touch the nose for one month after surgery.
- First 1–2 days after surgery: Internal nasal packing will stay in to support nasal tissues during the early phase of healing. The packing will be taken out by the surgeon. 15
- Day 8 after surgery: The external cast around your nose will be taken off by the surgeon. Be careful not to get this cast wet while it is still on.
- Within 2 weeks after surgery: Bruising around the nose and eyes typically fades by this time.
- One month after surgery: It is safe to do vigorous activity after this time. You can go back to wearing your glasses as normal.
- d) Chin reduction: Pain medication will be prescribed.
- Recovery time depends on the type of technique done; if significant bone reconstruction has been done recovery can take 4–5 weeks, with swelling remaining for up to 3–4 months.
- Usually you can go back to light work 5–6 days after surgery. e) Jaw reduction: Pain medication will be prescribed.
- The face is usually moderately swollen and bruised after surgery. Most of the swelling gradually fades over 10–14 weeks, but it can be difficult to see change until swelling has fully gone down 3–4 months after surgery.
- Usually you can go back to work 10–14 days after surgery.
- f) Lip augmentation: Usually a relatively minor procedure. There may be some swelling that typically goes away within 10–14 days of surgery.
Genital surgery recovery
Generally people start to feel more physically comfortable during the second week after surgery, but it can take a long time to fully heal, and there can be pain and soreness for a long time after genital surgery. You will see the surgeon at least once in the week after surgery, and then periodically after that. The surgeon will do a physical exam to check your general health and will also check your new clitoris for healing and sensation. You will be asked questions about your bowel and bladder function, and the surgical incisions will be checked for infection and scarring.
If you have had a vaginoplasty, the surgeon will put a finger inside your vagina to check healing. For the first 8 weeks after vaginoplasty you will continue to wear a prosthesis inside your vagina most of the time. At first, you will only take it out once a day, when you do routine cleaning (you will douche once a day initially). The amount of time the prosthesis is left out will gradually be increased (as per the surgeon’s protocol). You will have to continue to dilate your vagina every day, either by sex (dildo/penis/fingers) or using the dilator, to keep your vagina open. If you do not dilate every day, your vagina may become narrow and short.
If as part of vaginoplasty you have had a graft, you will have an incision at the graft site – usually the abdomen just above the pubic bone. Adhesive strips (“steri-strips”) will be used to bring the edges of the wound together and promote healing. Hospital staff will check this incision and change your dressings on a regular basis. After you go home, schedule an appointment with your regular GP or nurse to check the healing of the graft site and make sure it is not infected. It is normal for the incisions to be red, but the redness shouldn’t go beyond the incision for more than 1–2 cm (if this happens, see a doctor right away, as it can be a sign of infection).
It is also normal to see or feel the knot in the stitches at the end of the incision. The stitch knot is not a problem; it will either dissolve on its own or come to the surface of your skin, in which case a doctor or nurse can clip it free. You can go back to your usual routine when you feel well enough to do so (i.e., normal movements don’t cause pain). This is typically 4–6 weeks 21 but can take longer in some cases. You should avoid any activity that is vigorous enough to raise your heart rate until you have fully recovered. Check with your surgeon if you are not sure.
Read more about: Sex reassignment surgery
Is male to female surgery painful?
For the patient, severe pain, bruising and general discomfort for days after the male-to-female procedure are common. And the female-to-male gender-reassignment surgery is even more difficult surgically, with a longer recovery period. By the second week you will start to feel more comfortable physically, but your recovery will take a long time. It is natural to experience pain and soreness for a long time after genital surgery.
Read more about: side effects of gender reassignment surgery
Can you really change your gender?
Humans are most commonly said to have "a sex change" when they undergo sex reassignment therapy, that is, a set of medical procedures undergone by transgender people to alter their sexual characteristics from male to female or from female to male. The term may also refer specifically to sex reassignment surgery, which usually refers to genital surgery only. The term is also sometimes used for the medical procedures intersex people undergo, or, more often, are subjected to as children.
The term "sex change" is sometimes also used for the whole process of changing gender role ("living as a woman" instead of living as a man, or vice versa), not limited to medical procedures. (This process is often much more important to transgender people than the medical procedures themselves, although medically induced changes and surgeries may be needed to make a change of gender role possible, both socially and legally; they can also have a very significant impact on the person's well-being.)
Many people regard the term "sex reassignment surgery" as preferable to "sex change".Sex in humans is usually determined by four factors:
- Chromosomes
- Gonads (Ovaries and/or testicles and the associated gametes, eggs and sperm)
- Hormone status
- Primary sex characteristics and secondary sex characteristics
Can gender dysphoria go away?
Gender dysphoria is a serious and persistent condition, psychiatrically distinguishable from other issues of gender-expansive expression or confusion, or sexual orientation that may normally occur during childhood or adolescence.
Treatment can help people who have gender dysphoria to explore their gender identity and find the gender role that feels comfortable for them, easing distress. But treatment needs to be individualized. What might help one person might not help another. The process might or might not involve a change in gender expression or body modifications. Treatment options might include changes in gender expression and role, hormone therapy, surgery, and behavioral therapy.
If you have gender dysphoria, seek help from a doctor who has expertise in the care of transgender people.
When coming up with a treatment plan, your provider will screen you for mental health concerns that might need to be addressed, such as depression or anxiety. Failing to treat these concerns can make it more difficult to explore your gender identity and ease gender dysphoria.
Read more about: sex reassignment surgery regret
At what age can you change your gender?
Transgender youth are children or adolescents who do not identify with the sex they were assigned at birth. Because transgender youth are usually dependent on their parents for care, shelter, financial support, and other needs, and because most doctors are reluctant to provide medical treatments to them, transgender youth face different challenges compared to adults. There is a broad consensus among experts and professional associations that appropriate care may include supportive mental health care, social transition, and puberty blockers, which delay puberty and the development of secondary sex characteristics to give children time to make decisions about more permanent courses of action.
Questions have been raised regarding the morality of allowing children to transition and whether or not children can give informed consent for transitioning, as there are permanent ramifications from hormone therapy, and most children with gender dysphoria end up identifying with their biological sex after reaching puberty.
Read more about: sex reassignment surgery meaning