Understanding Gender Affirming Surgery
Some patients may choose to undergo gender affirming surgical interventions as part of their medical care to increase congruence of gender and overall well-being.
WPATH standards of care guidelines can be helpful in understanding surgical transition requirements followed by many surgeons to increase patient satisfaction. For more information regarding mental health referral letter requirements please visit Mental Health & Social Transition.
The Basics of Common Gender Affirming Surgical Options
Electrolysis is considered a surgical procedure to permanently remove hair from designated areas of the body as part of the process of aligning a patient’s body to their gender. The amount and location of hair removal is dependent upon the patient. Generally electrolysis is a stand-alone procedure (e.g., facial hair) or precedes trans-feminine bottom surgeries.
FFS includes a variety of procedures to the face and neck areas. These procedures consist of hairline advancement, tracheal shave, rhinoplasty (nose reshaping), jaw and chin contouring, and forehead and brow reshaping. Patients should discuss with their surgeons regarding surgical goals of care.
Tracheal Shave is a surgical procedure often performed on an outpatient basis to reduce the size of the laryngeal prominence, commonly referred to as an Adam’s apple.
Voice Feminization Surgery is a procedure by which the surgeon shortens the length of the vocal cords to change the voice to have a higher pitch. Vocal coaching along with a Speech and Language Pathologist is required before surgery.
Breast Augmentation is the procedure by which the surgeon inserts implants into the chest or uses fat from other parts of the body such as the buttocks, abdomen(belly area), and thighs to create a more feminine-appearing chest.
Chest Reconstruction is the procedure by which the surgeon removes breast and fat tissue from the chest to create a less feminine or more masculine-appearing chest. Individuals who undergo chest masculinization or non-binary reconstruction will continue to need preventative chest health cancer screenings.
Hysterectomy is the procedure by which an OB/Gyn removes the uterus and/or ovaries. If ovaries are removed there is an impact on hormonal production that will need addressed with HRT.
Metoidioplasty is the procedure by which the surgical team consisting of plastic and urological surgeons collaborate to create a phallus from the clitoris. This procedure includes release of a ligament that holds down the clitoris and surrounding areas. During the procedure a patient may also undergo a hysterectomy and vaginectomy. A scrotum can also be created, and testicular implants can be inserted pending patient preference.
Orchiectomy is the procedure for removing testes while all other parts of the anatomy and genitalia are left intact. Individuals may choose this surgical intervention to eliminate testosterone production without having to undergo full genital reconstruction.
Phalloplasty is a multi-stage surgery to create a phallus from skin taken from an area of the body and moved to the pelvic area. The urethra can be lengthened to the tip of the phallus. This is a complex surgery and is only done by experienced surgeons.
Vaginoplasty & Vulvoplasty are complex surgeries by which the surgical team creates a vulva and/or vagina of varying depth. This procedure often requires electrolysis of the skin prior to the procedure.