Wednesday, April 10, 2024

Female To Male Gender Reassignment Surgery

Recent Events Affecting Transgender Surgeries

Gender Affirmation Surgery Options for Female to Male Patients | UCLAMDChat

Fast-moving currents of both positive and negative change are affecting individuals access to gender reassignment treatments. To a growing extent, health insurance companies and large employers are covering gender-altering surgeries. A Willis Towers Watson industry survey found that an increasing number of employers are taking action to add transgender medical benefits. In December 2020, a federal prisoner in Wisconsin won her lawsuit demanding sexual reassignment surgery. And in May 2021, the Utah Supreme Court affirmed the right of transgender people to change their sex designation on their birth certificate.

On the other hand, based on reporting by The New York Times, hundreds of bills restricting the rights of transgender people have been introduced across the U.S. Treating gender dysphoria in younger people is particularly controversial.

For example, in May 2021, Karolinska hospital in Stockholm, the first in Sweden to offer gender identity assessments for children, stopped giving hormone treatment. This happened after the hospital found the treatments were causing serious, sometimes irreversible, side effects such as cardiovascular disease, osteoporosis, infertility, cancer, and thrombosis.

Outcome Of Surgical Gender Reassignment

There have now been several reviews of the outcome of gender reassignment surgery and their conclusions were summarized by Carroll . Lawrence reported on 232 male-to-female surgical reassignments all carried out by one surgeon between 1994 and 2000. Using a 010 scale to rate happiness with result, 86% scored 8 or higher. None reported consistent regret about having the surgery, and any regret that was reported was about disappointment with the functional outcome of the genital reconstruction, rather than with the gender reassignment per se.

Those whose transgender emerged from a previous phase of fetishistic transvestism or autogynephilia were more likely to regret reassignment or have more negative outcomes than those whose gender identity discordance was primary. The reasons for this are not established. Predictors of a poor outcome are personality problems of various kinds and a history of depression.

In general, these more recent reviews convey a more positive picture than those cited in the previous edition of this book, which was based on much more limited evidence. This may reflect more effective selection of suitable cases by referring clinicians as well as improvements in surgical techniques.

Peter Conway Dip Phyt MNIMH MCPP Cert Ed, in, 2011

How Gender Reassignment Surgery Works

Bradley Manning, the U.S. Army private who was sentenced Aug. 21 to 35 years in a military prison for releasing highly sensitive U.S. military secrets, is seeking gender reassignment. Heres how gender reassignment works:

An incision is made into the scrotum, and the flap of skin is pulled back. The testes are removed.

People who have male-to-female gender-reassignment surgery retain a prostate. Following surgery, estrogen will stimulate breast development, widen the hips, inhibit the growth of facial hair and slightly increase voice pitch.

The uterus and the ovaries are removed. Genital reconstructive procedures use either the clitoris, which is enlarged by hormones, or rely on free tissue grafts from the arm, the thigh or belly and an erectile prosthetic .

Breasts need to be surgically altered if they are to look less feminine. This process involves removing breast tissue and excess skin, and reducing and properly positioning the nipples and areolae. Androgens will stimulate the development of facial and chest hair, and cause the voice to deepen.

Reliable statistics are extremely difficult to obtain. Many sexual-reassignment procedures are conducted in private facilities that are not subject to reporting requirements.

The cost for female-to-male reassignment can be more than $50,000. The cost for male-to-female reassignment can be $7,000 to $24,000.

Between 100 to 500 gender-reassignment procedures are conducted in the United States each year.

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The Center For Transgender Health Team At Johns Hopkins

Embracing diversity and inclusion, the Center for Transgender Health provides affirming, objective, person-centered care to improve health and enhance wellness educates interdisciplinary health care professionals to provide culturally competent, evidence-based care informs the public on transgender health issues and advances medical knowledge by conducting biomedical research.

Is Gender Affirming Surgery Right For Me

Gender Change Before and After Surgery

Choosing to undergo any surgery is a big decision. Everyone affirms their gender in different ways, and that may or may not include surgery.

Surgery is permanent so you need to make sure its the right choice for you. Surgery doesnt make you more or less trans.

Before being able to access gender affirming surgery, you need to meet the criteria below:

  • A history of gender incongruence .
  • The ability to make a fully informed decision.
  • Be over the age of 16 for top surgery, or 18 for bottom surgery. Some surgeons will provide surgery to younger people in very specific situations.
  • Ensure that any physical or mental health conditions are well managed.

You will need letters of support from a mental health professional before having gender affirming surgery.

For top surgery, one letter is required. For bottom surgery two letters are required. For bottom surgery, you are also required to have lived as your current gender for 12 months, meaning you have socially transitioned. The letter needs to state that surgery is appropriate for you and is likely to help affirm your gender and reduce any gender dysphoria that may be present.

If you are taking gender affirming hormones, or want to take hormones in the future, you should do this for 12 months before having surgery. This is to allow any significant body changes to occur before surgery.

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What Is Discussed During My Consultation For Gender Reassignment Surgery Female To Male

During your consultation for transgender female to male surgery, you will have the opportunity to engage in a comprehensive and transparent conversation about your goals for transitioning from feminine to masculine physical characteristics.

Unfortunately, your transgender procedures cannot be completed together. Your body needs time to heal between surgeries. Dr. Agullo will provide you with an expected timeframe for your treatment depending on your cosmetic needs and desires.

Regardless of the procedures you expect to undergo, female to male transgender surgery always begins with top surgery. All of your procedures will be performed under general anesthesia to ensure your comfort and safety.

Additionally, Dr. Agullo will discuss the necessary preparations for surgery and expected results, sharing gender reassignment before and after photos of previous patients. Dr. Agullo will resolve any concerns or questions you have and examine your medical background, including your current health, about surgery safety and preparedness.

At Agullo Plastic Surgery, tailored care begins with a full consultation to discuss the goals and options available.

Removal Of The Uterus Ovaries And Fallopian Tubes

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.

In a partial hysterectomy, a surgeon will remove only the uterus.

In a total hysterectomy, they will also remove the cervix.

A bilateral salpingo-oophorectomy, or BSO, involves the removal of the right and left fallopian tubes and ovaries.

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Key Companies & Market Share Insights

The U.S. sex reassignment surgery market is fragmented. The companies contributing to the market growth are focusing on adopting several strategies to strengthen their market presence. They are offering advanced and innovative surgical solutions, including tracheal shave , male & female breast reduction, neo-vaginoplasty, and genital remodeling. Companies are investing in LGBTQ+ healthcare and are accredited on Health Care Equality Index. For instance, in September 2020, Cedars Sinai achieved a score of 100 on the Human Rights Campaign Foundation’s 2020 Health Care Equality Index. Some prominent players in the U.S. sex reassignment surgery market include:

  • The Mount Sinai Health System

  • Transgender Surgery Institute of Southern California

  • The University of Michigan Health System

  • The Johns Hopkins University

What Is Maxillofacial Surgery

Denver Health brings gender reassignment surgery back to Colorado

Maxillofacial surgery involves the removal, repair, or readjustment of soft and hard tissues in the face, jaw, teeth, mouth, or neck. It is a surgical specialty recognized by the American College of Surgeons.

Maxillofacial surgeons typically complete 1214 years of education and may specialize in:

  • pediatric maxillofacial and craniofacial surgery

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Affordable Care Act Policies

Individuals can purchase their own health insurance policies, often with significant government subsidies, at healthcare.gov. Subsidies on policy premiums have been boosted as part of COVID-19 relief.

Under the Affordable Care Act, insurers cannot discriminate against individuals on the basis of gender identity, and most insurance companies provide coverage for people who require gender reassignment surgery. Still, policies vary by state and in what they cover, and many health plans still exclude services related to sex change or sex reassignment surgery. Check a policys complete terms of coverage for the full explanation of which procedures and services are covered or excluded under each plan. Many plans deny coverage to transgender people for certain healthcare services.

What Questions Should I Ask Before Surgery

Its important to talk about the pros and cons of surgery in detail with your doctor. Its a good idea to ask to see pictures of how other people look after surgery.

  • What different surgical techniques are there?
  • What are the pros and cons of each technique for me?
  • What results can I expect?
  • What are the possible risks and complications?

For help in having the discussion, visit healthdirects Question Builder.

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Find The Right Health Insurance

Employer-provided insurancemay cover at least some of the expenses of gender reassignment treatment. In January 2021, for example, Aetna agreed to expand coverage for patients with gender dysphoria to include breast augmentation. It will also reimburse patients who have been denied coverage in recent years.

While coverage is changing quickly, large insurers provide a detailed list of what is and is not covered by their policies. For example, BlueCross BlueShield of Tennessees Medical Policy Manual covers surgeries it deems medically necessary but excludes a long list of procedures as not covered because theyre considered cosmetic. These include brow lift, cheek, chin, and nose implants, jaw shortening and sculpting, removal of redundant skin, and voice modification surgery.

Tricare, the civilian healthcare provider for the military, generally doesnt cover surgery for gender dysphoria, according to fact-checking website Snopes. However, conforming to the latest Biden administration orders, Tricare and active military healthcare may have to catch up its coverage.

What Are The Risks Or Complications Of Gender Affirmation Surgery

This Is What Male

Different procedures carry different risks. For example, individuals who have bottom surgery may have changes to their sexual sensation, or trouble with bladder emptying. In general, significant complications are rare, as long as an experienced surgeon is performing the procedure.

With any surgery, there is a small risk of complications, including:

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Pectoral Implants Or Fat Injections

Pectoral implants or fat injections allow Dr. Agullo to mold the chest for a more masculine contour.

  • Pectoral implants insert semi-solid silicone implants into the area where the breast once was to provide natural-looking, masculine definition. Patients must wait three months after their top surgery to get pectoral implants.
  • Fat grafting is available for patients who wish to add definition to the chest but do not want implants. Fat is taken from another region of the body and transplanted into the chest.

Are There Any Alternatives To Orif Surgery

A person usually receives ORIF surgery as a final resort if doctors cannot reset a bone using a splint or cast. Therefore, this means there are very few alternative procedures.

Some different operations may be possible depending on the location of the break. However, ORIF is likely necessary if the break is severe.

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What Does Gender Reassignment Female To Male Surgery Cost

Due to the fact that every patient has different needs and cosmetic goals, every gender reassignment procedure is unique. Basic surgical fees are listed on our fee schedule. However, depending on the simplicity or complexity of each surgery plan, the price can change. Dr. Agullo will provide a transparent dialogue and calculate the cost of your procedure during your consultation. All fees must be paid in full before your appointment.

Surgical Procedures: Clitoral Transposition And Penile Prosthesis Placement

Denver Surgeon Trains With ‘Unquestioned Leader’ In Gender Reassignment Surgery

Over half of patients of all three groups underwent transposition of the clitoris to the neophallus. While only one of ten patients of the group that underwent SP had undergone penile prosthesis placement , 2/3 of patients that underwent RAP had elected to proceed with penile prosthesis placement .

Table 2

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What Should I Expect After Surgery

Surgical recovery can be long and uncomfortable. Your surgeon will be able to give you more information on what can be expected before, during, and after surgery. This might include spending time in hospital afterwards, any special dressings, surgical garments, or follow up care.

Make sure you do everything your doctor tells you and go to all follow-up appointments. This will help you get the best results from your surgery.

Having surgery is a big deal. Even if youve been looking forward to it and are happy with the result, it can still be quite confronting. It might take some time to get used to your new body.

Talk to your doctor if you are feeling any distress following surgery.

Faq About Female To Male Reassignment Surgery

There are 1.4 million people in the United States that identify as being transgender. Of this group, a significant number of them are transgender men. Often transgender men have access to several types of female to male surgery options in order to aid in their transition. The team at Murphy Plastic Surgery share the following FAQ about the female to male surgery options provided.

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How Much Will Gender Affirming Surgery Cost Me

Gender affirming surgery can be very expensive. It can cost between $20,000 to more than $100,000, depending on which procedures you need.

Your surgeon will be able to tell you how much surgery will cost. The cost may include specialist visits before and after surgery, surgeon and anaesthetist fees, hospital and theatre costs, and any other products or services necessary.

Some costs may be covered by Medicare, such as specialist consults if you have a referral from your doctor. Unfortunately, most gender affirming surgery in Australia is done privately, meaning there will be large out-of-pocket costs.

You should ask your surgeon what Medicare item numbers they use. You can check the Medicare rebate at MBS Online.

Some private health insurance will also help with gender affirming surgery. If you have health insurance, its important to check with your health fund first about your level of cover. There is a range of health insurance comparison sites available online, such as privatehealth.gov.au.

What Happens During Gender Affirming Surgery

Gender Change Before and After Surgery

There are many different gender affirming surgeries and procedures. They may include making changes to your face, chest, genitals, or other body parts.

For people assumed male at birth, feminising surgeries may include:

  • Breast augmentation with insertion of breast implants.
  • Facial feminisation changing the shape of any or all facial features.
  • Vocal surgery shortening the vocal cords for a higher, more feminine voice.
  • Tracheal shave reducing the size of the Adams apple.
  • Fillers or liposuction, to achieve a more typically feminine shape.
  • Orchiectomy, or removal of testicles.
  • Bottom surgery or genital reconfiguration surgery, involving changes to the genitals.

Bottom surgery is called genital reconfiguration surgery. This was previously known as sex reassignment surgery or gender confirmation surgery. The name change shows that your genitals dont define your sex or gender.

Feminising bottom surgery may involve a combination of the following procedures:

  • Removing the testicles .
  • Shortening the urethra .
  • Creation of a vaginal canal . This is a complicated step which some people choose to skip. After surgery, vaginal dilators will need to be used to maintain the shape of the vaginal canal.

For people assumed female at birth, masculinising surgeries may include:

Masculinising bottom surgery may involve a combination of the following procedures:

  • Hysterectomy, if not already performed.

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What Are The Types Of Transgender Surgery

Gender-affirming surgery gives transgender people a body that aligns with their gender. It may involve procedures on the face, chest or genitalia. Common transgender surgery options include:

  • Facial reconstructive surgery to make facial features more masculine or feminine.
  • Chest or Top surgery to remove breast tissue for a more masculine appearance or enhance breast size and shape for a more feminine appearance.
  • Genital or Bottom surgery to transform and reconstruct the genitalia.

What Happens During Transgender Surgery

What happens during surgery varies depending on the procedure. You may choose facial surgery, top surgery, bottom surgery or a combination of these operations.

Facial surgery may change your:

  • Cheekbones: Many transgender women have injections to enhance the cheekbones.
  • Chin: You may opt to soften or more prominently define your chins angles.
  • Jaw: A surgeon may shave down your jawbone or use fillers to enhance your jaw.
  • Nose: You may have a rhinoplasty, surgery to reshape the nose.

If you are a transgender woman , other surgeries may include:

  • Adams apple reduction.
  • Placement of breast implants .

If you are a transgender man , you may have surgeries that involve:

  • Removal of the ovaries and uterus .

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What Is The Recovery Process

During hospitalization, the patient must be restricted in bed continuously or intermittently for several days between 3-5 days. After release from the hospital, the patient can return to their normal lives but not have to do physical exercise during the first 2 months after surgery. The patient has to do vaginal dilation continuously for 6 months to maintain the neovagina canal until completely healed and is ready for sexual intimacy.

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