Genital gender confirming surgery GCS has been shown to significantly decrease gender dysphoria and improve the quality of life of transgender patients 1 , 2. A fundamental goal of reconstructive genital GCS is to provide the patient with genitals whose appearance and function are consistent with those of members of the gender they identify with. For the female to male transsexual, surgical options include creation of a neophallus phalloplasty using a vascularized free-flap or pedicle flap with or without neourethra construction and anastomosis to the native urethra. At our centers and abroad, the most commonly used free-flap is the radial forearm-flap 3. At our center, the most common pedicle flap we use is harvested from the suprapubic area. Additional procedures are also performed: glansplasty to give the end of the phallus a natural glans-like appearance , transposition of the denuded clitoris to the neophallus base to consolidate erogenous sensation to the neophallus , and vaginectomy. At other centers 4 , these are performed at time of phalloplasty, whereas at our centers, these are performed at second-stage surgery.
Materials and methods
Sex reassignment surgery SRS refers to a variety of surgical techniques used to change the bodies of people who have gender dysphoria. The surgeries involved in sex reassignment are also referred to as gender confirming surgery, gender reassignment surgery GRS or sex change surgery. Gender dysphoria, also known as transgenderism or gender identity disorder GID , is a condition in which a person feels a major mismatch between their biological sex and their gender identity. It is not a type of mental illness, although it was wrongly believed to be one in the past. People with gender dysphoria can be treated with counselling, hormone therapy and sex change surgical procedures. Not every transgender individual requires or wishes to undergo sex change surgery. But some trans people do end up going through sex change operations. Sex change surgery is irreversible. Therefore and obviously anyone wishing to undergo a sex change operation from male to female should carefully consider that decision. Although in a few rare instances people who have undergone sex change operations have tried to revert back to their original sex, it is a very costly and not totally successful process.
Sex reassignment surgery for female-to-male transgender people includes a variety of surgical procedures that alter anatomical traits to provide physical traits more comfortable to the trans man's male identity and functioning. Often used to refer to phalloplasty , metoidoplasty , or vaginectomy , sex reassignment surgery can also more broadly refer to many procedures an individual may have, such as male chest reconstruction , hysterectomy , or oophorectomy. Sex reassignment surgery is usually preceded by beginning hormone treatment with testosterone. Chest reconstruction "top surgery" is an important component of transition in the transmasculine population that can substantially improve gender incongruence. The procedure can help transgender men transition physically to their self-affirmed gender. Surgeries for female-to-male transgender patients have similarities to both gynecomastia surgeries for cisgender men,  breast reduction surgery for gigantomastia , and the separate mastectomies done for breast cancer. Top surgery involves more than a mastectomy for the treatment of breast cancer. If the breast size is small, surgery that spares the skin, nipple and areola subcutaneous nipple-sparing mastectomy may be performed. This procedure minimizes scarring, has a faster healing time and usually preserves sensation in the nipples.
Try out PMC Labs and tell us what you think. Learn More. In female-to-male transsexuals, the operative procedures are usually performed in different stages: first the subcutaneous mastectomy which is often combined with a hysterectomy-ovarectomy endoscopically assisted.