The Complete Guide to Sex Reassignment Surgery

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Many people worldwide do not feel like they fit their gender and body. That’s why many people from the transgender community choose to go through sex reassignment surgery or SRS surgery to change their body parts to the opposite sex physically. The other, more progressive term for SRS is Gender Affirmation Surgery(GAS). 

There are various methods and procedures to make this transition from male to female and vice versa. With more and more people deciding to undergo these procedures, the SRS market has experienced enormous growth. The industry’s size was more than $316 million in 2019 and is expected to grow at a 25.1% CAGR from 2020 to 2026.

Various factors played an important role in the growth of the gender reassignment industry. Some of them are as follows:

  • Rising awareness about the transgender issues
  • Reduced social stigma
  • Better access to and availability of gender reassignment surgical centres

If you plan to go through the procedure, you need to understand that the procedures typically vary from case to case. Also, not everyone has to go through the surgery. For example, some individuals choose transgender hormonal therapy to closely align their secondary sexual characteristics with their gender identity.

The whole process of gender affirmation can be overwhelming to the individual who wants to go through the surgery. Therefore, it is essential to fully understand every tiny detail that one needs to take care of before the surgery, mid-surgery, and after the surgery. Here are some common steps that are part of the process.

Step 1: Mental Health Guidance

As a first step, many surgeons recommend talking with a mental health professional like a psychologist to get a clear perspective on gender issues. 

The mental health professional first confirms whether the individual has gender dysphoria, previously known as gender identity disorder. Gender dysphoria refers to psychological stress caused when people feel that they belong to the opposite sex. It can lead to social and emotional issues. 

The therapist will also help you understand the surgery’s risks and limitations. The counselling also evaluates whether the patient has a social network to support them and whether they have the mental strength to manage things independently. Counselling is an important step before the surgery as it’s a big transition from one gender to another, with one or more enhanced body parts. 

The next step is to obtain the individual’s consent to perform either the hormonal therapy or the surgery. After successful counselling, the individual is either referred to an endocrinologist or hormone specialist, depending on the outcome of the counselling sessions. 

2. Hormone Therapy

Hormones control various secondary sexual characteristics such as muscle mass, body hair, and breast size. Hormonal therapy helps to align the hormones to match the sexual characteristics of the desired gender.

Women who want to transition to men take hormones such as androgens, which help develop more masculine characteristics. Some of  those characteristics are:

  • Enhanced strength and muscles
  • Deeper voice
  • Facial and body hair growth

When the men take female hormones such as estrogens and antiandrogens, which develop more feminine characteristics. Here are some of those characteristics:

  • Body fat redistribution
  • Decreased strength and muscle mass
  • Increased breast tissues
  • Slower and thinner facial and body hair growth
  • Lower testosterone levels

Some physical changes take less time to develop, while some take over 2-3 years to develop, depending on the physical characteristics of the individual.

It’s also essential to ensure that the patient is healthy before going through the surgery, as some cases have shown various side effects. Hormonal therapy can boost multiple health risks such as weight gain, high blood pressure, infertility, blood clots, stroke, etc. 

The patient should go through regular checkups in the early months of the treatment to ensure their body adapts to the hormonal changes.

3. Surgery

Hormone therapy may not work for all due to various factors such as physical characteristics and hormone resistance. In the event that hormonal therapy does not work, surgery can be a good alternative. 

However, before going through the surgery, it’s essential to understand that gender affirmation surgeries are major and irreversible. Therefore, the surgeons and the patients need to be sure before going forward with the surgery. 

This is why guidelines state that patients must first undergo 12 months of hormone therapy before getting genital reassignment surgery(GRS). This surgical procedure involves removing the gonads, which are the primary reproductive organs in both genders(testicles in men and ovaries in women). 

The procedure also involves the recreation of opposite-sex genitals. That’s why experts suggest that the patient should spend at least a year with hormonal therapy, during which they are advised to live as their identified gender to see if that is what they want to be. 

Surprisingly, 75% of the people who want a transition to the opposite gender do not pursue surgery. Yet, it’s essential for the people who are distressed due to gender dysphoria. 

Risks of Gender Reassignment Surgery

Like many other surgeries, gender reassignment surgery carries several risks too. Some of the risks for men who transition to women are:

  • Tissue death of the skin from the genitals
  • Narrowed urethra can block the urine flow leading to kidney damage
  • Abnormal connections 

Some of the risks for women who transition to men include:

  • Fistulas and blockages in the urinary tract
  • Tissue death

With the high risk of complications in the surgery to make a new penis, many women choose not to get one. Instead, they only choose to have their uterus and ovaries removed.

Is childbirth possible after gender affirmation surgery?

Many transgender patients choose to perform fertility preservation before their gender affirmation surgery if they want biological children. Egg-freezing and sperm banking are some options available for people who wish to do this. The doctors will help you in creating the best future family-building plan. 

Although sex reassignment surgery has its risks and complications, it gives a liberating feeling to many women and men who find it challenging to live a life with the gender they were born with. This surgery allows them to live their lives the way they want. 

Hence, it is crucial to get it done by professional and experienced surgeons who have prior experience and a good track record of successful surgeries. 

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