In recent years, discussions surrounding gender identity and transition have become more open and inclusive. However, misconceptions still abound, particularly when it comes to the topic of gender affirming surgery. One common misconception is the belief that all transgender individuals undergo surgical procedures as part of their transition. This assumption overlooks the diverse experiences and affirmation goals within the transgender community.

It’s crucial to recognize that gender transition is a deeply personal journey, and there is no one-size-fits-all approach. While some transgender individuals may choose to pursue gender reassignment surgery as a vital aspect of their transition, others may not feel the need or desire for surgical interventions to affirm their gender identity. The decision to undergo surgery—or not—is entirely up to the individual and should be respected without judgment or scrutiny.

At the core of transgender identity lies the principle of self-determination and autonomy. Being transgender is not solely defined by one’s physical appearance or the presence of specific anatomical features. Rather, it’s rooted in an individual’s innermost sense of their gender, which may or may not align with the gender assigned to them at birth. Transitioning is about aligning one’s outward presentation with their internal sense of self, and this process can manifest in various ways for different people.

What are the different types of gender affirming surgery?

When discussing gender affirming surgery, it’s essential to understand that there are different types of procedures tailored to address diverse affirmation goals. These surgeries can be broadly categorized into bottom surgery, top surgery, and other surgical interventions aimed at achieving specific aesthetic or functional outcomes.

People’s gender affirmation goals vary, and so there are many different sorts of gender affirming surgery.

Bottom surgery:

This encompasses a range of surgeries on the genitals.

Surgeries for transfeminine people include penectomy (removal of the penis), orchidectomy (removal of the testes), and different forms of vaginoplasty (construction of a vagina).

Surgeries for transmasculine people include hysterectomy (removal of the uterus), bilateral salpingooopherectomy (removal of the ovaries and fallopian tubes), metoidoplasty (enlarging the clitoris into a penis), and different forms of phalloplasty (construction of a penis).

Top surgery:

This encompasses surgeries on the chest.

Surgeries for transfeminine people include breast augmentation and reconstruction.

Surgeries for transmasculine people include mastectomy (removal of the breasts) and chest reconstruction.

Other surgeries:

Other surgeries include facial feminisation, facial masculinisation, chondrolaryngoplasty (reduction of the “Adam’s apple”), and vocal feminisation surgery.

Your surgeon will be able to discuss the range of available surgical options to you, as well as the risks and benefits of these options.

What risks are associated with surgery?

As with all surgical procedures, gender affirming surgery has risks. The specific risks will depend on the specific sort of surgery. Your surgeon will be able to advise you about these specific risks.

General risks that are common to all surgical procedures include:

Bleeding: Blood loss is a common complication of any major surgical procedure. This can usually be managed by proper fluid management during and after surgery. Less commonly, if the blood loss is severe, then a blood transfusion may be recommended.

Infection: In addition to possible wound infections, surgery increases the risk of chest infections and urinary tract infections. This risk can be decreased by the use of prophylactic antibiotics if indicated, proper postoperative care, and proper postoperative hygiene.

Blood clots: Surgery can increase the risk of blood clots, such as deep vein thrombosis and pulmonary embolism. This risk can be decreased by the use of prophylactic anticoagulant medications, compression stockings, proper postoperative care, and keeping mobile after surgery.

Anaesthetic complications: Very rarely, people may have reactions to the anaesthetic.

Your surgeon will be able to advise you further on these risks, as well as on the more specific risks of specific sorts of surgery.

Is the prostate removed in feminising surgery?

One common question that arises is whether the prostate is removed during feminizing surgery. Contrary to misconception, feminizing surgery typically does not involve the removal of the prostate. The focus of these procedures is primarily on altering external genitalia and secondary sexual characteristics to align with an individual’s gender identity.

In conclusion, the landscape of gender affirming surgery is multifaceted, reflecting the diverse needs and experiences within the transgender community. Respect for individual autonomy and informed consent should guide discussions and decisions regarding surgical interventions. By fostering understanding and inclusivity, we can create a supportive environment where transgender individuals feel empowered to navigate their transition journey authentically and without judgment.