Gender reassignment surgery is a surgical specialty practiced by a limited number of reconstructive surgeons. It is performed when a patient wants to bring his or her physical sex into line with mental gender characteristics. In the case of a male patient, the outcome of a series of surgeries will give the patient a female body, and a female patient can obtain a male body after multiple sessions of surgery. Some aspects of gender reassignment surgery are highly invasive, and the recovery time can be slow. Proper training for the surgeon performing the operations can take several years.
The goal of gender reassignment surgery is to give the patient a new body. After the surgical series is complete, the patient will feel more comfortable in his or her own body. The surgery itself is the culmination of years of treatment which include psychiatric care for gender dysphoria and hormone therapy. The entire process is usually called transitioning, and the patient is known as transgendered, or simply trans. Some transpeople choose to forgo gender reassignment surgery, while others feel that it is integral to the treatment process.
In the case of a female transitioning to a male, gender reassignment surgery includes a double mastectomy and recontouring of the groin area. Typically, the tissue of the breast has already started to shrink due to hormone therapy, and the mastectomy removes the additional breast tissue. Recovery from a mastectomy is a lengthy process, and involves the placement of strategic surgical drains so that fluids do not build up at the surgery site. Some patients also opt for liposuction, to reduce characteristically female hips and thighs.
Patients who are born male usually grow breasts as a result of the hormones that they take during the transitioning process. If the patient is dissatisfied with her breasts, a surgeon may offer breast augmentation. In some cases, the breasts grow unevenly, and a surgeon corrects this by reducing one or augmenting the other, after evaluating the situation with the patient. In some instances, a patient may receive augmentation such as buttock implants to contour her body even further as part of her gender reassignment surgery.
Surgery on the groin area reflects specialized skills. Although patients have been undergoing gender reassignment surgery since the 1950s, the techniques used to create realistic and usable genitals were only perfected in the 1980s and 1990s. A limited number of surgeons around the world offer the surgery, and only to patients who have fully undergone treatment with a psychiatrist and endocrinologist. If a patient demonstrates commitment to the change, he or she will undergo an irreversible gender reassignment surgery which can last for many hours to create new genitals.