how is sex reassignment performed –

Sex reassignment, transgenitalization, or neophalloplasty surgery, popularly known as sex change surgery, is performed with the objective of changing the physical characteristics of Organs genitals, so that the person can have a body suitable for what he/she considers correct for herself.

This surgery can be performed on either female or male, and includes complex and lengthy surgical procedures, which involve both the construction of a new genital organ, called a “neopenis” or “neovagina”, as well as the removal of accessory organs, like testicles, breast, uterus and ovaries.

Before carrying out this type of procedure, it is advised to have medical follow-up prior to starting hormonal treatment, in addition to psychological follow-up, so that it is possible to determine that the new physical identity will suit the person.

where is made

Gender reassignment surgery can be performed by SUS since 2008, however, as the waiting in line can last for several years, many people choose to have the procedure done with private surgeons.

how is it done

Before performing the reassignment surgery, some important steps must be followed:

• Monitoring with psychologist, psychiatrist and social worker;
• Socially assume the gender you want to adopt;
• Hormonal treatment to acquire female or male characteristics, guided by the endocrinologist for each case.

These steps prior to surgery last about 2 years and are very important as they are a step towards physical, social and emotional adaptation.

1. Change from female to male

There are 2 types of surgical techniques for transforming the female sexual organ into male:

Methodioplasty

It is the most used and available technique, and consists of:

1. Testosterone hormone treatment causes the clitoris to grow larger than the average female clitoris;
2. Incisions are made around the clitoris, which is detached from the pubis, making it freer to move;
3. Vaginal tissue is used to increase the length of the urethra, which will be inside the neopenis;
4. Tissue from the vagina and labia minora is also used to line and shape the neopenis;
5. The scrotal sac is made from the labia majora and silicone implants to simulate the testicles.

The resulting penis is small, reaching about 6 to 8 cm, however this method is quick and capable of preserving the natural sensitivity of the genitalia.

phalloplasty

It is a more complex, expensive and not readily available method, which is why many people who seek this method end up looking for professionals abroad. In this technique, grafts of skin, muscles, blood vessels and nerves from another part of the body, such as the forearm or thigh, are used to create a new genital organ with greater size and volume.

• care after surgery: to complement the masculinization process, it is necessary to remove the uterus, ovaries and breasts, which can be done during the procedure or can be scheduled for another time. Generally, the sensitivity of the region is maintained, and intimate contact is released, after about 3 months.

2. Change from male to female

For the transformation of male genitalia into female, the technique commonly used is the modified penile inversion, which consists of:

1. Incisions are made around the penis and scrotal sac, defining the region where the neovagina will be made;
2. Part of the penis is removed, preserving the urethra, skin and nerves that give sensitivity to the region;
3. The testicles are removed, preserving the skin of the scrotum;
4. A space for fighting the neovagina is opened, measuring about 12 to 15 cm, using the skin of the penis and scrotal sac to cover the region. The hair follicles are cauterized so that hair does not grow in the region;
5. The rest of the skin from the scrotal sac and foreskin is used to form the labia;
6. The urethra and urinary tract are adapted so that urine comes out of an orifice and the person can urinate while sitting;
7. The glans is used to form the clitoris, so that the feeling of pleasure can be maintained.

To allow the new vaginal canal to remain viable and not close, a vaginal mold is used, which can be exchanged for larger sizes over the weeks to dilate the neovagina.

• Care after surgery: Physical activities and sex life are usually allowed after about 3 to 4 months after surgery. It is usually necessary to use lubricants specific to the region during sexual intercourse. In addition, it is possible that the person has follow-up with a gynecologist, for guidance and assessments of the neovagina and urethra skin, however, as the prostate remains, it may also be necessary to consult a urologist.

In addition, after any surgery, it is recommended to eat light meals, respect the rest period recommended by the doctor, in addition to using prescribed medication to relieve pain, such as anti-inflammatory drugs or analgesics, to facilitate recovery. Check out the essential care to recover from surgery.

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