Sex reassignment surgery

Sex Reassignment Surgery Electronic supplementary material

Many translated example sentences containing "sex reassignment surgery" – German-English dictionary and search engine for German translations. Many translated example sentences containing "gender reassignment surgery" – German-English dictionary and search engine for German translations. Increased prevalence and advances in surgical options available to patients requesting gender reassignment surgery have made this an. Clinical Practice Guideline. Quality of Life Following Male-To-Female Sex Reassignment Surgery. Dtsch Arztebl Int ; DOI: /arztebl​. Surgery & Getting to Know the New You ~ (Transgender Sex Reassignment Surgery) (English Edition) eBook: Nye, Eleanor: safstaekoforskola.se: Kindle-Shop.

Sex reassignment surgery

Surgery & Getting to Know the New You ~ (Transgender Sex Reassignment Surgery) (English Edition) eBook: Nye, Eleanor: safstaekoforskola.se: Kindle-Shop. Many man-to-female-transsexuals prefer sex reassignment surgery. Surgical complications are common, most frequently a stenosis of the vagina as well as the. Übersetzung im Kontext von „sex reassignment surgery“ in Englisch-Deutsch von Reverso Context: While transgender people can undergo sex reassignment.

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PDP GROUP INC Zurück zum Suchergebnis. Psychosomatics 50 6 — PubMed. Diese Beispiele können umgangssprachliche Wörter, die auf der Grundlage Ihrer Suchergebnis enthalten. Abstract Background Currently available patient-reported outcome measures are limited in the field of sex reassignment surgery SRS. Nachdem ein Transsexueller sich der geschlechtsangleichenden Operation unterzogen hat, wird ihm offiziell das Lesbians suck cock Geschlecht zugeordnet. Oxford Uo. Sexologies 15 Carrie cummings hd — CrossRef.
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Dent Mein b. I wouldn't be surprised if Billy had applied for sex reassignment at all of them and been rejected. Nachdem ein Two men and a woman having sex sich der geschlechtsangleichenden Operation unterzogen hat, Adriana malao pictures ihm offiziell das neue Geschlecht zugeordnet. InTeen black dildo proposed a project to allow transgender people to receive sex reassignment surgery and change their legal gender. Ein Beispiel vorschlagen. Auf diesem Markt gibt es absolut alles, was Thailand an Produkten zu bieten hat und das zu günstigen Preisen, handeln muss man trotzdem. Zurück zum Suchergebnis. Jetzt testen 2. Übersetzung für "sex reassignment surgery" im Deutsch. Sex reassignment surgery Surgery and Getting to Know the New You ~ (Transgender Sex Reassignment Surgery) (English Edition) eBook: Nye, Eleanor: safstaekoforskola.se: Kindle-Shop. Male-to-Female Sex Reassignment Surgery using the Combined Vaginoplasty Technique: Satisfaction of Transgender Patients with Aesthetic. Many man-to-female-transsexuals prefer sex reassignment surgery. Surgical complications are common, most frequently a stenosis of the vagina as well as the. Übersetzung im Kontext von „sex reassignment surgery“ in Englisch-Deutsch von Reverso Context: While transgender people can undergo sex reassignment.

The colon is re-anastomosis with the stapler tools. The sigmoid colon segment is closed at the upper end and pulled through the neovaginal canal and anastomosis to the neovaginal opening.

The average length of sigmoid colon is approximately inches. The average operation time is 7 hours. It also helps patients with very short penises.

The vagina has a natural lubricant. It is possible to determine the depth of the newly constructed vagina.

The patient must be hospitalized for at least days. In order to look after the wound whilst recovering at the hospital, the patient must take the following actions:.

On the third day after the surgery, the patient may lie on her side. The wound will then be cleaned, and the patient may return home.

The patient must refrain from sexual intercourse for at least 2 months. During the first 3 days, the patients cannot eat or drink until the Intestinal function is recovered.

In this period, the patients will have fluid via intra venous lines. The paients need to avoid bulk food in the first month. Patients can do light activity after 3 weeks and resume normal daily activity at the 3 months.

Our staff are here to make your visit to our services as easy as it can be —you may have lots of questions, here are some frequently asked questions which you may find useful.

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Skip to content. Characteristics of those who qualify for Sex Reassignment Surgery from male to female are as follows: 1. Sex Reassignment Surgery methods available in Kamol Cosmetic Hospital accordance with the construction procedures of the new vagina and clitoris as follows: 1.

SRS with optional procedures: In case of deficient penile and scrotal skin or secondary SRS that limitation of skin in the genital area, optional procedures may needed.

Penile Skin Inversion: This surgery involves inverting the skin of the penis to create and beautify the vagina. The disadvantage is that it is not suitable for men with penises shorter than 4 inches because this will result in a vagina that is not deep enough in general, the vagina depth is equivalent to the length of the skin covering the penis minus one inch this includes skin required to construct the Minor Labia.

In this way, patients may need secondary labiaplasty and clitoral hood reconstruction. SRS without skin graft: The technique involved using penile skin and scrotum to construct the external genitalia such as inner and outer labia, neoclitoris and clitoral hood, and female urethra.

SRS with scrotal skin graft: This technique involves using the skin covering the penis to construct the inner labia, parts of glans penis to construct the neoclitoris and scrotal skin graft to cover the vaginal wall.

The procedure enables them to possess the desired deep vagina as well. The advantage is that this technique takes less operation time and less complications.

The Sigmoid Colon Vaginoplasty: This technique is used in the case where patients have short penises, or to assist patients whose vaginas have become obstructed.

Open technique The sigmoid colon is cut as a pedicle flap with intact neuro-vascular bundle via the low transverse abdominal incision as the bikini line.

Laparoscopic technique The sigmoid colon is harvested through the small 4-incision by laparoscopic technique as the pedicle flap with the neurovascular bundle.

Advantages: 1. Disadvantages and limitations: 1. In order to look after the wound whilst recovering at the hospital, the patient must take the following actions: 1.

If this is before — Hope dream may come. Then this is after — Dream come true. This was followed by Lili Elbe in Dresden during — She started with the removal of her original sex organs, the operation supervised by Dr.

Magnus Hirschfeld. Lili went on to have four more subsequent operations that included an orchiectomy , an ovary transplant, a penectomy , and ultimately an unsuccessful uterine transplant , the rejection of which resulted in death.

An earlier known recipient of this was Magnus Hirschfeld's housekeeper , [8] but their identity is unclear at this time. In , Dr. Harold Gillies , a plastic surgeon active in World War II, worked to develop the first technique for female-to-male SRS , producing a technique that has become a modern standard, called phalloplasty.

Following phalloplasty, in , the procedure for metoidioplasty was developed for female-to-male surgical transition by Drs.

Lebovic and Laub. This allows the patient to have a sensation-perceiving penis head. On 12 June , the European Court of Human Rights ruled in favor of Van Kück, a German trans woman whose insurance company denied her reimbursement for sex reassignment surgery as well as hormone replacement therapy.

This affair is referred to as Van Kück vs Germany. In , Christiane Völling won the first successful case brought by an intersex person against a surgeon for non-consensual surgical intervention described by the International Commission of Jurists as "an example of an individual who was subjected to sex reassignment surgery without full knowledge or consent".

As of , [update] some European countries require forced sterilization for the legal recognition of sex reassignment. The early history of sex reassignment surgery in transgender people has been reviewed by various authors.

Some transgender persons present with health conditions including diabetes , asthma , and HIV , which can lead to complications with future therapy and pharmacologic management.

Typically, a patient's treatment involves a healthcare team consisting of a variety of providers including endocrinologists, whom the surgeon may consult when determining if the patient is physically fit for surgery.

People with HIV or hepatitis C may have difficulty finding a surgeon able to perform successful surgery. Many surgeons operate in small private clinics that cannot treat potential complications in these populations.

Some surgeons charge higher fees for HIV and hepatitis C-positive patients; other medical professionals assert that it is unethical to deny surgical or hormonal treatments to transgender people solely on the basis of their HIV or hepatitis status.

Other health conditions such as diabetes , abnormal blood clotting , ostomies , and obesity do not usually present a problem to experienced surgeons.

The conditions do increase the anesthetic risk and the rate of post-operative complications. Surgeons may require overweight patients to reduce their weight before surgery, any patients to refrain from hormone replacement before surgery, and smoking patients to refrain from smoking before and after surgery.

Surgeons commonly stipulate the latter regardless of the type of operation. Fertility is also a factor considered in SRS, as patients are typically informed that if an orchiectomy or oöphoro-hysterectomy is performed, it will make them irreversibly infertile.

SRS does not refer to surgery performed on infants with differences in sex development intersex. Sex reassignment surgery performed on unconsenting minors babies and children may result in catastrophic outcomes including PTSD and suicide—such as in the David Reimer case, following a botched circumcision when the individual's sexual identity determined by neuroanatomical brain wiring is discrepant with the surgical reassignment previously imposed.

Burns School of Medicine, University of Hawaii recommended that physicians do not perform surgery on children until they are old enough to give informed consent and to assign such infants in the gender to which they will probably best adjust.

Diamond believed introducing children to others with differences of sex development could help remove shame and stigma.

Diamond considered the intersex condition as a difference of sex development, not as a disorder. Sex reassignment surgery can be difficult to obtain due to financial barriers, insurance coverage, and lack of providers.

An increasing number of surgeons are now training to perform such surgeries. Some treatment may require a minimum duration of psychological evaluation and living as a member of the target gender full-time, sometimes called the real life experience RLE sometimes mistakenly referred to as the real life test RLT before sex reassignment surgeries are covered by insurance.

Standards of Care usually give certain very specific "minimum" requirements as guidelines for progressing with treatment, causing them to be highly controversial and often maligned documents among transgender patients seeking surgery.

Alternative local standards of care exist, such as in the Netherlands, Germany, and Italy. Many surgeons require two letters of recommendation for sex reassignment surgery.

At least one of these letters must be from a mental health professional experienced in diagnosing gender identity disorder now recognized as gender dysphoria , who has known the patient for over a year.

Letters must state that sex reassignment surgery is the correct course of treatment for the patient. Many medical professionals and numerous professional associations have stated that surgical interventions should not be required in order for transsexual individuals to change sex designation on identity documents.

In some jurisdictions legal gender change is prohibited in any circumstances, even after genital or other surgery or treatment. In June , the American Medical Association AMA House of Delegates stated that the denial to patients with gender dysphoria or otherwise covered benefits represents discrimination, and that the AMA supports "public and private health insurance coverage for treatment for gender dysphoria as recommended by the patient's physician.

In , the United States Defense Health Agency for the first time approved payment for sex reassignment surgery for an active-duty U. The patient, an infantry soldier who identifies as a woman, had already begun a course of treatment for gender reassignment.

The procedure, which the treating doctor deemed medically necessary, was performed on November 14 at a private hospital, since U.

The array of medically indicated surgeries differs between trans women male to female and trans men female to male. For trans women, genital reconstruction usually involves the surgical construction of a vagina , by means of penile inversion or the sigmoid colon neovagina technique; or, more recently, non-penile inversion techniques that make use of scrotal tissue to construct the vaginal canal.

For trans men, genital reconstruction may involve construction of a penis through either phalloplasty or metoidioplasty.

For both trans women and trans men, genital surgery may also involve other medically necessary ancillary procedures, such as orchiectomy , penectomy , mastectomy or vaginectomy.

These require additional surgery to correct and are often fixed by colorectal surgeons. As underscored by WPATH, a medically assisted transition from one sex to another may entail any of a variety of non-genital surgical procedures, any of which are considered "sex reassignment surgery" when performed as part of treatment for gender dysphoria.

For trans men, these may include mastectomy removal of the breasts and chest reconstruction the shaping of a male-contoured chest , or hysterectomy and bilateral salpingo-oophorectomy removal of ovaries and Fallopian tubes.

For some trans women, facial feminization surgery , hair implants, and breast augmentation are also aesthetic components of their surgical treatment.

The best known of these surgeries are those that reshape the genitals, which are also known as genital reassignment surgery or genital reconstruction surgery GRS - or bottom surgery the latter is named in contrast to top surgery , which is surgery to the breasts; bottom surgery does not refer to surgery on the buttocks in this context.

However, the meaning of "sex reassignment surgery" has been clarified by the medical subspecialty organization, the World Professional Association for Transgender Health WPATH , to include any of a larger number of surgical procedures performed as part of a medical treatment for "gender dysphoria" or "transsexualism".

According to WPATH, medically necessary sex reassignment surgeries include "complete hysterectomy, bilateral mastectomy, chest reconstruction or augmentation Patients of sex reassignment surgery may experience changes in their physical health and quality of life, as well as side effects of sex steroid treatment.

Several studies have measured quality of life and self-perceived physical health using different scales. Overall, transsexual people have rated their quality of life as normal or quite good, although their overall score was lower than those in the control group.

For instance, trans men obtained a higher self-perceived health score than women because they had a higher level of testosterone than women. Trans women who had undergone face feminization surgery reported higher satisfaction in their general physical health.

After sex reassignment surgery, transsexuals people who underwent cross-sex hormone therapy and sex reassignment surgery tend to be less gender dysphoric.

They also normally function well both socially and psychologically. Anxiety, depression and hostility levels were lower after sex reassignment surgery.

In these studies, most of the patients have reported being very happy with the results and very few of the patients have expressed regret for undergoing sex reassignment surgery.

Although studies have suggested that the positive consequences of sex reassignment surgery outweigh the negative consequences, [50] it has been suggested that most studies investigating the outcomes of sex reassignment surgery are flawed as they have only included a small percentage of sex reassignment surgery patients in their studies.

Persistent regret can occur after sex reassignment surgery. Regret may be due to unresolved gender dysphoria, or a weak and fluctuating sense of identity, and may even lead to suicide.

Many patients perceive the outcome of the surgery as not only medically but also psychologically important.

Social support can help them to relate to their minority identity, ascertain their trans identity and reduce minority stress. Looking specifically at transsexual people's genital sensitivities, trans men and trans women are capable of maintaining their genital sensitivities after SRS.

However, these are counted upon the procedures and surgical tricks which are used to preserve the sensitivity. Considering the importance of genital sensitivity in helping transsexual individuals to avoid unnecessary harm or injuries to the genitals, allowing trans men to obtain an erection by inserting a penile implant after phalloplasty , [58] the ability for transsexual to experience erogenous and tactile sensitivity in their reconstructed genitals is one of the essential objectives surgeons want to achieve in SRS.

Erogenous sensitivity is measured by the capabilities to reach orgasms in genital sexual activities, like masturbation and intercourse.

The majority of the transsexual individuals have reported enjoying better sex lives and improved sexual satisfaction after sex reassignment surgery.

Hence, they were frigid and not enthusiastic about engaging in sexual activity. In consequence, transsexuals individuals who have undergone SRS are more satisfied with their bodies and experienced less stress when participating in sexual activity.

Most of the individuals have reported that they have experienced sexual excitement during sexual activity, including masturbation.

The female-to-male transgender individuals reported that they had been experiencing intensified and stronger excitements while male-to-female individuals have been encountering longer and more gentle feelings.

The rates of masturbation have also changed after sex reassignment surgery for both trans women and trans men.

Moreover, trans men also had a lower sexual satisfaction with their sexual life than trans women. Georges Burou 's clinic for transgender women.

Burou is considered one of the pioneers of SRS. India: India is offering affordable sex reassignment surgery to a growing number of medical tourists [66] and to the general population.

Iran: The Iranian government's response to homosexuality is to endorse, and fully pay for, sex reassignment surgery. Thailand: Thailand is the country that performs the most sex reassignment surgeries, followed by Iran.

France: Since , France no longer requires SRS as a condition for a gender change on legal documents. France was found in violation of the European Convention on Human Rights for requiring the forced sterilization of transgender people seeking to change their gender on legal documents.

Malta: As late as , transgender people that have undergone SRS can change their sex on legal documents. Spain: Despite a resolution from the European Parliament in suggesting advanced rights for all European Union citizens, as of only Andalusia 's public health system covers sex reassignment surgery.

These included requirements of at least 2 years of psychotherapy before health insurance was obligated to cover the cost of SRS [77] [78] and inability to procreate.

Ukraine: In , the Administrative District Court of Kiev ruled that forced sterilization was unlawful and no longer required for legal gender change.

Canada: Laws regarding legal recognition of gender identity vary from province to province in Canada with most provinces requiring reassignment surgery for a sex change on legal identification.

The United States of America: Many of the surgeries mentioned in the History section of this article were developed in the United States.

Before the legalization of same-sex marriage in the United States, there were several notable Supreme Court cases that did not legally recognize individuals who underwent SRS by invalidating marriages of trans people.

Mexico : As of a law, [82] Mexico City no longer requires SRS for changes of sex on birth certificates, and several states have followed suit. Argentina: In , Argentina began offering government subsidized total or partial SRS to all persons 18 years of age or older.

At the same time, the Argentinian government repealed a law that banned SRS without authorization from a judge. Chile: In , a bill was introduced that stated SRS was no longer a requirement for legal name and sex change.

In , Chile's public health plan was required to cover sex reassignment surgery. From Wikipedia, the free encyclopedia. Health care and medicine.

Rights issues.

Did you see Ali's picture of the sex-reassignment surgery? Im Jahre rief sie ein Bengali movie mit dem Ziel Pornos arabes Leben, dass geschlechtsangleichende Operationen sowie eine rechtliche Office 4-play: intern edition des Geschlechts erlaubt werden sollen. Zurück zum Suchergebnis. Lana rhoades? 55 1 — CrossRef PubMed. Jokic-Begic Dildo png transparent, Korajlija A, Jurin T: Psychosocial adjustment to sex reassignment surgery: a qualitative examination and personal experiences of six transsexual persons in Croatia.

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Es kann nur einmal getestet werden. DOI: Bildnachweise Mail Icon II. Zurück zum Zitat Bockting WO Psychotherapy and the real-life experience: From gender dichotomy to gender diversity. Springer Medizin. These questionnaires focused on demographic Cusco escorts, the satisfaction with aesthetic and functional results, and sexuality. Zurück Katt garcia lesbian Suchergebnis. He was the first researcher Efurkt recognize how gender identity and sexual orientation are two independent dimensions of Dirty nylon soles person's human nature. In order to look after the wound Find sex recovering at the hospital, Googledating patient must take the following actions: 1. Infor the first time, the United States Defense Health Agency approved payment for sex reassignment surgery Cheating wife fucked an active-duty U. Unsourced material may be challenged and removed. Article Sources. Surgeon's requirements, procedures, and recommendations vary Singles in alabama in the days Ebony black milf and Jackurai, and the months following these procedures. The goal of early transition surgeries was the removal of hormone-producing organs Aj applegate blacks on blondes as the testicles and the ovaries in order to reduce their masculinizing or feminizing effects. Asian delight hayward Group: More U. The article also identified Dr.

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Contrary to popular myth, total external emasculation after puberty does not necessarily "de-sex" the person. Complete castration after puberty leaves the young Hijra with her newfound feelings of sexual arousal and her newfound orgasmic capabilities.

While the psychological impact of such surgery would usually cripple the libido of a normal male, the effect on a young transsexual girl is usually just the opposite: The surgery can be liberating and can enable a fuller expression of her sensuality and her female libidinous feelings.

Just as in the case of modern post-operative transsexual women, many Hijra can have strong feelings of sexual arousal in the inner remnants of their genitalia even though they lack the external nerve tissue left by modern SRS, they retain the internal portions of the erectile corpora cavernosa and of course the prostate, with its spasmodic orgasmic capabilities.

Although Hijra lack vaginas, many greatly enjoy to orgasm penetrative anal sexual activities with men. Because of their complete external emasculation, Hijra genitalia and pelvic regions look very "girly", and many men in India greatly enjoy lovemaking with them.

The Hijra in turn accept their fate and their limited, but real, possibilities for finding at least a little bit of love as a woman in this life.

Many also work as prostitutes and beggars in this lowly but traditional Indian caste. Some Hijra today are fortunate to have access to female hormones, and can feminize their bodies by growing breasts and developing natural female body contours.

The combination of emasculation as teenagers combined with use of estrogen enables some Hijra now to become very beautiful - even though, sadly, they do not have female genitalia vaginas and are not socially accepted as women.

The origins of the Hijra caste goes back hundreds of years in Indian history. This widespread practice enables transsexuals to escape the angst and fate of masculinization as teenagers, and provides a safe though lowly place in society for them.

The agonizing extremes to which these transsexual youngsters will go in order to "approximately have a female gender", with full knowledge that they will never see their families again and will face social degradation for the rest of their lives, is a testament to the reality and extremity of the gender conflict that they face within themselves.

There are several million Hijra in India and Bangladesh today. It is not an imitated or learnt one, but a natural instinct that urges us to be women.

By fully emasculating themselves, and then falling upon the medical system for "patching up", they can thus achieve a "low-cost SRS early in life".

A number of girls in the U. Even larger numbers of young TS girls in the U. The long history of traditional 'Hijra-style' surgeries extends from ancient times right up to today, continuing onward in countries such as India and Bangladesh.

The detailed knowledge of the postoperative effects of the Hijra-type emasculations provided an important empirical background for the development of modern transsexual surgeries.

Abraham, M. During the 's, transsexual women began to benefit enormously from the newly available female sex hormones, which enable the development of breast, soften the skin and over time produce female body contours.

Also during the 's, a few surgeons began exploratory surgeries to construct vaginas in MtF transsexuals by using skin grafts taken from the thighs or buttocks, drawing upon then recently developed techniques for constructing vaginas in intersexed girls.

Christine Jorgensen, a U. She was "outed" in by U. Through her story, many transsexuals for the first time learned of the existence of the new hormonal and surgical treatments.

However, access to this new, experimental surgery was limited to a tiny handful of patients in Europe. At the time of Christine's surgery in the '50's, doctors first removed the transsexual's male organs in one or more surgeries.

The patient then waited through an extended period for healing. Then, in a surgery similar to those done to create vaginas for intersexed patients, surgeons constructed the patient's vagina by using skin grafts taken from her thighs or buttocks Christine's vaginoplasty surgery was in The skin grafts were unreliable, and sometimes partially failed to "take".

The use of extensive grafts also left large disfiguring scars at the donor sites. In addition, a lot of sensitive genital tissue was forever lost in the first step, affecting patients' feelings of sexual arousal and capacity for orgasm.

During the late 50's and into the 60's, several hundred transsexuals in the United States came under the care of Harry Benjamin, M. D, a compassionate physician and endocrinologist who had offices in New York, N.

Instead of viewing transsexuals as mentally ill deviants as did most psychiatrists of the day, he began to visualize transsexuals as truly suffering from a genuine mis-gendering condition of unknown origins.

In efforts to ease their suffering, he began prescribing estrogen to selected patients in response their profound pleas for medical feminization.

He also maintained close watch on the results of transsexual surgeries being performed, and began to refer his most intensely transsexual patients to those surgeons who were obtaining the best results.

Then, in the late 50's, a french plastic surgeon named Georges Burou, M. Variations of Dr. Burou's technique have been used ever since.

Burou's classic innovation was to use the male genitalia as source of skin and sensitive erotic tissue to create the new female genitalia, including the vagina.

Thanks to Pascale from France for finding these photos of Dr. Burou performed these surgeries in his clinic in Casablanca, Morocco.

In , several famous and very beautiful young "female impersonators" from the club Le Carrousel in Paris, France, including Coccinelle more info , Bambi and April Ashley , were successfully transformed into women by Dr.

Many of the young Le Carrousel girls had received female hormones as a side-benefit of working at the club, and as a result had become incredibly beautiful, feminine and sexy.

Several returned to perform at the club after their genital surgery. Their successful "sex changes" became widely known about, and they became sought after as love objects by many prominent, wealthy men.

Some very wealthy men including Aristotle Onassis would occasionally "sponsor" the sex change surgery of a Le Carrousel girl, who would then became their mistress for a while.

Among the keys to the success of these surgeries were i the use of the skin of the penis and scrotum to form the new labia and a sexually functional vagina thus avoiding the source area disfigurement caused in earlier operations by the use of large, deep skin grafts , and ii the careful dissection and placement of the terminated corpora cavernosa and the saving and relocation of some of the sensitive nerves and a small amount of erectile tissue.

If done properly, the post-operative patient can have powerful feelings of sexual arousal erection of the corpora stumps remaining inside her body and can easily be orgasmic the prostate is left intact, and can spasm during orgasm just as before SRS - while the nerve tissues throughout the corpora, the clitoris and the vulva spasm, throb and release at the same time, just as in any other woman.

Benjamin's practice grew rapidly as more and more transsexuals learned that they could obtain compassionate treatment from him.

He began referring ever larger numbers of patients to surgeons, especially to Dr. Burou in Casablanca. By the mid 60's, several other top surgeons abroad began performing SRS surgeries on transsexuals using Dr.

Burou's techniques, and Dr. Benjamin referred patients to these surgeons too. The most notable of these was Jose Jesus Barbosa, M.

However, such surgeries were still virtually unheard in the U. Under intense pressure from religious groups following the publicity of the Jorgensen case in , most U.

Then too, the U. Instead of receiving help for gender-transition from medical professionals, many transsexuals were forced into mental institutions, where psychiatrists tried to "cure them of their mental illness" by electroshock therapy and aversion therapy.

During the late 50's and into the early 60's, a number of intensely transsexual girls in the U. Once no longer intact, the girl might hope to obtain complete SRS in some hospitals here - if she had the money to pay for it.

See for example, the story of transsexual pioneer Aleshia Brevard. At a young age and feminized on estrogen, Aleshia became a star performer at Finocchio's, the world famous "female impersonator" nightclub in San Francisco.

As did so many postop transsexual women in the 's including Lynn Aleshia left her past life behind and entered stealth mode. She went on to become a showgirl, a "Playboy Bunny" a hostess at one of the famous "Playboy" clubs , a widely recognized actress in movies, on stage and on TV, and got married three times!

Aleshia only recently came out to tell her story in a wonderful book about her amazing life. Finally, in , surgeons at the John Hopkins Medical Center began performing a limited number of MtF SRS operations in effort to help some intensely transsexual patients under care of Hopkins' new gender identity clinic.

The Hopkin's staff believed that transsexuals were mentally ill, but they also believed that there was no psychological method for reversing the "incorrectly formed gender identity".

In an experimental program they began to explore the possibility of helping patients via surgery, as was being recommended by Dr. The Hopkins' Surgeons used a variant of Dr.

Burou's method. In the fall of , newspapers around the country propagated the following item from a column in the New York Daily News: "Making the rounds of Manhattan clubs these nights is a stunning girl who admits she was a male less than one year ago and that she underwent a sex change operation at, of all places, Johns Hopkins Hospital in Baltimore.

Surprisingly, the hospital confirms the case, saying surgery followed psychotherapy. Such operations, although rare in this country, are neither illegal nor unethical, according to a Johns Hopkins spokesman.

Officials at a number of major hospitals here agreed with Johns Hopkins on the legality and ethics of the operations but none could recall such an operation ever having been performed in New York.

The Times article provided extensive information on the surgical and hormonal treatments then being done abroad, and on the new program at John's Hopkins University Medical Center, where several surgeries had recently been done.

The article also identified Dr. Benjamin as being the world's leading authority on transsexualism, and as author of a new textbook on the subject entitled The Transsexual Phenomenon see this link for an online version of the original text.

Harry Benjamin, M. Benjamin was the pioneer of the whole new area of medical knowledge of transsexualism.

His paradigm-shifting medical text described his experiences with many patients over several decades. He was the first researcher to recognize how gender identity and sexual orientation are two independent dimensions of each person's human nature.

Benjamin recommend how "intense transsexuals" could and really should be treated, in order to enable them to live in the gender they sought.

His book documented the results of the new, innovative surgical and hormonal treatments and put those treatments into a rational context as therapy for transsexualism.

This book gave fresh hope to many transsexuals, and opened the door for the modern medical approaches that we now take for granted. At the same time, the fact that Johns Hopkins was actually doing transsexual surgeries greatly enhanced the visibility of Dr.

Benjamin's theories and the attention that his research results received from the medical community. These figures are taken from Chapter 22, by Howard W.

Jones, Jr. By this time it was common to refer to this type of surgery as "sex reassignment surgery" SRS. The illustrations were reproduced from an original article by Howard W.

Schirmer, and John E. Figure 1. A sketch of the perineum showing the line of primary incision. Figure 2. The right spermatic cord is clamped and ligated.

Figure 3. The primary incision is continued up the ventral side of the shaft of the penis. Figure 4. The anterior flap is developed from the skin of the penis.

Figure 5. The urethra is dissected from the shaft of the penis. Figure 6. The corpora cavernosa are separated to assure a minimal stump.

Figure 7. The perineal dissection. Figure 8. The perineal dissection has been completed and the anterior flap perforated to position the urethral meatus.

Figure 9. The skin flaps are sutured and placed in position in the vaginal cavity. This procedure uses the tissue of the labia to create a penis.

For those identified as female at birth, the change to a masculine appearance may also include hormone therapy with testosterone, a mastectomy , a hysterectomy procedure, and perhaps additional cosmetic procedures intended to masculinize the appearance.

While some health insurance providers in the United States are now covering the portion of sex reassignment surgery that alters the genitals, those companies remain in the minority.

For most transgender individuals, the burden of financing the procedure s is the main difficulty in obtaining treatment.

Some patients seek sex reassignment surgery overseas as the procedures are often far less expensive in other countries.

It is important to remember that traveling to a foreign country for surgery, also known as surgery tourism, can be very risky.

Regardless of where the surgery will be performed, it is essential to utilize a surgeon who is skilled in the procedure being performed and that surgery will be performed in a reputable facility that offers high-quality care.

When choosing a surgeon , it is important to do your research, whether the surgery is performed in the U. Talk to people who have already had the procedure and ask about their experience and their surgeon.

Before and after photos don't tell the whole story, and can easily be altered, so consider asking for a patient reference with whom you can speak.

It is important to remember that surgeons have specialties and to stick with your surgeon's specialty. For example, you may choose to have one surgeon perform a genitoplasty, but another to perform facial surgeries.

This may result in more expenses, but the right surgeon performing the right procedure typically results in a better outcome.

Gender reassignment surgery is very complex, and the procedures that will be necessary for one person to achieve their desired result can be very different from what a different patient will require.

Each individual's goals for their appearance will be different, and the surgical needs of the patient will vary as well.

A personalized approach is essential to satisfaction because personal appearance is so highly individualized. For example, one individual may feel strongly that breast implants are essential to having a desirable and feminine appearance, while a different person may not feel that breast size is a concern.

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Davy Z, Toze M. What Is Gender Dysphoria? A Critical Systematic Narrative Review. Surgeons vary considerably in their techniques and skills, patients' skin varies in elasticity and healing ability which is affected by age, nutrition, physical activity and smoking , any previous surgery in the area can impact results, and surgery can be complicated by problems such as infections, blood loss, or nerve damage.

Supporters of colovaginoplasty state that this method is better than use of skin grafts for the reason that colon is already mucosal, whereas skin is not.

Lubrication is needed when having sex and occasional douching is advised so that bacteria do not start to grow and give off odors.

Because of the risk of vaginal stenosis the narrowing or loss of flexibility of the vagina , [3] [4] any current technique of vaginoplasty requires some long-term maintenance of volume by the patient using a vaginal expander , [5] [6] or vaginal dilation using graduated dilators to keep the vagina open.

Daily dilation of the vagina for six months in order to prevent stenosis is recommended among health professionals.

Regular application of estrogen into the vagina, [ citation needed ] for which there are several standard products, may help, but this must be calculated into the total estrogen dose.

Some surgeons have techniques to ensure continued depth, but extended periods without dilation will still often result in reduced diameter vaginal stenosis to some degree, which would require stretching again, either gradually, or, in extreme cases, under anaesthetic.

With current procedures, trans women are unable to receive ovaries or uterus. This means that they are unable to bear children or menstruate , and that they will need to remain on hormone therapy after their surgery to maintain female hormonal status and features.

Occasionally these basic procedures are complemented further with feminizing cosmetic surgeries or procedures that modify bone or cartilage structures, typically in the jaw, brow, forehead, nose and cheek areas.

These are known as facial feminization surgery or FFS. Breast augmentation is the enlargement of the breasts. Some trans women choose to undergo this procedure if hormone therapy does not yield satisfactory results.

Usually, typical growth for trans women is one to two cup sizes below closely related females such as the mother or sisters. Progesterone also rounds out the breast to an adult Tanner stage -5 shape and matures and darkens the areola.

Some MTF individuals may elect to have voice surgery, which alters an individual's vocal range or pitch. However, this procedure carries a risk of impairing a trans woman's voice forever.

Since estrogen alone does not alter a person's vocal range or pitch, some people take the risk that comes along with voice feminization surgery.

Other options, like voice feminization lessons, are available to people wishing to speak with less masculine mannerisms.

A tracheal shave procedure is also sometimes used to reduce the cartilage in the area of the throat and minimize the appearance of the Adam's apple in order to assimilate to female physical features.

Some MTF individuals will choose to undergo buttock augmentation because anatomically, male hips and buttocks are generally smaller than those presented on a female.

If, however, efficient hormone therapy is conducted before the patient is past puberty, the pelvis will broaden slightly, and even if the patient is past their teen years, a layer of subcutaneous fat will be distributed over the body, rounding contours.

Trans women usually end up with a waist to hip ratio of around 0. From Wikipedia, the free encyclopedia. Sex reassignment surgery.

This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources.

Unsourced material may be challenged and removed. Gender identities. Health care and medicine. Rights issues. Society and culture.

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