Gender Reassignment Surgery

Gender reassignment surgery (GRS) in short means "sex or gender change" and is where male genitals are surgically formed into female genitals or vice versa. The process includes surgical, psychological and emotional transition.

What is Gender Reassignment Surgery?

The medical term used to describe such surgical sex change is gender reassignment surgery (GRS) or sex reassignment surgery (SRS). It is where the genitals are reconstructed into the desired sex to provide normal functionality for excretion and erogenous sensation during sexual intercourse.

Recovery Time

After surgery pain may be experienced for 3 to 5 days and sensitivity for 4 to 6 weeks as the body recovers from treatment. The surgeon usually prescribes painkillers to reduce discomfort. Individuals who undergo gender reassignment surgery should not engage in vigorous exercise or physical activity for at least 6 weeks after the operation, and no sexual intercourse should be attempted for at least 3 months and only be done when the consultant says it is safe.

Potential Risks

All types of surgery carry a risk of infection, bleeding and scarring. With gender reassignment surgery there may be scarring, but the surgeon will attempt to hide these as best as possible within the vaginal lining for a natural genital appearance. Although bowel injury is a possibility surgeons are trained to minimise the risk of such complications. In some cases further surgery, such as surgery due to penile bulb enlargement or meatoplasty, is required where stenosis prevents normal urination.

Results of Gender Reassignment Surgery

The expected results are an entire sex change or gender reassignment with normal functionality for urination and sexual pleasure. Psychological, emotional and physical gender transitioning is achieved. The individual often feels a sense of relief and enhanced confidence to finally be complete in their gender of comfort. Once male to female GRS is complete the surgery is irreversible, though pregnancy is not possible with gender reassignment.

The Treatment Process

The process involves initial consultation where the consultant will determine the suitability of the candidate for gender reassignment. Criteria evaluated in determining suitability for GRS include a desire to have male to female GRS for at least 2 years, having a psychological assessment within 2 years, living as a female for at least 1 year, not being overweight or obese and understanding the risks, complications and side-effects of treatment.

A person undergoing gender reassignment surgery needs to have a support system, such as family and friends, to cope with the surgery and subsequent transition. An honest discussion of lifestyle choices, past surgeries, illnesses and medications should take place for the health and safety of the patient. All risks, complications, benefits, results and costs are discussed, and the person's psychological and emotional well-being is taken into consideration. Recommendations are then made appropriate to male to female GRS or female to male GRS.

Once consent is given for treatment patients are provided with their date of surgery and pre-operative guidelines, such as the avoidance of alcohol, smoking and the use of anti-inflammatory medications. Four weeks prior to surgery the patient will be placed on hormone therapy, but if infection sets in prior to treatment the consultant will need to be informed immediately.

On the day of surgery patients are administered general anaesthetic to ensure treatment is free of any painful symptoms. With male to female GRS the male testes and penis are reformed into a normal functioning vagina. The surgical procedures used include orchiectomy, penectomy, labiaplasty and clitoroplasty, and the entire surgery takes between 4 to 5 hours. Where females undergo GRS to become males the surgery and duration may differ.

After admission to hospital the patient is monitored, blood tests are conducted and the bowels are prepared for the upcoming surgery. The patient will be given general anaesthetic while undergoing gender reassignment surgery. The duration of the hospital stay is usually 8 nights and a urinary catheter is required but removed before discharge.

Once the surgeon is satisfied with the recovery of the patient they will be discharged and need to be accompanied home by a friend or family member. Post-operative care guidelines are provided and appointments are set to monitor the patient's healing progress.

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