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  • Tell me more about living in a social role that matches my gender identity
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Transition involves a profound change in your life; this may seem daunting but we are here to help. There are a range of challenges to be addressed during your transition, so we’ve prepared a checklist to help you prepare.

This list is not exhaustive. Transition involves much, much more than the obvious medical interventions of hormone therapy and surgery. You will also need to consider its social and legal implications, from formally changing your name through to dealing with the emotional aspects of informing family and friends.

Helpful hints for transition

  • You will be provided with a great deal of new information about gender identity issues by the clinic. We recommend that you keep this and all correspondence relating to your treatment in a file, to support your Gender Recognition Certificate application in the future, should this be required. 
  • Living life in your new social role may be very different to your current life and you are likely to have many new experiences; be ready for change and for some challenging situations. Ask your Named Professional for help if you feel overwhelmed by everything; difficult challenges can be overcome with help.
  • Medication and hormone treatment may be offered. We strongly discourage self-medication with irregularly sourced drug treatments. Internet-sourced hormone therapies can be dangerous and are sometimes contaminated. Their use is likely to affect blood test results and, if our medical team are unaware of your self-medication, they may inadvertently offer inappropriate advice or recommend unnecessary investigation. Please, be honest with us. 
  • Gender reassignment surgery (GRS) cannot be provided until you have lived in a social role appropriate to your gender identity for at least twelve months. 
  • At some point, you will want to tell other people about your transition. We can advise you on how to carefully and sensitively inform all those who need to know about your transition, from family members to employers. Employers have legal responsibilities to protect you and Unite have written a guide on Trans Equality at Work, click here to view the Trans Equality at Work Guide . 
  • You may be eligible for NHS-funded treatment to reduce your facial hair (epilation).  There is a limit to the amount of treatment funded by the NHS and there is no guarantee that this will reduce your facial hair to your complete satisfaction. If you want additional or future epilation treatment, you will have to pay for this yourself. We can advise you about this.
  • Your pension and any benefits arrangements might be affected if you’re a transgender. Seek advice from your private provider and/or the Department of Works and Pensions .  
  • Appropriate use of pronouns may become an issue. Politely advise people of your preferred pronoun.
  • Transphobic hate incidents may happen and can take many forms including verbal and physical abuse through to threatening behaviour and online abuse.  Transphobic hate crime is a criminal offence.
  • As you prepare for your new life you may require assistance with clothing, footwear, wigs, and cosmetics. You may also need guidance with this, your Named Professional will be able to provide advice on all these matters.

In this section

  • Gender identity information
  • Patient Care & Health Information
  • Tests & Procedures
  • Feminizing surgery

Feminizing surgery, also called gender-affirming surgery or gender-confirmation surgery, involves procedures that help better align the body with a person's gender identity. Feminizing surgery includes several options, such as top surgery to increase the size of the breasts. That procedure also is called breast augmentation. Bottom surgery can involve removal of the testicles, or removal of the testicles and penis and the creation of a vagina, labia and clitoris. Facial procedures or body-contouring procedures can be used as well.

Not everybody chooses to have feminizing surgery. These surgeries can be expensive, carry risks and complications, and involve follow-up medical care and procedures. Certain surgeries change fertility and sexual sensations. They also may change how you feel about your body.

Your health care team can talk with you about your options and help you weigh the risks and benefits.

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Why it's done

Many people seek feminizing surgery as a step in the process of treating discomfort or distress because their gender identity differs from their sex assigned at birth. The medical term for this is gender dysphoria.

For some people, having feminizing surgery feels like a natural step. It's important to their sense of self. Others choose not to have surgery. All people relate to their bodies differently and should make individual choices that best suit their needs.

Options for feminizing surgery include:

  • Removal of the testicles alone. This is called orchiectomy.
  • Removal of the penis, called penectomy.
  • Removal of the testicles.
  • Creation of a vagina, called vaginoplasty.
  • Creation of a clitoris, called clitoroplasty.
  • Creation of labia, called labioplasty.
  • Breast surgery. Surgery to increase breast size is called top surgery or breast augmentation. It can be done through implants, the placement of tissue expanders under breast tissue, or the transplantation of fat from other parts of the body into the breast.
  • Plastic surgery on the face. This is called facial feminization surgery. It involves plastic surgery techniques in which the jaw, chin, cheeks, forehead, nose, and areas surrounding the eyes, ears or lips are changed to create a more feminine appearance.
  • Tummy tuck, called abdominoplasty.
  • Buttock lift, called gluteal augmentation.
  • Liposuction, a surgical procedure that uses a suction technique to remove fat from specific areas of the body.
  • Voice feminizing therapy and surgery. These are techniques used to raise voice pitch.
  • Tracheal shave. This surgery reduces the thyroid cartilage, also called the Adam's apple.
  • Scalp hair transplant. This procedure removes hair follicles from the back and side of the head and transplants them to balding areas.
  • Hair removal. A laser can be used to remove unwanted hair. Another option is electrolysis, a procedure that involves inserting a tiny needle into each hair follicle. The needle emits a pulse of electric current that damages and eventually destroys the follicle.

Your health care provider might advise against these surgeries if you have:

  • Significant medical conditions that haven't been addressed.
  • Behavioral health conditions that haven't been addressed.
  • Any condition that limits your ability to give your informed consent.

Like any other type of major surgery, many types of feminizing surgery pose a risk of bleeding, infection and a reaction to anesthesia. Other complications might include:

  • Delayed wound healing
  • Fluid buildup beneath the skin, called seroma
  • Bruising, also called hematoma
  • Changes in skin sensation such as pain that doesn't go away, tingling, reduced sensation or numbness
  • Damaged or dead body tissue — a condition known as tissue necrosis — such as in the vagina or labia
  • A blood clot in a deep vein, called deep vein thrombosis, or a blood clot in the lung, called pulmonary embolism
  • Development of an irregular connection between two body parts, called a fistula, such as between the bladder or bowel into the vagina
  • Urinary problems, such as incontinence
  • Pelvic floor problems
  • Permanent scarring
  • Loss of sexual pleasure or function
  • Worsening of a behavioral health problem

Certain types of feminizing surgery may limit or end fertility. If you want to have biological children and you're having surgery that involves your reproductive organs, talk to your health care provider before surgery. You may be able to freeze sperm with a technique called sperm cryopreservation.

How you prepare

Before surgery, you meet with your surgeon. Work with a surgeon who is board certified and experienced in the procedures you want. Your surgeon talks with you about your options and the potential results. The surgeon also may provide information on details such as the type of anesthesia that will be used during surgery and the kind of follow-up care that you may need.

Follow your health care team's directions on preparing for your procedures. This may include guidelines on eating and drinking. You may need to make changes in the medicine you take and stop using nicotine, including vaping, smoking and chewing tobacco.

Because feminizing surgery might cause physical changes that cannot be reversed, you must give informed consent after thoroughly discussing:

  • Risks and benefits
  • Alternatives to surgery
  • Expectations and goals
  • Social and legal implications
  • Potential complications
  • Impact on sexual function and fertility

Evaluation for surgery

Before surgery, a health care provider evaluates your health to address any medical conditions that might prevent you from having surgery or that could affect the procedure. This evaluation may be done by a provider with expertise in transgender medicine. The evaluation might include:

  • A review of your personal and family medical history
  • A physical exam
  • A review of your vaccinations
  • Screening tests for some conditions and diseases
  • Identification and management, if needed, of tobacco use, drug use, alcohol use disorder, HIV or other sexually transmitted infections
  • Discussion about birth control, fertility and sexual function

You also may have a behavioral health evaluation by a health care provider with expertise in transgender health. That evaluation might assess:

  • Gender identity
  • Gender dysphoria
  • Mental health concerns
  • Sexual health concerns
  • The impact of gender identity at work, at school, at home and in social settings
  • The role of social transitioning and hormone therapy before surgery
  • Risky behaviors, such as substance use or use of unapproved hormone therapy or supplements
  • Support from family, friends and caregivers
  • Your goals and expectations of treatment
  • Care planning and follow-up after surgery

Other considerations

Health insurance coverage for feminizing surgery varies widely. Before you have surgery, check with your insurance provider to see what will be covered.

Before surgery, you might consider talking to others who have had feminizing surgery. If you don't know someone, ask your health care provider about support groups in your area or online resources you can trust. People who have gone through the process may be able to help you set your expectations and offer a point of comparison for your own goals of the surgery.

What you can expect

Facial feminization surgery.

Facial feminization surgery may involve a range of procedures to change facial features, including:

  • Moving the hairline to create a smaller forehead
  • Enlarging the lips and cheekbones with implants
  • Reshaping the jaw and chin
  • Undergoing skin-tightening surgery after bone reduction

These surgeries are typically done on an outpatient basis, requiring no hospital stay. Recovery time for most of them is several weeks. Recovering from jaw procedures takes longer.

Tracheal shave

A tracheal shave minimizes the thyroid cartilage, also called the Adam's apple. During this procedure, a small cut is made under the chin, in the shadow of the neck or in a skin fold to conceal the scar. The surgeon then reduces and reshapes the cartilage. This is typically an outpatient procedure, requiring no hospital stay.

Top surgery

Breast incisions for breast augmentation

  • Breast augmentation incisions

As part of top surgery, the surgeon makes cuts around the areola, near the armpit or in the crease under the breast.

Placement of breast implants or tissue expanders

  • Placement of breast implants or tissue expanders

During top surgery, the surgeon places the implants under the breast tissue. If feminizing hormones haven't made the breasts large enough, an initial surgery might be needed to have devices called tissue expanders placed in front of the chest muscles.

Hormone therapy with estrogen stimulates breast growth, but many people aren't satisfied with that growth alone. Top surgery is a surgical procedure to increase breast size that may involve implants, fat grafting or both.

During this surgery, a surgeon makes cuts around the areola, near the armpit or in the crease under the breast. Next, silicone or saline implants are placed under the breast tissue. Another option is to transplant fat, muscles or tissue from other parts of the body into the breasts.

If feminizing hormones haven't made the breasts large enough for top surgery, an initial surgery may be needed to place devices called tissue expanders in front of the chest muscles. After that surgery, visits to a health care provider are needed every few weeks to have a small amount of saline injected into the tissue expanders. This slowly stretches the chest skin and other tissues to make room for the implants. When the skin has been stretched enough, another surgery is done to remove the expanders and place the implants.

Genital surgery

Anatomy before and after penile inversion

  • Anatomy before and after penile inversion

During penile inversion, the surgeon makes a cut in the area between the rectum and the urethra and prostate. This forms a tunnel that becomes the new vagina. The surgeon lines the inside of the tunnel with skin from the scrotum, the penis or both. If there's not enough penile or scrotal skin, the surgeon might take skin from another area of the body and use it for the new vagina as well.

Anatomy before and after bowel flap procedure

  • Anatomy before and after bowel flap procedure

A bowel flap procedure might be done if there's not enough tissue or skin in the penis or scrotum. The surgeon moves a segment of the colon or small bowel to form a new vagina. That segment is called a bowel flap or conduit. The surgeon reconnects the remaining parts of the colon.

Orchiectomy

Orchiectomy is a surgery to remove the testicles. Because testicles produce sperm and the hormone testosterone, an orchiectomy might eliminate the need to use testosterone blockers. It also may lower the amount of estrogen needed to achieve and maintain the appearance you want.

This type of surgery is typically done on an outpatient basis. A local anesthetic may be used, so only the testicular area is numbed. Or the surgery may be done using general anesthesia. This means you are in a sleep-like state during the procedure.

To remove the testicles, a surgeon makes a cut in the scrotum and removes the testicles through the opening. Orchiectomy is typically done as part of the surgery for vaginoplasty. But some people prefer to have it done alone without other genital surgery.

Vaginoplasty

Vaginoplasty is the surgical creation of a vagina. During vaginoplasty, skin from the shaft of the penis and the scrotum is used to create a vaginal canal. This surgical approach is called penile inversion. In some techniques, the skin also is used to create the labia. That procedure is called labiaplasty. To surgically create a clitoris, the tip of the penis and the nerves that supply it are used. This procedure is called a clitoroplasty. In some cases, skin can be taken from another area of the body or tissue from the colon may be used to create the vagina. This approach is called a bowel flap procedure. During vaginoplasty, the testicles are removed if that has not been done previously.

Some surgeons use a technique that requires laser hair removal in the area of the penis and scrotum to provide hair-free tissue for the procedure. That process can take several months. Other techniques don't require hair removal prior to surgery because the hair follicles are destroyed during the procedure.

After vaginoplasty, a tube called a catheter is placed in the urethra to collect urine for several days. You need to be closely watched for about a week after surgery. Recovery can take up to two months. Your health care provider gives you instructions about when you may begin sexual activity with your new vagina.

After surgery, you're given a set of vaginal dilators of increasing sizes. You insert the dilators in your vagina to maintain, lengthen and stretch it. Follow your health care provider's directions on how often to use the dilators. To keep the vagina open, dilation needs to continue long term.

Because the prostate gland isn't removed during surgery, you need to follow age-appropriate recommendations for prostate cancer screening. Following surgery, it is possible to develop urinary symptoms from enlargement of the prostate.

Dilation after gender-affirming surgery

This material is for your education and information only. This content does not replace medical advice, diagnosis and treatment. If you have questions about a medical condition, always talk with your health care provider.

Narrator: Vaginal dilation is important to your recovery and ongoing care. You have to dilate to maintain the size and shape of your vaginal canal and to keep it open.

Jessi: I think for many trans women, including myself, but especially myself, I looked forward to one day having surgery for a long time. So that meant looking up on the internet what the routines would be, what the surgery entailed. So I knew going into it that dilation was going to be a very big part of my routine post-op, but just going forward, permanently.

Narrator: Vaginal dilation is part of your self-care. You will need to do vaginal dilation for the rest of your life.

Alissa (nurse): If you do not do dilation, your vagina may shrink or close. If that happens, these changes might not be able to be reversed.

Narrator: For the first year after surgery, you will dilate many times a day. After the first year, you may only need to dilate once a week. Most people dilate for the rest of their life.

Jessi: The dilation became easier mostly because I healed the scars, the stitches held up a little bit better, and I knew how to do it better. Each transgender woman's vagina is going to be a little bit different based on anatomy, and I grew to learn mine. I understand, you know, what position I needed to put the dilator in, how much force I needed to use, and once I learned how far I needed to put it in and I didn't force it and I didn't worry so much on oh, did I put it in too far, am I not putting it in far enough, and I have all these worries and then I stress out and then my body tenses up. Once I stopped having those thoughts, I relaxed more and it was a lot easier.

Narrator: You will have dilators of different sizes. Your health care provider will determine which sizes are best for you. Dilation will most likely be painful at first. It's important to dilate even if you have pain.

Alissa (nurse): Learning how to relax the muscles and breathe as you dilate will help. If you wish, you can take the pain medication recommended by your health care team before you dilate.

Narrator: Dilation requires time and privacy. Plan ahead so you have a private area at home or at work. Be sure to have your dilators, a mirror, water-based lubricant and towels available. Wash your hands and the dilators with warm soapy water, rinse well and dry on a clean towel. Use a water-based lubricant to moisten the rounded end of the dilators. Water-based lubricants are available over-the-counter. Do not use oil-based lubricants, such as petroleum jelly or baby oil. These can irritate the vagina. Find a comfortable position in bed or elsewhere. Use pillows to support your back and thighs as you lean back to a 45-degree angle. Start your dilation session with the smallest dilator. Hold a mirror in one hand. Use the other hand to find the opening of your vagina. Separate the skin. Relax through your hips, abdomen and pelvic floor. Take slow, deep breaths. Position the rounded end of the dilator with the lubricant at the opening to your vaginal canal. The rounded end should point toward your back. Insert the dilator. Go slowly and gently. Think of its path as a gentle curving swoop. The dilator doesn't go straight in. It follows the natural curve of the vaginal canal. Keep gentle down and inward pressure on the dilator as you insert it. Stop when the dilator's rounded end reaches the end of your vaginal canal. The dilators have dots or markers that measure depth. Hold the dilator in place in your vaginal canal. Use gentle but constant inward pressure for the correct amount of time at the right depth for you. If you're feeling pain, breathe and relax the muscles. When time is up, slowly remove the dilator, then repeat with the other dilators you need to use. Wash the dilators and your hands. If you have increased discharge following dilation, you may want to wear a pad to protect your clothing.

Jessi: I mean, it's such a strange, unfamiliar feeling to dilate and to have a dilator, you know to insert a dilator into your own vagina. Because it's not a pleasurable experience, and it's quite painful at first when you start to dilate. It feels much like a foreign body entering and it doesn't feel familiar and your body kind of wants to get it out of there. It's really tough at the beginning, but if you can get through the first month, couple months, it's going to be a lot easier and it's not going to be so much of an emotional and uncomfortable experience.

Narrator: You need to stay on schedule even when traveling. Bring your dilators with you. If your schedule at work creates challenges, ask your health care team if some of your dilation sessions can be done overnight.

Alissa (nurse): You can't skip days now and do more dilation later. You must do dilation on schedule to keep vaginal depth and width. It is important to dilate even if you have pain. Dilation should cause less pain over time.

Jessi: I hear that from a lot of other women that it's an overwhelming experience. There's lots of emotions that are coming through all at once. But at the end of the day for me, it was a very happy experience. I was glad to have the opportunity because that meant that while I have a vagina now, at the end of the day I had a vagina. Yes, it hurts, and it's not pleasant to dilate, but I have the vagina and it's worth it. It's a long process and it's not going to be easy. But you can do it.

Narrator: If you feel dilation may not be working or you have any questions about dilation, please talk with a member of your health care team.

Research has found that that gender-affirming surgery can have a positive impact on well-being and sexual function. It's important to follow your health care provider's advice for long-term care and follow-up after surgery. Continued care after surgery is associated with good outcomes for long-term health.

Before you have surgery, talk to members of your health care team about what to expect after surgery and the ongoing care you may need.

Clinical trials

Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions.

Feminizing surgery care at Mayo Clinic

  • Tangpricha V, et al. Transgender women: Evaluation and management. https://www.uptodate.com/ contents/search. Accessed Aug. 16, 2022.
  • Erickson-Schroth L, ed. Surgical transition. In: Trans Bodies, Trans Selves: A Resource by and for Transgender Communities. 2nd ed. Kindle edition. Oxford University Press; 2022. Accessed Aug. 17, 2022.
  • Coleman E, et al. Standards of care for the health of transgender and gender diverse people, version 8. International Journal of Transgender Health. 2022; doi:10.1080/26895269.2022.2100644.
  • AskMayoExpert. Gender-affirming procedures (adult). Mayo Clinic; 2022.
  • Nahabedian, M. Implant-based breast reconstruction and augmentation. https://www.uptodate.com/contents/search. Accessed Aug. 17, 2022.
  • Erickson-Schroth L, ed. Medical transition. In: Trans Bodies, Trans Selves: A Resource by and for Transgender Communities. 2nd ed. Kindle edition. Oxford University Press; 2022. Accessed Aug. 17, 2022.
  • Ferrando C, et al. Gender-affirming surgery: Male to female. https://www.uptodate.com/contents/search. Accessed Aug. 17, 2022.
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Surgeon Phil Thomas from the Nuffield hospital in Brighton.

Meet the gender reassignment surgeons: 'Demand is going through the roof'

Under a dozen people in the UK can carry out vaginoplasty or phalloplasty operations – and attracting new talent is tough

The problem, according to Phil Thomas, is this: there are simply not enough people in Britain who know how to make a vagina.

“We need more surgeons,” the urologist said from the private Nuffield hospital in Brighton. “In March I received 24 new referral letters. Multiply that by 12 and you can see what the issue is.

“The volume that we need to do to meet the demand is just going through the roof and NHS England are not keeping up.”

The problem of waiting lists for transgender patients who want genital gender reassignment surgery (GRS) is not just one of growing demand, but of supply. This is niche work. Thomas is one of fewer than a dozen practitioners in the UK. About two-thirds deal with male-to-female surgery – vaginoplasty – and the other third handle the opposite procedure – phalloplasty for trans men.

Most work both privately and on the NHS. One has just gone on maternity leave. Thomas and another colleague, James Bellringer, are due to retire in the next five years. “At this stage if we were both on a plane to go to a meeting abroad and something were to happen, there’d be a problem,” said Thomas.

Thomas calculates that people wait about six months for his services. For Bellringer, waiting times are even longer. His NHS patients in London face waits of more than a year and a half.

Referrals for vaginoplasty surgery have been growing at 20% per year and as of March 2016, 266 trans women were waiting for surgery at Charing Cross , the oldest gender identity clinic in the country.

“One of my patients has been making ‘Bellringer Babe’ badges,” he said with a smile. The badges bear the silhouette of an elegant woman in a ballgown and indicate that the wearer has had male to female gender reassignment surgery (GRS) at the hands of the London-based surgeon.

Bellringer came to vaginoplasty almost by accident, in 2000. He was working at Charing Cross hospital in west London, part of Imperial College NHS trust and the only NHS hospital that performs the surgery in the UK, when Mike Royle, the surgeon who built up the practice for GRS in the UK, announced his retirement.

“I was in the right place at the right time,” said Bellringer. “They needed someone with the technical ability and the right approach with the patients, so they asked me.”

In 2014 Bellringer and Thomas were joined by Tina Rashid, a 34-year-old urologist who is now the only woman performing gender reassignment surgery in the country. “There are not many younger surgeons going into gender reassignment,” said Bellringer. “Tina is our secret weapon. She is down there with the kids.”

James Bellringer

Rashid first witnessed vaginoplasty surgery during her training period at Charing Cross, where she was appointed as consultant in 2014. “I knew it would be a missed opportunity not to observe the surgery,” said Rashid. “Wherever I ended up, at some point in my consultant career I would see a handful of patients who had male to female reconstruction. I wanted to understand how to treat them.”

“James and Phil should really be credited for setting up the service in the UK,” she continued. “I see my role as really helping take it forward. They are towards the end of their careers and I am at the beginning of mine.”

But attracting new surgeons into the speciality was, said Rashid, “extremely difficult”. “GRS is a very niche area. A lot of trainees don’t get exposure to it,” she said.

The situation is not likely to improve in the short term. Rashid went on maternity leave in April and expects to be away for the rest of the year. Charing Cross has been training a new surgeon to replace her, but he is not quite ready to operate. There are two others doing a small amount of this work for the NHS elsewhere in the UK, Oliver Fenton and Charles Coker.

In contrast trans men looking to have female to male reassignment surgery are in a better position – those who wish to have genital surgery can expect to receive it within the 18-week referral target.

Estimates from the Charing Cross gender identity clinic suggest that whereas about 60% of all trans women will go on to have genital surgery, only 10-30% of trans men will want phalloplasty – the surgical construction of a penis, which involves four operations and takes a total of 16 hours.

David Ralph, consultant urologist at St Peter’s Andrology Centre in London, and his team treat about four trans patients a week and receive 200 new patients a year.

“There are a lot more male to female trans patients than there are female to male, but saying that it takes four operations to make a penis and only one to make a vagina,” said Ralph. “The main thing that trans men want is to be able to stand to void [urinate]. Secondary to that of course is being able to have sex with their new penis. This really changes their lives.”

The surgeons performing these operations are passionate about what they do and urge more of their colleagues to consider training to be able to do the surgery.

“I think most of my urology peers think I’m mad. Well actually, compared to staring down a laparoscope for four hours removing someone’s prostate this is much more fun,” said Bellringer.

For Rashid, the driving force is being able to help a group of vulnerable patients who are at high risk of depression, anxiety and suicide.

“I have patients say: ‘You have saved my life.’ It is very gratifying and not something that I can quite put into words,” she said.

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Gender Confirmation Surgery (GCS)

What is Gender Confirmation Surgery?

  • Transfeminine Tr

Transmasculine Transition

  • Traveling Abroad

Choosing a Surgeon

Gender confirmation surgery (GCS), known clinically as genitoplasty, are procedures that surgically confirm a person's gender by altering the genitalia and other physical features to align with their desired physical characteristics. Gender confirmation surgeries are also called gender affirmation procedures. These are both respectful terms.

Gender dysphoria , an experience of misalignment between gender and sex, is becoming more widely diagnosed.  People diagnosed with gender dysphoria are often referred to as "transgender," though one does not necessarily need to experience gender dysphoria to be a member of the transgender community. It is important to note there is controversy around the gender dysphoria diagnosis. Many disapprove of it, noting that the diagnosis suggests that being transgender is an illness.

Ellen Lindner / Verywell

Transfeminine Transition

Transfeminine is a term inclusive of trans women and non-binary trans people assigned male at birth.

Gender confirmation procedures that a transfeminine person may undergo include:

  • Penectomy is the surgical removal of external male genitalia.
  • Orchiectomy is the surgical removal of the testes.
  • Vaginoplasty is the surgical creation of a vagina.
  • Feminizing genitoplasty creates internal female genitalia.
  • Breast implants create breasts.
  • Gluteoplasty increases buttock volume.
  • Chondrolaryngoplasty is a procedure on the throat that can minimize the appearance of Adam's apple .

Feminizing hormones are commonly used for at least 12 months prior to breast augmentation to maximize breast growth and achieve a better surgical outcome. They are also often used for approximately 12 months prior to feminizing genital surgeries.

Facial feminization surgery (FFS) is often done to soften the lines of the face. FFS can include softening the brow line, rhinoplasty (nose job), smoothing the jaw and forehead, and altering the cheekbones. Each person is unique and the procedures that are done are based on the individual's need and budget,

Transmasculine is a term inclusive of trans men and non-binary trans people assigned female at birth.

Gender confirmation procedures that a transmasculine person may undergo include:

  • Masculinizing genitoplasty is the surgical creation of external genitalia. This procedure uses the tissue of the labia to create a penis.
  • Phalloplasty is the surgical construction of a penis using a skin graft from the forearm, thigh, or upper back.
  • Metoidioplasty is the creation of a penis from the hormonally enlarged clitoris.
  • Scrotoplasty is the creation of a scrotum.

Procedures that change the genitalia are performed with other procedures, which may be extensive.

The change to a masculine appearance may also include hormone therapy with testosterone, a mastectomy (surgical removal of the breasts), hysterectomy (surgical removal of the uterus), and perhaps additional cosmetic procedures intended to masculinize the appearance.

Paying For Gender Confirmation Surgery

Medicare and some health insurance providers in the United States may cover a portion of the cost of gender confirmation surgery.

It is unlawful to discriminate or withhold healthcare based on sex or gender. However, many plans do have exclusions.

For most transgender individuals, the burden of financing the procedure(s) is the main difficulty in obtaining treatment. The cost of transitioning can often exceed $100,000 in the United States, depending upon the procedures needed.

A typical genitoplasty alone averages about $18,000. Rhinoplasty, or a nose job, averaged $5,409 in 2019.  

Traveling Abroad for GCS

Some patients seek gender confirmation surgery overseas, as the procedures can be less expensive in some 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 that your surgeon is skilled in the procedure being performed and that your 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.S. or elsewhere. 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 it can result in a better outcome.

A Word From Verywell

Gender confirmation surgery is very complex, and the procedures that one person needs to achieve their desired result can be very different from what another person wants.

Each individual's goals for their appearance will be different. 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. A personalized approach is essential to satisfaction because personal appearance is so highly individualized.

Davy Z, Toze M. What is gender dysphoria? A critical systematic narrative review . Transgend Health . 2018;3(1):159-169. doi:10.1089/trgh.2018.0014

Morrison SD, Vyas KS, Motakef S, et al. Facial Feminization: Systematic Review of the Literature . Plast Reconstr Surg. 2016;137(6):1759-70. doi:10.1097/PRS.0000000000002171

Hadj-moussa M, Agarwal S, Ohl DA, Kuzon WM. Masculinizing Genital Gender Confirmation Surgery . Sex Med Rev . 2019;7(1):141-155. doi:10.1016/j.sxmr.2018.06.004

Dowshen NL, Christensen J, Gruschow SM. Health Insurance Coverage of Recommended Gender-Affirming Health Care Services for Transgender Youth: Shopping Online for Coverage Information . Transgend Health . 2019;4(1):131-135. doi:10.1089/trgh.2018.0055

American Society of Plastic Surgeons. Rhinoplasty nose surgery .

Rights Group: More U.S. Companies Covering Cost of Gender Reassignment Surgery. CNS News. http://cnsnews.com/news/article/rights-group-more-us-companies-covering-cost-gender-reassignment-surgery

The Sex Change Capital of the US. CBS News. http://www.cbsnews.com/2100-3445_162-4423154.html

By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.

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How to find an NHS gender dysphoria clinic

Trans and non-binary people's general health needs are the same as anyone else's. But trans people may have specific health needs in relation to gender dysphoria.

Your particular needs may be best addressed by transgender health services offered by NHS gender dysphoria clinics (GDCs).

All NHS GDCs are commissioned by NHS England, who set the service specifications for how they work.

A GP or another health professional can refer you directly to one of the 8 GDCs. You do not need an assessment by a mental health service first. Neither does the GP need prior approval from their integrated care board (ICB). 

The websites of the clinics listed on this page also have useful information for you to think about before you see a GP. 

Gender dysphoria clinics in London and the southeast

The Tavistock and Portman NHS Foundation Trust: Gender Dysphoria Clinic for Adults

Lief House 3 Sumpter House Finchley Road London NW3 5HR

Phone: 020 8938 7590

Email: [email protected]

The GDC website has an overview of information useful for anyone with gender identity needs, not just those in the area.

The Tavistock and Portman NHS Foundation Trust Gender Identity Development Service (GIDS) for children and young people

GIDS The Tavistock Centre 120 Belsize Lane London NW3 5BA

Phone: 020 8938 2030

Email:  [email protected]  

GIDS also has a clinic in Leeds, which is for people from northern regions of England:

8 Park Square Leeds LS1 2LH

Phone: 0113 247 1955

The  Gender Identity Development Service website includes information about the services they offer young people (up to the age of 18). They help those who are experiencing difficulties in the development of their gender identity, and their families.

Gender dysphoria clinics in the north

Sheffield Health and Social Care NHS Foundation Trust Gender Dysphoria Service

Porterbrook Clinic Michael Carlisle Centre 75 Osborne Road Sheffield S11 9BF

Phone: 0114 271 6671

Email: [email protected]

The  Sheffield clinic's website includes information about referrals, clinic opening hours and links to eligibility criteria.

Leeds and York Partnership NHS Foundation Trust Gender Dysphoria Service

Management Suite 1st Floor The Newsam Centre Seacroft Hospital York Road Leeds LS14 6WB

Phone: 0113 855 6346

Email: [email protected]

The Leeds clinic's website covers referrals, commonly used medicines and information on the clinic's Gender Outreach workers.

Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust Northern Region Gender Dysphoria Service

Benfield House Walkergate Park Benfield Road Newcastle NE6 4PF

Phone: 0191 287 6130

Email: [email protected]

The Northern Region Gender Dysphoria Service website has a range of leaflets, including information about referral, hormones and support groups.

Gender dysphoria clinics in the Midlands

Northamptonshire Healthcare NHS Foundation Trust Gender Dysphoria Clinic

Danetre Hospital H Block London Road Daventry Northamptonshire NN11 4DY

Phone: 03000 272858

Email:  [email protected]

Visit the  Northampton clinic's website for more information about how to get a referral and the role of the GP.

Nottinghamshire Healthcare NHS Foundation Trust The Nottingham Centre for Transgender Health

12 Broad Street Nottingham NG1 3AL

Phone: 0115 876 0160

Email: [email protected]

Visit The Nottingham Centre for Transgender Health website  for more information about how to get a referral.

Gender dysphoria clinics in the southwest

Devon Partnership NHS Trust West of England Specialist Gender Dysphoria Clinic

The Laurels 11-15 Dix's Field Exeter EX1 1QA

Phone: 01392 677 077

Email: [email protected]

The Laurels' website has information about the types of services on offer and the help available during transition.

New gender dysphoria services in 2020

In 2020 new NHS gender dysphoria services for adults will open in Greater Manchester, London and Merseyside.

These services will be delivered by healthcare professionals with specialist skills and based in local NHS areas, such as sexual health services. Full details will be available once each service is opened.

Initially, access to these services will be available to people who are already on a waiting list to be seen at one of the established gender dysphoria clinics.

NHS England will assess how useful these new pilot services are.

Page last reviewed: 13 May 2020 Next review due: 13 May 2023

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The Gender Identity Service at Parkside Hospital is headed by  Mr James Bellringer  and  Miss Tina Rashid , Consultant Urological Surgeons supported by Martina Zurli and Sandie Ruston. The clinic is based at Parkside at Putney  with all operations taking place at Parkside Hospital. The Gender Identity Service currently deals with transwomen only.

What is genital reconstructive surgery.

Genital Reconstructive Surgery (GRS) involves reshaping the male genitals to anatomically and, as far as possible, functionally resemble that of female genitalia. Prior to surgery, patients undergo hormone replacement therapy and counselling from recognised gender specialists. Other associated operations that patients may elect to have are facial feminisation surgery and breast augmentation. The Gender Identity Service at Parkside currently offers vaginoplasty, labioplasty and orchidectomy.

If you would like to know more detail about the two surgeries, please click the link in the box on the right.

What support services do you offer?

Martina Zurli and Sandie Ruston will be your dedicated nurses should you choose to have the surgery at Parkside Hospital. Their role is to see you through, from the first consultation to post-operative check-ups, and are available to advise you at any time. Daniel and Laura are there to support you and your family during these changes and can liaise with other healthcare professionals, on your behalf, to ensure continued care and support during your journey.

How can I book a consultation?

If you are a  private patient , or if you have private insurance which covers gender treatment, you can book a consultation with Mr Bellringer or Miss Rashid by calling one of our Client Service Advisors on  020 8971 8026 .

If you are an  NHS patient  please contact the Service Coordinator,  [email protected] who will advise you further.

Gender Identity Service Consultants

gender reassignment surgery male to female nhs

Want to book an appointment?

Call us on: 020 8971 8000 or BOOK ONLINE

For assistance call us on: 020 8971 8000 Email us

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NHS population screening: information for trans and non-binary people

Updated 4 January 2023

Applies to England

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This publication is available at https://www.gov.uk/government/publications/nhs-population-screening-information-for-transgender-people/nhs-population-screening-information-for-trans-people

This information is for trans (transgender) and non-binary people in England. It tells you about the adult NHS screening programmes that are available in England and explains who we invite for screening.

We use trans as an umbrella term to embrace the diverse range of identities outside the traditional male/female definitions. These include transgender, gender fluid and non-binary. Find more trans health information on NHS.UK .

Screening for trans people at a glance

Trans women and non-binary people assigned male at birth who are registered with a GP as female:

  • are invited for breast screening
  • are invited for bowel cancer screening
  • do not need cervical screening as they do not have a cervix
  • are not routinely invited for abdominal aortic aneurysm ( AAA ) screening but can request screening

Trans women and non-binary people assigned male at birth who are registered with a GP as male:

  • are not routinely invited for breast screening but can request screening
  • are invited for AAA screening

Trans men and non-binary people assigned female at birth who are registered with a GP as female:

  • are invited for cervical screening
  • are not invited for AAA screening

Trans men and non-binary people assigned female at birth who are registered with a GP as male:

  • are not routinely invited for cervical screening but can request screening
  • are invited for AAA screening but do not have a high risk of AAA

Trans men who are pregnant should be offered the same antenatal and newborn screening tests as all other pregnant individuals.

Breast screening

Breast screening is a free NHS test that is carried out at breast screening centres and at mobile breast screening units across England.

Breast screening can find cancers when they are too small to see or feel. Finding and treating cancer early gives you the best chance of survival. Screening will miss some cancers, and some cancers cannot be cured.

Taking part in breast screening is your choice. You can find out more information from your GP or by visiting NHS.UK .

Breast screening invitation process

All individuals from 50 up to their 71st birthday who are registered as female with their GP are automatically invited to breast screening. When you are due for screening, we will send you an invitation letter. It is not possible for individuals registered as male to have mammograms as part of the NHS Breast Screening Programme, but your GP can refer you for mammograms at a hospital near you (see the information for people registered as male below).

We invite you for breast screening every 3 years. Your first invitation will arrive sometime between the ages of 50 and 53. If you are trans it is important that your GP makes sure that your records are up to date so you are invited for screening correctly.

If you do not want to be invited for breast screening, you need to contact your local breast screening office. They will explain how you can opt out of breast screening.

It is important that you feel that you are treated with dignity and respect at all times.

Let your screening service know if you would:

  • like your appointment at the beginning or end of a clinic
  • prefer to be screened at your local breast screening centre rather than a mobile breast screening unit

Visit NHS.UK for your service’s contact details.

Trans men and non-binary people assigned female at birth

Registered with a gp as female.

If you are aged from 50 years up to your 71st birthday and registered with a GP as female, you will be routinely invited for breast screening. We recommend you consider having breast screening if you have not had chest reconstruction (top surgery) or still have breast tissue.

If you are worried about visiting a breast screening unit you can ring to arrange a more suitable appointment. For example, we can arrange for you to have an appointment at the beginning or end of a clinic.

Registered with a GP as male

If you are registered with a GP as male, you will not be invited for breast screening. If you have not had chest reconstruction (top surgery) and are aged 50 or over we suggest you talk to your GP . They can arrange a referral for you to have mammograms at a hospital near you.

You should keep aware of the symptoms of breast cancer , and contact your GP if you notice any unusual changes.

If you have had chest reconstruction (top surgery), we advise you have a conversation with your surgeon about the amount of breast tissue you have remaining. If they confirm you still have breast tissue, you can ask your GP to refer you for mammograms at a hospital near you.

Trans women and non-binary people assigned male at birth

Registered with a gp as a female.

If you are aged from 50 up to your 71st birthday and registered with a GP as female, you will be routinely invited for screening. Long-term hormone therapy can increase your risk of developing breast cancer so it is important that you consider going for breast screening when you are invited.

If you are registered with a GP as male, you will not be invited for breast screening.

If you have been on long-term hormone therapy you may be at increased risk of developing breast cancer. Your GP can arrange a referral for you to have mammograms at a hospital near you.

Breast screening test

A breast X-ray called a mammogram is used to look for signs of cancer. Each breast is pressed firmly between the plates of an X-ray machine for a few seconds. The pressure is needed to get good images and also reduce the radiation dose. Your test will be carried out by a specially trained female mammographer.

Some people say having a mammogram is uncomfortable and a few may find it painful, but the discomfort should pass quickly.

Breast screening usually involves 2 X-rays of each breast. People who have implants are offered the choice of additional X-rays so the mammographer can see as much breast tissue as possible.

Preparation

If you are a trans man or non-binary person assigned female at birth who is registered with a GP as female, has not had chest reconstruction (top surgery) and wears a binder, you will need to remove this before having your mammogram.

Private changing facilities will be available so that you can remove your binder just before having your mammogram. If you have any concerns about your appointment, you can contact your local breast screening service.

Breast screening results

For most people the mammograms will show no signs of cancer. If changes are seen on your X-rays, you will be recalled to an assessment clinic for more tests which will include:

  • a breast examination
  • more X-rays or ultrasound scans

You may also have a biopsy, where a small sample of tissue is taken from the breast with a needle.

Sometimes breast screening can pick up cancers that would never have caused harm, so people are treated for breast cancer that would never have been life-threatening.

Reducing your risk

Screening reduces the number of deaths from breast cancer by finding signs of disease at an early stage.

It is important to know what is normal for your body. If you notice any changes report them to your GP .

Cervical screening

Cervical screening (also known as a smear test) is a free NHS test that is carried out at your GP surgery or at some sexual health clinics. The test looks for early changes in the cells of the cervix.

Cervical screening aims to prevent cancer from developing in the cervix (neck of the womb).

It is important to go for screening as finding changes before they become cancer gives you the best chance of successful treatment.

Nearly all cervical cancers are caused by human papillomavirus ( HPV ). HPV is a very common virus – most people will be infected with it at some point in their life. It can be passed on through any type of sexual activity.

Screening will not prevent all cancers and not all cancers can be cured.

Taking part in cervical screening is your choice. You can find out more information from your GP or by visiting NHS.UK .

Cervical screening invitation process

We invite people registered as female for cervical screening every 3 years from the age of 25 to 49 and every 5 years from the ages of 50 to 64. We also invite people who are over 65 who have not been screened since age 50 or those who have recently had abnormal tests.

We send an invitation letter when the cervical screening test is due, asking you to make an appointment.

If you are trans it is important that your GP contacts the NHS Cervical Screening Programme so you are invited for screening correctly. If you do not want to be invited for screening you should contact your GP . They will be able to remove you from the cervical screening invitation list.

It is important that you feel that you are treated with dignity and respect at all times. If you are worried about having cervical screening, talk to your doctor or practice nurse.

If you are aged 25 to 64 and registered with a GP as female, you will be routinely invited for cervical screening. We recommend that you consider having cervical screening if you have not had a total hysterectomy and still have a cervix.

If you are aged 25 to 64 and registered with a GP as male, you will not be invited for cervical screening. However, if you have not had a total hysterectomy and still have a cervix, you should still consider having cervical screening. This is especially important if you have had any abnormal cervical screening results in the past. If this applies to you, let your GP or practice nurse know so you can talk to them about having the test.

If you are a trans woman or non-binary person assigned male at birth, you will not need to be screened as you do not have a cervix.

If you are registered with a GP as female, you will be routinely invited for cervical screening unless your GP has already told us you’re not eligible. We can update our records so you are not invited unnecessarily.

If you are registered with a GP as male, you will not be invited for cervical screening.

Cervical screening test

The nurse or doctor will put an instrument called a speculum into the vagina to help them see the cervix. They will then take a sample of cells with a soft brush.

If you are a trans man who has taken long-term testosterone, you may find screening uncomfortable or painful. You may want to talk to your doctor or nurse about using a different size speculum and some extra lubrication.

Cervical screening results

For most people their test results are normal. If cell changes are found you may need another cervical screening test, or an appointment at a colposcopy clinic where the cervix is looked at in detail.

Nearly all cervical cancers are caused by a virus called human papillomavirus ( HPV ) which is passed on through any type of sexual activity. If you are worried about your risk of developing cervical cancer you may want to speak to your GP or practice nurse.

We recommend you consider going for cervical screening every time you are invited, even if you have had a previous normal result.

Let your GP or practice nurse know if you think you should be invited for screening.

Even if you have had the HPV vaccine we still recommend you consider going for cervical screening when invited.

Consider stopping smoking, as smoking increases your risk of cervical cancer.

If you have symptoms such as unusual vaginal discharge or bleeding, or pain during or after sex, please speak to your doctor even if you have had a normal cervical screening result.

AAA screening

AAA screening is a free NHS test that is carried out in the community, including hospitals, health clinics and GP practices.

AAA screening involves a simple ultrasound scan to measure the abdominal aorta.

The aorta is the main blood vessel that supplies blood to the body. Sometimes the wall of the aorta in the abdomen can become weak and stretch to form an abdominal aortic aneurysm ( AAA ). There is a risk that an AAA may split or tear (rupture).

There is a high risk of dying from a ruptured AAA . Finding an aneurysm early gives you the best chance of treatment and survival. AAA screening reduces your risk of dying from a ruptured AAA .

Taking part in AAA screening is your choice. You can find out more information about AAA screening from your GP or by visiting NHS.UK .

AAA screening invitation process

AAAs are far more common in men aged over 65 than in women and younger men. That’s why the NHS AAA Screening Programme only invites for screening individuals registered as male. However, any trans woman will have the same risk as a man and should consider accessing screening.

Individuals registered as male are invited for an ultrasound scan to check the size of their abdominal aorta when they are 65.

Individuals over 65 can request a scan by contacting their local AAA screening service directly. Visit NHS.UK for contact details.

If you are trans it is important that your GP contacts the NHS AAA Screening Programme so you are invited for screening correctly. If you do not want to be invited for AAA screening, you will need to let us know.

If you are not sure if you should be screened or not, contact your local screening office. You will find your local screening office number and more information about clinic locations on NHS.UK .

Trans men and non-binary people assigned female at birth do not have the same risk of AAA as people assigned male at birth.

If you are registered with a GP as female, you will not be invited for AAA screening.

If you are a trans man aged 65 who is registered with a GP as male, you will be sent an appointment to attend for AAA screening. You can have AAA screening if you wish even though your risk is lower. If the clinic location or appointment time is not suitable, you can contact your local screening office to change this. You will find your local screening office phone number on your invitation letter.

If you are registered with a GP as female, you will not be invited for screening. However, if you are 65, you will have the same risk as a man aged 65 and should consider accessing screening. You can contact us to arrange a suitable appointment. Visit NHS.UK for contact details.

If you are aged 65 and registered with a GP as male, you will be invited for AAA screening.

Any trans woman or non-binary person assigned male at birth will have the same AAA risk as a man and should consider accessing screening.

AAA screening test

The test is a simple ultrasound scan of your abdomen to measure the size of the aorta. Your screening appointment usually takes about 10 to 15 minutes.

The screener will check your personal details and ask for your consent (permission) to do the ultrasound scan.

You will be asked to lie on your back and lift up your top. You will not need to undress completely. If you are wearing a binder, you may be asked to remove it.

The ultrasound scan is usually painless. It can be slightly uncomfortable as the screener may need to apply some pressure.

AAA screening results

The screener will give you your results following your scan.

It is not always possible to see your aorta at your screening test so you may be referred to hospital.

If your aorta is found to be bigger than normal, you will need regular scans to check if it is growing. Some people never need surgery for their AAA .

If your AAA is large you will be referred to a specialist team to discuss planned surgery. Large AAAs can be treated successfully with surgery.

Consider taking part in AAA screening and follow-up when you are invited.

You should also consider:

  • stopping smoking
  • drinking less alcohol

It is also important to maintain a healthy weight through a healthy diet and physical activity.

Bowel cancer screening

Bowel cancer screening starts with a test kit that is offered for use at home. If the result shows further tests are needed, you are offered a colonoscopy (an examination of the bowel).

Bowel cancer screening reduces your risk of dying from bowel cancer.

Finding cancer early gives you the best chance of survival.

Screening will miss some cancers, and some cancers cannot be cured.

Taking part in bowel cancer screening is your choice. You can find out more information from your GP or by visiting NHS.UK .

Bowel cancer screening invitation process

Both men and women are routinely invited for screening.

Bowel cancer screening is offered every 2 years from the ages of 60 to 74. This age range is gradually being extended down to age 50. People aged 75 and over can request a test kit every 2 years by calling the free programme helpline on 0800 707 60 60.

The home test kit

A bowel screening test kit and information pack will be sent to you when you are due for screening. You are asked to collect one or more samples of your poo using the test kit provided.

You will need to complete the test kit within the timeframe on the instructions and return it using the freepost packaging provided.

The test looks for tiny amounts of blood in the sample which you may not be able to see and which could be a sign of bowel cancer. You can contact the free NHS Bowel Cancer Screening Programme helpline for advice on 0800 707 60 60.

Results from the test kit

If blood is found, you will be referred for further tests. This may involve you having a colonoscopy, which looks at the lining of the bowel using a flexible camera. You may find this more uncomfortable if you have had gender reassignment surgery.

To reduce your risk of bowel cancer you should:

  • consider taking part in screening, even if you have had a previous normal result
  • try to eat a high-fibre diet with plenty of fruit and vegetables, take regular physical exercise and stop smoking
  • visit your GP if you notice blood in your poo, a change in your bowel habit over a number of weeks or unexplained weight loss

Bowel cancer can run in families. If you are worried about your risk please speak to your GP .

Your personal information

It is your decision whether or not to have any of these tests.

The NHS Screening Programmes use personally identifiable information about you to ensure you are invited for screening at the right time. NHS England also uses your information to ensure you receive high quality care.

Find out more about how your information is used and protected, and your options . Find out how to opt out of screening .

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Transgender Surgery: Everything You Need to Know

Gender-affirming surgeries help trans men and women achieve their desired bodies. This can include top surgery, bottom surgery, facial surgery, and more.

gender reassignment surgery male to female nhs

Transgender surgery goes by a constellation of names. People call it gender-affirming surgery; gender reassignment, realignment, or confirmation surgery; masculinization or feminization surgery; male-to-female or female-to-male surgery; or even sex reassignment surgery.

Increasingly, as medicine breaks out of a gender-binary box, more inclusive and culturally appropriate descriptors, such as "gender-affirmation surgery" and "gender-affirming care," are catching on. Older terms such as gender- or sex-reassignment surgery and male-to-female or female-to-male surgery have fallen out of favor.

Having surgery to change one or more sex characteristics—breasts/chest, genitalia, or facial features, for example—is a highly personal decision. But to say it's a "choice" misses the mark, explained Steph DeNormand (they/them), trans health program manager at Fenway Health in Boston. It's a matter of survival; it's "can I be the person that I know I am?" DeNormand told Health .

Whether you are supporting someone who's transitioning or you're on your own journey to align your body with your sense of self, it's important to know what masculinizing, feminizing, and gender-nullification surgeries may involve, including potential risks and complications.

We spoke with surgeons and trans health professionals to find out more about this expanding category of care.

What To Consider Before Transgender Surgery

First, it is important to note that an individual does not need surgery to transition. Many transgender people do not undergo surgery. If they do, it is usually only one part of their transition.

"What I always tell patients is if you don't have dysphoria about a body part, [then] don't have surgery," Christopher McClung, MD , a urologist with OhioHealth in Columbus, Ohio, told Health .

Dysphoria refers to the distress that trans people may experience when their gender identity doesn't match their sex assigned at birth.

In some cases, surgery may be medically necessary to treat the dysphoria, according to the World Professional Association for Transgender Health (WPATH). The organization publishes evidence-based standards for the care of transsexual, transgender, gender non-conforming, genderqueer, gender diverse, and nonbinary individuals.

Hormone Therapy

Gender-affirming hormone therapy uses sex hormones and hormone blockers to help align the person's physical appearance with their gender identity.

For example, when people take masculinizing hormones, "They start growing hair, their voice deepens, they get more muscle mass," Heidi Wittenberg, MD , medical director of the Gender Institute at Saint Francis Memorial Hospital in San Francisco and director of MoZaic Care Inc., which specializes in gender-related genital, urinary, and pelvic surgeries, told Health .

Types of hormone therapy include:

  • Masculinizing hormone therapy uses testosterone. This helps to suppress the menstrual cycle, grow facial and body hair, increase muscle mass, and promote other male secondary sex characteristics.
  • Feminizing hormone therapy includes estrogens and testosterone blockers. These medications work to promote breast growth, slow the growth of body and facial hair, increase body fat, shrink the testicles, and decrease erectile function.
  • Non-binary hormone therapy is typically tailored to the individual and may include female or male sex hormones and/or hormone blockers.

Research shows that cross-sex hormone therapy has positive physical and psychological effects on transitioning individuals.

Hormone therapy is used either as a stand-alone therapy or in combination with other treatments. It can include oral or topical medications, injections, a patch you wear on your skin, or a drug implant. 

It is typically recommended before gender-affirming surgery unless hormone therapy is medically contraindicated or not desired by the individual.

Mental Health Counseling

There's also psychotherapy . People may find it helpful to work through the negative mental health effects of dysphoria. Typically, people seeking gender-conforming surgery must be evaluated by a qualified mental health professional to obtain a referral.

Some people may find that living in their preferred gender is all that's needed to ease their dysphoria, WPATH points out. Doing so for one full year prior is a prerequisite for many surgeries.

While these are guidelines, every person's treatment is individualized, so "there's not one linear path," Julie Thompson , a physician assistant and medical director of trans health at Boston's Fenway Health, told Health .

Masculinizing Surgeries

Masculinizing surgeries can include top surgery, bottom surgery, or both. Common trans male surgeries include:

  • Chest masculinization (breast tissue removal and areola and nipple repositioning/reshaping)
  • Hysterectomy (uterus removal)
  • Metoidioplasty (lengthening the clitoris and possibly extending the urethra)
  • Oophorectomy (ovary removal)
  • Phalloplasty (surgery to create a penis)
  • Scrotoplasty (surgery to create a scrotum)

Top Surgery

Chest masculinization surgery, or top surgery, often involves removing breast tissue and reshaping the areola and nipple. There are two main types of chest masculinization surgeries:

  • Double-incision approach : Used to remove moderate to large amounts of breast tissue, this surgery involves two horizontal incisions below the breast to remove breast tissue and accentuate the contours of pectoral muscles. The nipples and areolas are removed and, in many cases, resized, reshaped, and replaced.
  • Short scar top surgery : For people with smaller breasts and firm skin, the procedure involves a small incision along the lower half of the areola to remove breast tissue. The nipple and areola may be resized before closing the incision.

"I think a lot of trans men, in general, will just get top surgery and stop there," depending on the level of dysphoria, said Dr. McClung. Others opt for bottom surgery to reconstruct the pelvic area.

Metoidioplasty

Some trans men elect to do metoidioplasty, also called a meta, which involves lengthening the clitoris to create a small penis. Both a penis and a clitoris are made of the same type of tissue and experience similar sensations.

Prior to metoidioplasty, testosterone therapy may be used to enlarge the clitoris. The procedure can be completed in one surgery, which may also include:

  • Constructing a glans (head) to look more like a penis
  • Extending the urethra (the tube urine passes through), which allows the person to urinate while standing
  • Creating a scrotum (scrotoplasty) from labia majora tissue

Some people may request a variation called a simple release (or simple meta) "to stretch the clitoris out and do nothing else," said Dr. McClung.

Phalloplasty

Other trans men opt for phalloplasty to give them a phallic structure (penis) with sensation. Phalloplasty typically requires several procedures but results in a larger penis than metoidioplasty.

The first and most challenging step is to harvest tissue from another part of the body, often the forearm or back, along with an artery and vein or two, to create the phallus, Nicholas Kim, MD , assistant professor in the division of plastic and reconstructive surgery in the department of surgery at the University of Minnesota Medical School in Minneapolis, told Health .

Those structures are reconnected under an operative microscope using very fine sutures—"thinner than our hair," said Dr. Kim. That surgery alone can take six to eight hours, he added.

In a separate operation, called urethral reconstruction, the surgeons connect the urinary system to the new structure so that urine can pass through it, said Dr. Kim. Urethral reconstruction, however, has a high rate of complications, which include fistulas or strictures.

According to Dr. Kim, some trans men prefer to skip that step, especially if standing to urinate is not a priority.

People who want to have penetrative sex will also need prosthesis implant surgery.

Hysterectomy and Oophorectomy

Masculinizing surgery often includes the removal of the uterus (hysterectomy) and ovaries (oophorectomy). People may want a hysterectomy to address their dysphoria, said Dr. Wittenberg, and it may be necessary if their gender-affirming surgery involves removing the vagina.

Many also opt for an oophorectomy to remove the ovaries, almond-shaped organs on either side of the uterus that contains eggs and produces female sex hormones. In this case, oocytes (eggs) can be extracted and stored for a future surrogate pregnancy, if desired.

However, this is a highly personal decision, and some trans men choose to keep their uterus to preserve fertility.

Feminizing Surgeries

Surgeries are often used to feminize facial features, enhance breast size and shape, reduce the size of an Adam’s apple , and reconstruct genitals.   Feminizing surgeries can include: 

  • Breast augmentation
  • Facial feminization surgery
  • Penis removal (penectomy)
  • Scrotum removal (scrotectomy)
  • Testicle removal (orchiectomy)
  • Tracheal shave (chondrolaryngoplasty) to reduce an Adam's apple
  • Vaginoplasty
  • Voice feminization

Breast Augmentation

Top surgery, also known as breast augmentation or breast mammoplasty, is often used to increase breast size for a more feminine appearance. The procedure can involve placing breast implants, tissue expanders, or fat from other parts of the body under the chest tissue.

Breast augmentation can significantly improve gender dysphoria. Studies show most people who undergo top surgery are happier, more satisfied with their chest, and would undergo the surgery again.

Most surgeons recommend 12 months of feminizing hormone therapy before breast augmentation. Since hormone therapy itself can lead to breast tissue development, transgender women may or may not decide to have surgical breast augmentation.

Facial Feminization and Adam's Apple Removal

Facial feminization surgery (FFS) is a series of plastic surgery procedures that reshape the forehead and hairline, eyebrows, nose, cheeks, and jawline. Nonsurgical treatments like cosmetic fillers, botox, fat grafting, and liposuction may also be used to create a more feminine appearance.  

Some trans women opt for chondrolaryngoplasty, also known as a tracheal shave. The procedure reduces the size of the Adam's apple, an area of cartilage around the larynx (voice box) that tends to be larger in people assigned male at birth.

Vulvoplasty and Vaginoplasty

As for bottom surgery, there are various feminizing procedures from which to choose. Vulvoplasty (to create external genitalia without a vagina) or vaginoplasty (to create a vulva and vaginal canal) are two of the most common procedures.

Dr. Wittenberg noted that people might undergo six to 12 months of electrolysis or laser hair removal before surgery to remove pubic hair from the skin that will be used for the vaginal lining.

Surgeons have different techniques for creating a vaginal canal. A common one is a penile inversion, where the masculine structures are emptied out and inverted into a created cavity, explained Dr. Kim.

Vaginoplasty may be done in one or two stages, said Dr. Wittenberg, and the initial recovery is three months—but it will be a full year until people see results.

Wound healing difficulties are a common complication. People undergoing vaginoplasty must use a dilator to maintain the vaginal cavity's depth and width, which places stress on the surgical site, said Dr. Kim.

"So you have two competing goals," said Dr. Kim, one of trying to heal wounds and the other trying to keep the vaginal cavity "as deep and wide as possible," he added. If wounds become infected, antibiotics may be necessary, or even another operation to clean out the infection.

A growing number of minimal-depth vaginoplasties are being performed in response to those wanting feminine genitalia but are not willing to risk complications or the hassle of dilating.

"Recently, we're finding out that, from a patient's perspective, the external appearance of the vulva is just as important as the vaginal cavity," said Dr. Kim.

Surgical removal of the penis or penectomy is sometimes used in feminization treatment. This can be performed along with an orchiectomy and scrotectomy.

However, a total penectomy is not commonly used in feminizing surgeries nowadays. Instead, many people opt for penile-inversion surgery, a technique that hollows out the penis and repurposes the tissue to create a vagina during vaginoplasty.

Orchiectomy and Scrotectomy

An orchiectomy is a surgery to remove the testicles —male reproductive organs that produce sperm. Scrotectomy is surgery to remove the scrotum, that sac just below the penis that holds the testicles.

"You could do an orchiectomy alone, which is just removal of the testicles," said Dr. McClung. "You could do an orchiectomy and scrotectomy [removal of the scrotum]," said Dr. McClung.

However, some people opt to retain the scrotum. Scrotum skin can be used in vulvoplasty or vaginoplasty, surgeries to construct a vulva or vagina.

Other Surgical Options

Some gender non-conforming people opt for other types of surgeries. This can include:

  • Gender nullification procedures
  • Penile preservation vaginoplasty
  • Vaginal preservation phalloplasty

Gender Nullification

People who are agender or asexual may opt for gender nullification, sometimes called nullo. This involves the removal of all sex organs. The external genitalia is removed, leaving an opening for urine to pass and creating a smooth transition from the abdomen to the groin.

Depending on the person's sex assigned at birth, nullification surgeries can include:

  • Breast tissue removal
  • Nipple and areola augmentation or removal

Penile Preservation Vaginoplasty

Some gender non-conforming people assigned male at birth want a vagina but also want to preserve their penis, said Dr. Wittenberg.

This is called a penile preservation vaginoplasty, or "phalgina," as one of her patients coined it. Often, that involves taking skin from the lining of the abdomen to create a vagina with full depth.

Vaginal Preservation Phalloplasty

Alternatively, a patient assigned female at birth can undergo phalloplasty (surgery to create a penis) and retain the vaginal opening. Known as vaginal preservation phalloplasty, it is often used as a way to resolve gender dysphoria while retaining fertility.

What Doctors Wish People Knew Before Surgery

All in all, the entire transition process—living as your identified gender, obtaining mental health referrals, getting insurance approvals, taking hormones, going through hair removal, and having various surgeries—can take years, healthcare providers explained.

By the time they finally have a surgical consult, people tend to be focused on doing the surgery as quickly as possible, said Dr. Wittenberg.

Yet it's important to proceed with the utmost care. Dr. McClung wished people had a better idea of the potential risks.

A 6-year study of 7,905 transgender people who had gender-affirming surgeries found about 5.8% had complications, and that phalloplasty had the highest rate of complications.

"I always tell my patients, 'Look, I want the same thing as you: I want a cosmetically and functionally perfect set of genitals that is going to make you happy,'" said Dr. McClung. But the procedures must be done in the safest way possible to avoid complications.

A Quick Review

Transgender surgeries help to reduce or resolve gender dysphoria in transsexual, transgender, and gender non-conforming people. It is a highly personalized process that looks different for each person and can often take several months or years. Psychotherapy and hormone therapy are typically required prior to surgical planning. 

Gender-affirming procedures often involve multiple surgeries. Feminizing or masculinizing top surgery involves adding, removing, or reshaping breasts, areoles, and nipples.

Masculinizing bottom surgeries may involve procedures to remove the uterus (hysterectomy) and ovaries (oophorectomy) and create a phallic structure by either phalloplasty or a procedure to lengthen the clitoris (metoidioplasty). Some trans men also have a procedure to extend the urethra, which allows them to urinate in a standing position.

Feminizing bottom surgeries can include penis removal or inversion, testicle and scrotum removal (orchiectomy and scrotectomy), and creating a vagina and vulva (vaginoplasty) or vulva without a vaginal canal (vulvoplasty).

Gender nullification surgery is often used for people who identify as agender, asexual, or non-binary. This involves removing external genitalia to create a smooth transition from the abdomen to the groin. 

Gender-affirming procedures can also involve plastic surgery to modify facial features for a more masculine, feminine, or non-binary appearance. In addition, vocal cord and voice-box modifications are sometimes used to change the voice pitch and reduce the size of the Adam’s apple. 

gender reassignment surgery male to female nhs

Coleman E, Radix AE, Bouman WP, et al. Standards of care for the health of transgender and gender diverse people, version 8 .  Int J Transgend Health . 2022;23(S1):S1-S260. doi:10.1080/26895269.2022.2100644 

Unger CA. Hormone therapy for transgender patients . Transl Androl Urol . 2016;5(6):877–84. doi:10.21037/tau.2016.09.04

Richards JE, Hawley RS. Chapter 8: Sex Determination: How Genes Determine a Developmental Choice . In: Richards JE, Hawley RS, eds. The Human Genome . 3rd ed. Academic Press; 2011: 273-298.

Randolph JF Jr. Gender-affirming hormone therapy for transgender females . Clin Obstet Gynecol . 2018;61(4):705-721. doi:10.1097/GRF.0000000000000396

Cocchetti C, Ristori J, Romani A, Maggi M, Fisher AD. Hormonal treatment strategies tailored to non-binary transgender individuals . J Clin Med . 2020;9(6):1609. doi:10.3390/jcm9061609

Van Boerum MS, Salibian AA, Bluebond-Langner R, Agarwal C. Chest and facial surgery for the transgender patient .  Transl Androl Urol . 2019;8(3):219-227. doi:10.21037/tau.2019.06.18

Djordjevic ML, Stojanovic B, Bizic M. Metoidioplasty: techniques and outcomes . Transl Androl Urol . 2019;8(3):248–53. doi:10.21037/tau.2019.06.12

Bordas N, Stojanovic B, Bizic M, Szanto A, Djordjevic ML. Metoidioplasty: surgical options and outcomes in 813 cases .  Front Endocrinol . 2021;12:760284. doi:10.3389/fendo.2021.760284

Al-Tamimi M, Pigot GL, van der Sluis WB, et al. The surgical techniques and outcomes of secondary phalloplasty after metoidioplasty in transgender men: an international, multi-center case series .  The Journal of Sexual Medicine . 2019;16(11):1849-1859. doi:10.1016/j.jsxm.2019.07.027

Waterschoot M, Hoebeke P, Verla W, et al. Urethral complications after metoidioplasty for genital gender affirming surgery . J Sex Med . 2021;18(7):1271–9. doi:10.1016/j.jsxm.2020.06.023

Nikolavsky D, Hughes M, Zhao LC. Urologic complications after phalloplasty or metoidioplasty . Clin Plast Surg . 2018;45(3):425–35. doi:10.1016/j.cps.2018.03.013

Nota NM, den Heijer M, Gooren LJ. Evaluation and treatment of gender-dysphoric/gender incongruent adults . In: Feingold KR, Anawalt B, Boyce A, et al., eds.  Endotext . MDText.com, Inc.; 2000.

Carbonnel M, Karpel L, Cordier B, Pirtea P, Ayoubi JM. The uterus in transgender men . Fertil Steril . 2021;116(4):931–5. doi:10.1016/j.fertnstert.2021.07.005

Miller TJ, Wilson SC, Massie JP, Morrison SD, Satterwhite T. Breast augmentation in male-to-female transgender patients: Technical considerations and outcomes . JPRAS Open . 2019;21:63-74. doi:10.1016/j.jpra.2019.03.003

Claes KEY, D'Arpa S, Monstrey SJ. Chest surgery for transgender and gender nonconforming individuals . Clin Plast Surg . 2018;45(3):369–80. doi:10.1016/j.cps.2018.03.010

De Boulle K, Furuyama N, Heydenrych I, et al. Considerations for the use of minimally invasive aesthetic procedures for facial remodeling in transgender individuals .  Clin Cosmet Investig Dermatol . 2021;14:513-525. doi:10.2147/CCID.S304032

Asokan A, Sudheendran MK. Gender affirming body contouring and physical transformation in transgender individuals .  Indian J Plast Surg . 2022;55(2):179-187. doi:10.1055/s-0042-1749099

Sturm A, Chaiet SR. Chondrolaryngoplasty-thyroid cartilage reduction . Facial Plast Surg Clin North Am . 2019;27(2):267–72. doi:10.1016/j.fsc.2019.01.005

Chen ML, Reyblat P, Poh MM, Chi AC. Overview of surgical techniques in gender-affirming genital surgery . Transl Androl Urol . 2019;8(3):191-208. doi:10.21037/tau.2019.06.19

Wangjiraniran B, Selvaggi G, Chokrungvaranont P, Jindarak S, Khobunsongserm S, Tiewtranon P. Male-to-female vaginoplasty: Preecha's surgical technique . J Plast Surg Hand Surg . 2015;49(3):153-9. doi:10.3109/2000656X.2014.967253

Okoye E, Saikali SW. Orchiectomy . In: StatPearls [Internet] . Treasure Island (FL): StatPearls Publishing; 2022.

Salgado CJ, Yu K, Lalama MJ. Vaginal and reproductive organ preservation in trans men undergoing gender-affirming phalloplasty: technical considerations . J Surg Case Rep . 2021;2021(12):rjab553. doi:10.1093/jscr/rjab553

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What is gender reassignment surgery?

Gender reassignment surgery is any surgical procedure involved in facilitating a male-to-female (MtF) or female-to-male (FtM) transition . Gender reassignment surgery is complex and can involve a number of separate procedures, carried out over several operations.

gender reassignment surgery male to female nhs

When is gender reassignment surgery required?

Surgery is generally the last step of a person’s transition. In the UK, to receive gender reassignment surgery through the NHS you need to first spend twelve months living in a social role appropriate to your gender identity. Gender reassignment surgery also comes after any hormonal treatment you have received, whether oestrogen (for MtF transitions) or testosterone (for FtM transitions).

What does it involve?

The exact procedures involved depend on whether you are undergoing a MtF or FtM transiton:

Male-to-female transition

The procedures involved in a male-to-female transition include:

  • removal of the penis and testes
  • breast implants
  • construction of a vagina, vulva and clitoris – usually from the skin from the penis
  • surgery on the face to make it more feminine
  • in some cases, the removal of the prostate gland

Female-to-male transition

The procedures involved in a female-to-male transition include:

  • removal of the breasts
  • removal of the womb, ovaries and fallopian tubes
  • construction of a penis and testes – using vaginal tissue and skin from the forearm
  • a penile implant

In both forms of surgery, the aim is to retain sexual sensation and function.

The extent of follow-up care depends on how much surgery you elect to have and where you have the procedure. It is very likely you will receive psychotherapy to help you adjust to your new body and lifestyle.

  • Gender reassignment surgery

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Female-to-male genital reconstruction surgery has a high negative outcome rate, including urethral compromise and worsened mental health.

The results of a 2021 international survey [1] of 129 female-to-male patients who underwent genital reconstruction surgery support anecdotal reports that complication rates following genital reconstruction are higher than are commonly reported in the surgical literature. 

Complication rates, including urethral compromise, and worsened mental health outcomes remain high for gender affirming penile reconstruction. In total, the 129 patients reported 281 complications requiring 142 revisions.

Another paper [2] found a 70% complication rate in one type of female-to-male genital reconstruction surgery.

Even with the “radial forearm free flap” method of creating a synthetic penis — “considered by many as the gold standard for phalloplasty” [3] — there are high rates of complications, with up to 64% urethroplasty related complications [4] .

[1] Robinson, I.S., Blasdel, G., Cohen, O., Zhao, L.C. & Bluebond-Langner, R. (2021). Surgical Outcomes Following Gender Affirming Penile Reconstruction: Patient-Reported Outcomes From a Multi-Center, International Survey of 129 Transmasculine Patients. J Sex Med 18 (4): 800-811. [ Link ]

[2] Bettocchi, C., Ralph, D.J. & Pryor, J.P. (2005). Pedicled pubic phalloplasty in females with gender dysphoria. BJU Int. 95:120–4. [ Link ]

[3] Rashid, M. & Tamimy, M. S. (2013). Phalloplasty: The dream and the reality. Indian J Plast Surg 46 (2): 283-293. [Link]

[4] Fang, R.H., Lin, J.T. & Ma S. (1994). Phalloplasty for female transsexuals with sensate free forearm flap. Microsurgery 15: 349–52. [ Link ]

Medical transition puts both males and females at risk of infertility.

A wide-ranging study [1] found that gender-related drug regimens place patients at risk of infertility:

Suppression of puberty with gonadotropin-releasing hormone agonist analogs (GnRHa) in the pediatric transgender patient can pause the maturation of germ cells, and thus, affect fertility potential. Testosterone therapy in transgender men can suppress ovulation and alter ovarian histology, while estrogen therapy in transgender women can lead to impaired spermatogenesis and testicular atrophy. The effect of hormone therapy on fertility is potentially reversible, but the extent is unclear.

On surgeries, the study noted that cross-sex surgery that includes hysterectomy and oophorectomy in transmen or orchiectomy in transwomen results in permanent sterility.

[1] Cheng, P.J., Pastuszak, A.W., Myers, J.B., Goodwin, I.A. & Hotaling, J.M. (2019). Fertility concerns of the transgender patient. Transl Androl Urol. 8 (3): 209-218. [ Link ]

Genital surgeries tend to reduce the capacity for orgasm in males, and may do so in females.

One study showed that around 30% of male-to-female genital surgeries result in the inability to orgasm [1] .

Figures on female-to-male transitioners are less clear. However, a clinical follow-up study [2] of 38 transmen – 29 of whom had received phalloplasty, and 9 metoidioplasty – found that reported loss of orgasmic capacity was more marginally common than reported gain of orgasmic capacity.

The negative intrapsychic and interpersonal consequences of anorgasmia (the inability to climax) is well-documented, and applies equally to transgender individuals [3] .

[1] Manrique, O., Adabi, K., Martinez-Jorge, J., Ciudad, P., Nicoli, F. and Kiranantawat, K. (2018). Complications and Patient-Reported Outcomes in Male-to-Female Vaginoplasty—Where We Are Today. Annals of Plastic Surgery 80 (6): 684-691. [ Link ]

[2] van de Grift, T., Pigot, G., Kreukels, B., Bouman, M., & Mullender, M. (2019). Transmen’s Experienced Sexuality and Genital Gender-Affirming Surgery: Findings From a Clinical Follow-Up Study. Journal Of Sex & Marital Therapy 45 (3): 201-205. [ Link ]

[3] Levine, S. (2018). Informed Consent for Transgendered Patients. Journal Of Sex & Marital Therapy, 45(3), 218-229. [ Link ]

Vaginoplasty can result in fistula, stenosis, necrosis, prolapse and even death.

Male-to-female genital surgery (vaginoplasty) is associated with significant long-term complications: there is a 2% risk of fistula, 14% risk of stenosis (abnormal narrowing), 1% risk of necrosis (tissue death) and 4% risk of prolapse [1] .

One systematic review [2] found an overall complication rate of 32.5%.

A Dutch study [3] of 55 (out of an original 70) adolescents treated with puberty blockers, cross sex hormones, and genital surgery, showed that among 22 male-to-female patients who underwent vaginoplasty, one adolescent died as a result of necrotizing fasciitis after the surgery.

[2] Dreher, P.C., Edwards, D., Hager, S., Dennis, M., Belkoff, A., Mora, J., Tarry, S. & Rumer, K.L. (2018). Complications of the neovagina in male-to-female transgender surgery: A systematic review and meta-analysis with discussion of management. Clin Anat. 31 (2):191-199. [ Link ]

[3] de Vries, A., McGuire, T., Steensma, E., Wagenaar, T., Doreleijers, P. & Cohen-Kettenis, P. (2014). Young adult psychological outcome after puberty suppression and gender reassignment . [ Link ]

Around 1 in 5 vaginoplasty surgeries lead to corrective surgery.

A systematic review [1] of neo-vagina surgeries found a re-operation rate of 21.7% for non-esthetic reasons.

A Brazilian paper [2] found a somewhat lower, but similar, reoperation rate of 16.8%.

[1] Dreher, P.C., Edwards, D., Hager, S., Dennis, M., Belkoff, A., Mora, J., Tarry, S. & Rumer, K.L. (2018). Complications of the neovagina in male-to-female transgender surgery: A systematic review and meta-analysis with discussion of management. Clin Anat. 31 (2):191-199. [ Link ]

[2] Moisés da Silva, G.V., Lobato, M.I.R., Silva, D.C., Schwarz, K., Fontanari, A.M.V., Costa, A.B., Tavares, P.M., Gorgen, A.R.H., Cabral, R.D. & Rosito, T.E. (2021). Male-to-Female Gender-Affirming Surgery: 20-Year Review of Technique and Surgical Results. Frontiers in Surgery 8. [ Link ]

There is evidence that up to a quarter of transgender genital surgeries result in incontinence.

A systematic literature review [1] found that 21% of male-to-female patients and 25% of female-to-male patients suffered from incontinence as a result of transgender genital surgery.

One recent study [2] estimates the number of post-operative transsexuals suffering stress incontinence to be 23%. This study was not a literature review, and almost all of the participants were male-to-female.

[1] Nassiri, N., Maas, M., Basin, M., Cacciamani, G.E. & Doumanian, L.R. (2020). Urethral complications after gender reassignment surgery: a systematic review. Int J Impot Res. [ Link ]

[2] Kuhn, A., Santi, A. & Birkhäuser, M. (2011). Vaginal prolapse, pelvic floor function, and related symptoms 16 years after sex reassignment surgery in transsexuals. Fertil Steril. 95: 2379-82. [ Link ]

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  • Health And Fitness

What is gender reassignment surgery? Does the NHS offer it, what does it cost privately and how does it work?

Caitlyn Jenner revealed she "underwent gender reassignment surgery" and has raised awareness of the procedure

  • Becky Pemberton
  • Published : 15:36, 15 Jan 2018
  • Updated : 15:37, 15 Jan 2018

UK surgeries are seeing patient numbers rise as more people seek to undergo gender reassignment procedures.

Statistics have shown that some surgeries have seen demand shoot up over the past decade as society became increasingly accepting of trans-sexuality, but what is it and what is involved?

 On average, the waiting time for a sex change therapy is nine months for adults and half that time for children

What is gender reassignment surgery?

Gender reassignment surgery is a surgical procedure where a transgender person can alter their existing characteristics to resemble that of their identified gender.

Genital surgeries may be performed on the individual who wishes to pursue sex reassignment surgery.

The surgery is part of treatment for gender dysphoria in transgender people, where a person experiences distress due to a mismatch of their biological sex and their gender identity.

It is also sometimes referred to as gender identity disorder (GID), transgenderism or gender incongruence.

 Caitlyn Jenner, formerly known as Bruce Jenner, underwent gender reassignment surgery

Caitlyn Jenner revealed she "underwent gender reassignment surgery in January 2017" in new memoir The Secrets of My Life.

Until 2015, Caitlyn had been known as Bruce Jenner before revealing she was transgender during an interview with American TV journalist Diane Sawyer in April 2015.

Can you get gender reassignment surgery on the NHS?

Yes, gender reassignment surgery is available on the NHS, but may be subject to waiting lists.

Imperial College Healthcare Trust  stated that as of April 24, 2017, there were 280 patients on the list for surgery, with 111 patients actively attending outpatient clinics or awaiting surgery. Another 169 patients were under the Trust's care but not currently ready for surgical procedures.

NHS gender identity clinics offer transgender health services but people will usually need to be referred by their GP.

GP referrals for gender dysphoria treatments are usually followed by an assessment by a psychiatrist or another specialist doctor before treatment begins.

In 2014 there were 172 sex operations on the NHS— double the 83 of a decade earlier — costing taxpayers at least £2million.

On average, the waiting time for a sex change therapy is nine months for adults and half this time for kids.

TRANS WOMEN SURGICAL OPTIONS MAY INCLUDE:

  • Breast implants
  • Removal of testicles (orchidectomy)
  • Removal of penis (penectomy)
  • Creation of a vagina (vaginoplasty)
  • Creation of a clitoris (clitoroplasty)
  • Creation of labia or ‘lips’ of the vagina (labioplasty)
  • Facial feminisation surgery
  • Trachea (or Adam’s apple) shaving

How much does gender reassignment surgery cost privately?

The costs for gender reassignment surgery can vary depending on the complexity of the surgery.

A quote will be made to a patient following a consultation with a surgeon.

According to ITV, the cost of gender reassignment is £19,236 per patient, this figure includes support as well as surgery.

FOR TRANS MEN SURGICAL OPTIONS MAY INCLUDE:

  • Chest surgery/ breast removal (double mastectomy)
  • Removal of the womb (hysterectomy)
  • Removal of the ovaries (oophorectomy)
  • Removal of the vagina (vaginectomy)
  • Construction of a phallus (phalloplasty) or ‘micropenis’ (metoidioplasty)
  • Creation of a scrotum with testicular implants (scrotoplasty)

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How does gender reassignment surgery work.

Gender reassignment works by changing genital organs from one sex to another.

Converting a male to a female requires removal of the penis and the reshaping of the genital tissue to appear more female to create a vagina.

Female hormones will then be given to reshape the body and stimulate the growth of breasts.

Female to male surgery involves the creation of a functioning penis from smaller clitoral tissue.

Breasts will often be removed to create a masculine chest area.

  • Caitlyn Jenner

gender reassignment surgery male to female nhs

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Gender reversal surgery is more in-demand than ever before

But what are the consequences, article bookmarked.

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gender reassignment surgery male to female nhs

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Gender reassignment surgery has been available on the NHS for more than 17 years.

It’s a treatment for those experiencing gender dysphoria, whereby a person recognises a discrepancy between their biological sex and their gender identity.

Gender identity clinics are in place throughout the UK to provide support to those feeling distressed by the condition - but what happens when a trans person undergoes surgery and later decides to revert back to their original gender?

Recommended

  • John Lewis gender neutral clothing labels faces public backlash

Is it possible? Is it safe? And is it available on the NHS?

These are not questions that are not easily-answered. Five phone calls and endless emails later, the details regarding what circumstances would allow for such a treatment to be carried out on the NHS remain muddled.

It's potentially why some of those seeking “reversal” surgeries are heading to a clinic in Serbia, where Professor Misoslav Djordjevic has been performing them for five years at the Belgrade Center for Genital Reconstructive Surgery.

A specialist in genital reconstruction with 20 years of experience, Prof Djordjevic began conducting the innovative procedures after a transgender patient who had undergone surgery to remove male genitalia requested a reversal.

It's by no means a common practice. He has performed just 14 surgeries to date and is currently in the process of treating two “reversal” patients, reports The Daily Telegraph , explaining that the procedure is extremely complex and can cost up to €18,000 (£15,965).

  • Parents hit out at school's 'political agenda' over transgender pupil

However, his services aren't easily-accessed. Djordjevic will only treat patients who have undergone a full one-year-long psychiatric evaluation and he stresses the importance of post-surgery aftercare, revealing that he remains in contact with the majority of his patients.

It's not simply a case of people regretting their decision, explains James Morton, manager at the Scottish Trans Alliance , who told The Independent that a range of factors could catalyse the desire for a gender reversal including unusual surgical complications, being worn down by transphobic harassment, family rejection, or developing religious or political beliefs that being transgender is unacceptable.

"If a person has regret about undergoing gender reassignment, it is especially important that they receive counselling and in-depth assessment before undergoing any surgery to attempt partial reversal as their chance of regretting further surgery could be even higher," he said.

  • What the legalisation of gay sex 50 years ago means to LGBT people now

"Any further NHS surgery is determined on an individualised case by case basis because the numbers are so tiny."

So far, Djordjevic has exclusively treated transgender females who have asked to recreate their male genitalia.

Known as phalloplasty, the procedure entails the construction of a penis from skin taken from the groin, abdomen or thigh. Though the surgery produces aesthetic results, many mistakenly assume that it will ultimately render one’s genitalia physically futile.

However, a 2013 study revealed that the introduction of penile stiffeners has allowed some plastic surgeons to create a fully functioning organ.

  • We need more clothing sections than 'men's' and 'women's' says tailor

It is a much more risky procedure than its male to female counterpart, vaginoplasty, whereby the testicles are removed and the skin of the penis is used to artificially create a vagina.

Whilst awareness of non-binary issues has increased in recent years, gender reassignment remains a severely under researched topic, so much so that the NHS has produced an online e-learning guide to GPs who might be unfamiliar with gender dysphoria.

The severe lack of understanding surrounding the topic - and its reversal counterpart - became particularly prevalent last week, when a proposed study to explore why transsexual people may want to “detransition” was reportedly shut down by Bath Spa University so as “not to offend people.”

  • Trans artist helps break down period stigma with bold post

“The fundamental reason given was that it might cause criticism of the research on social media and criticism of the research would be criticism of the university and they also added it was better not to offend people,” James Caspian, the psychotherapist behind the proposed research, told BBC Radio 4 .

He confessed to being “astonished” at the university’s decision.

As of 30 August, there were 213 patients on the list for gender reassignment surgery at Imperial College Healthcare NHS Trust .

At present, there are no statistics regarding gender reversal surgeries in the UK.

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Hull University Teaching Hospitals NHS Trust

Hull University Teaching Hospitals NHS Trust

Gender Reassignment Surgery – Female to Male Breast Surgery

Patient Experience 10th December 2021

  • Reference Number: HEY-434/2021
  • Departments: Breast Services
  • Last Updated: 10 December 2021

You can translate this page by using the headphones button (bottom left) and then select the globe to change the language of the page. Need some help choosing a language? Please refer to Browsealoud Supported Voices and Languages .

Introduction

You will have been given an appropriate referral from the Gender Identity Service, supported by a specialist confirming your diagnosis. The referral confirms that funding is now in place for your surgery. Most of your questions should have been answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but If, after reading it you have any concerns or require any further explanation, please discuss this with a member of the healthcare team.

The surgical team comprises a group of surgeons who all work together to provide the best surgical care for you. It is important that if you decide to have your surgery with us, you are aware of the appointments schedule. You will need to attend all appointments both before and after .

  • You will have the initial consultation and then be placed on the waiting list.
  • There will be pre-operative assessment prior to the surgery
  • A post-operative follow-up at around 10 days for drain  removal, nipple and wound check
  • A post-operative follow up at 6 months to assess how the surgery has gone and to discuss if any further surgery is necessary.

You will need to agree to attend all of these visits before we can consider you for surgery.

What is this type of breast surgery?

This surgery is an operation to remove most of the breast tissue in order to help create a flatter chest shape and masculine appearance.

Your initial consultation

You will be seen by the consultant and asked various questions about your general health, as well as being given a physical examination, which will include several measurements of the breast being taken and recorded.  Consent will be required for clinical photography, involving before and after surgery pictures, to complete an accurate visual record.  Each option of surgery will be discussed with you including the risks, advantages and disadvantages of each, as relevant to you.

This consultation provides an opportunity to see pictures of previous pre and postoperative surgery results. You are encouraged to ask questions and discuss any concerns fully with your consultant and understand the potential issues of your surgery. It is important that you have realistic expectations of the final appearance of your chest.

Can there be any complications or risks?

As with all surgery, there can be complications or risks. Your consultant will go through these in detail with you as part of your consultation, we have listed some of these below for your information.  If you have additional concerns regarding risks or complications, please do not hesitate to discuss these with your consultant.

General complications and risks could include:

General surgery risks – bleeding, infection, bruising and scars. Steps are taken to reduce risks, such as injections to help prevent adverse blood clotting; use of compression stockings to help prevent deep vein thrombosis and antibiotic cover.

Haematoma – a collection of partially clotted blood under the skin at the site of the surgery. This may result in a return to theatre to drain depending on the severity.

Asymmetry – this is when both sides are uneven post-surgery. It may be possible to correct this with further surgery at a later date.

Synmastia – this is when the 2 scar lines meet at the central point and results in one long scar. This may be unavoidable, but may possibly be corrected by surgery at a later date

Loss of nipple graft – there is a small possibility that the nipple graft may not take and you may lose your nipple graft. It may be possible to have a nipple reconstruction at a later date.

Bruising – this may cause the breast area to become a little discoloured and may spread down towards the abdomen. Your body will absorb this bruising and rarely needs any intervention but if worried, contact your surgeon.

Seroma – this is a build-up of serous fluid between the tissues and the skin. This fluid is usually absorbed by the body but if it is present in large amounts, it can be uncomfortable. The fluid can be removed by inserting a fine needle and removing the fluid.  This is quite a common procedure undertaken in the breast clinic outpatient department.

Skin necrosis – occasionally the blood supply to the flaps of skin on either side of the surgical incision is inadequate.  This is significantly more common in people who smoke. The skin involved dies (necrotic) and gradually heals by scarring. If this area is quite extensive, surgical removal may be required, although this is not common.

Nipple necrosis –  if the nipple is retained there is a small possibility that the nipple may lose its blood supply and become necrotic. This means that a poor blood supply to this area may result in the loss of some colour and the nipple may not survive. If this happens, it is possible to have a nipple reconstruction at a later date.

Infection – this may occur despite the routine administration of antibiotics. Any signs of redness, heat, discharge or raised temperature needs to be reported to the doctor, consultant or the surgical ward. An earlier follow-up appointment can then be made to attend the ward or the breast clinic outpatient department.

Fat necrosis – this is a condition that can occur under the skin post-operatively. It results in hard lumps forming within the breast area which can be a concern for the patient. The condition is benign (harmless) and does not carry any risk of cancer, however all lumps should be investigated appropriately.

  Scarring – there will be scarring that will gradually fade, varying with each individual. If you do suffer from an infection, this can affect scarring; the scar can become thicker than expected and take longer to fade. Even without any infection, some scarring can become thicker and overgrown due to a condition called Keloid (excessive tissue growth in the wound area). This may require a special silicone dressing in order to help treat the scar.

Nipple sensation – this may be lost completely or there may be some small loss or even increased feeling in the cases of surgery retaining the nipple area. There can be no guarantee regarding this.

Skin sensation – it is quite normal for the skin sensation to change with areas of numbness, tingling, small sharp feelings after surgery due to the normal healing process. Again, this can vary greatly from one individual to another.

What will happen after your initial consultation?

After your initial consultation, you will be placed onto a waiting list. When a suitable date becomes available for your surgery, you will receive a letter with appropriate details including:

  • A date for your pre-assessment appointment.
  • A date for your surgery, times and where to attend.

 Pre-operative assessment

You will be sent an appointment about 2 weeks before your surgery to attend a pre op assessment. This will be performed by the nursing staff on the breast care unit.

You will have your blood pressure, pulse and temperature recorded along with height and weight.  You will be swabbed for MRSA (routine for all surgical procedures) and blood samples will be taken.  These need to be performed in readiness for your surgery and cannot be performed at your local hospital. At this appointment you will receive all the information about your surgery and recovery so it is important that you attend. We will answer any questions you may have. You will receive your fasting instructions for the day of your surgery. You will be able to eat until midnight and the have clear fluids up until 6am. Make sure you drink plenty prior to your surgery.

Your operation

You will need to take a Covid test 72 hours prior to your surgery. This may be sent to you through the post or you may need to attend the drive through at the hospital. You and your household will then need to isolate from this test until you attend for your surgery.

You will need to attend the ward at 07:30am alone and with your face covered. This will allow time for your surgeon to talk to you, explain the procedure, any risks or complications which may be involved. If you are still happy to go ahead he will ask you to sign a consent form and will mark the area for surgery. The anaesthetist will then review you and ensure that you are fit enough for the surgery. The ward will have a rough estimation of the time of your surgery, so your relative will be able to contact the ward following this.

There is no room for any relatives to stay at the hospital during your surgery so they will need to book into a nearby hotel or Bed and Breakfast.

You will then need to wait for your surgery, which may take some time so you may wish to bring something to read, phone or tablet. When your surgery time nears the ward staff will ask you to put on a surgical gown, this is backless so you will need a dressing gown to put on over it and a pair of soft shoes/slippers as you will walk to theatre. You will also be fitted with a pair of white anti embolic socks which help to prevent blood clots post-surgery. We do advise that you continue to wear these for 2 weeks post-surgery.

The operation is performed under general anaesthesia and involves the removal of most of the breast tissue with the preservation of the nipple and areola (coloured) area, if possible. The particular surgical technique used is dependent on the breast size of the individual patient and initial assessment:

  • Liposuction may be used to remove breast tissue via small incisions.
  • An Inframammary Fold Mastectomy and free nipple areolar grafts (removal of the breast from the fold underneath the breast) results in a scar along the crease of the skin directly under the breast. The nipples may be completely removed and repositioned. If the nipples are not preserved, both nipple and areola tattoos can be done at a later date.
  • A peri-areolar reduction may be used by making a circular cut around the outer edge of the areola, leaving the nipple partially attached. Breast tissue is removed and the excess skin is trimmed. The nipple is then repositioned and a ‘purse-string’ (type of stitch) technique is used to pull the skin around the areola tighter together to close the reduced area.

All of these surgical options will be discussed fully as to which will be the most appropriate for you.

Post-operative

Following your surgery, you will wake up in recovery. This is a high observation area where you will be monitored until you are considered well enough to return to the ward. The staff will perform blood pressure and pulse checks and you may have an oxygen mask on. This will be removed once you have fully recovered from the anaesthetic.

You may have been fitted with a pair of Flowtron boots during your surgery. These are self-inflating bands that go around the lower leg, inflate and help to improve blood flow back up the leg to prevent blood clots. They will be removed once you have recovered. You will need to leave the white socks on.

The nursing staff will ensure that have appropriate pain relief medication but if you experience any pain you need to let them know. You will need to ensure that you have a supply of paracetamol or ibuprofen at home as you may not be discharged with pain relief medication.

You be fitted with a binder in theatre following your surgery. This will be padded with cotton wool and will help to ensure that your suture lines stay flat and are supported post-surgery. This will help to ensure your scars are flat and not raised. You will need to wear the binder for a full 6 weeks post you surgery but you will be able to take it off to wash.

You will have 2 drains following your surgery. These help to prevent any fluid build-up between the tissue and the skin. You will be discharged with the drains, but the nursing staff will ensure that you are shown have to empty and re-vacuum them. You will need to return approximately 10 days post-surgery to have these drains removed. It is important that you attend this appointment as we will check to ensure that your suture line is healing, check your nipple grafts have taken and give you important advice and instructions.

At this appointment we will remove the drains and all dressings. You will need to continue to wear the binder for a full six weeks post-surgery. You will need to buy micropore tape to cover the suture line whilst you have your binder on. This will help to keep your suture line flat and help to keep your scarring to a minimum. We will show you how to apply this and to care for your nipple grafts at this visit. You are not able to drive whilst you have yours drains in so you will need to arrange for someone to bring you to this appointment.

The normal length of stay for this type of surgery is 2 days. You will be reviewed by your surgeon the day following your surgery and if everything is OK and you have had had no problems there may be a chance that you could be discharged at this point. You would have to stay locally, so there would need to be a room in the hotel for you. You are not able to travel until the following day. You would need someone with you for this night. If you are travelling by car, it is advisable to put a cushion or soft pillow under your seat belt for comfort and protection. You still need to wear a seat belt by law. Before you go home your surgeon will advise you of any activities you will need to avoid and give you advice about the type of exercises you will need to perform.

The recuperation period post-surgery normally takes 4-6 weeks. It is normal to have some bruising and swelling, but this will settle within time.  You are able to go out the house and do your normal activates but avoid any heavy lifting and lifting your arms over your head. We do advise that you take some time off work, the length depends on the type of job you do. The ward will be able to provide a sick note. It is not advisable to drive a car in this period, as you will need to have full range of upper body movements and be able to perform an emergency stop. After six weeks you can remove your binder. You will need to continue to use the micropore tape for 3 months post-surgery. You can then start to use bio oil on your scars. At six weeks if everything is healed and healthy you can start to use the gym and go swimming. You can do more strenuous work and drive.

Follow up and further treatments

You will be reviewed at 6 months post-surgery which will allow your surgeon to access how well you have healed and whether any further surgery is necessary. Photographs will be recorded for audit purposes to ensure an accurate record.

The surgeries that may be considered are:

Liposuction – this involves the removal of extra fatty/glandular tissue from the breast/armpit area to help create a flatter contour. This procedure may sometimes be undertaken at the same time as the mastectomy (removal of the breast) or at a later date, when post-operative swelling has subsided, allowing particular areas of concern to be identified and discussed.

Dog-ear – this refers to the possible, puckered appearance of the skin at the end of the scar line, looking like a little flap. This can be removed by a minor operation at a later date.

Nipple reconstruction – a procedure can be undertaken to replace the lost nipple, if not retained, by creating a small lump projecting from the skin on the breast. This could be done at a later date, once the original wound area has healed properly.

Nipple / areola tattoo – the area around the nipple can be tattooed with colour onto the skin, either around an existing nipple or colour shading applied to provide definition of nipple and areola. This procedure can produce extremely realistic results.

Contact Information:

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Breast Care Unit  (01482) 622679

General Advice and Consent Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team. Consent to treatment Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information. The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid . That means: you must be able to give your consent you must be given enough information to enable you to make a decision you must be acting under your own free will and not under the strong influence of another person Information about you We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data. We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you. Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You . If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.

QR code to open leaflet

IMAGES

  1. How Gender Reassignment Surgery Works (Infographic)

    gender reassignment surgery male to female nhs

  2. What it’s Really Like to Have Female to Male Gender Reassignment

    gender reassignment surgery male to female nhs

  3. What it’s Really Like to Have Female to Male Gender Reassignment

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  4. Imperial College Healthcare

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  5. The Role of Nasal Feminization Rhinoplasty in Male-to-Female Gender

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  6. Transgender murderer granted gender reassignment surgery on NHS

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VIDEO

  1. Gender reassignment steering

  2. Before and After

  3. Gender reassignment surgery| male to female gender reassignment surgery slow animation ( part 2)

  4. male to female surgery

  5. Things I didn't expect after gender reassignment surgery |Transgender MTF

  6. Gender Reassignment Surgery- Transwoman

COMMENTS

  1. Gender dysphoria

    Some young people with lasting signs of gender dysphoria who meet strict criteria may be referred to a hormone specialist (consultant endocrinologist) to see if they can take hormone blockers as they reach puberty. This is in addition to psychological support. Puberty blockers and cross-sex hormones

  2. What to expect during transition

    Gender reassignment surgery (GRS) cannot be provided until you have lived in a social role appropriate to your gender identity for at least twelve months. At some point, you will want to tell other people about your transition.

  3. Feminizing surgery

    Overview. Feminizing surgery, also called gender-affirming surgery or gender-confirmation surgery, involves procedures that help better align the body with a person's gender identity. Feminizing surgery includes several options, such as top surgery to increase the size of the breasts. That procedure also is called breast augmentation.

  4. PDF A guide to lower surgery for those assigned female, identifying ...

    A guide to lower surgery for those assigned female, identifying as men, trans masculine, non-binary or non-gender Transgender wellbeing and healthcare 2 © GIRES revised 11/10/2015 A GUIDE TO LOWER SURGERY FOR TRANS MEN funded by Department of Health About this publication 1 Introduction 2 How do I qualify for lower surgery?

  5. Meet the gender reassignment surgeons: 'Demand is going through the

    The badges bear the silhouette of an elegant woman in a ballgown and indicate that the wearer has had male to female gender reassignment surgery (GRS) at the hands of the London-based surgeon.

  6. Gender dysphoria

    As part of social transitioning, most gender dysphoria clinics recommend you change your name by deed poll. You can do this for free and then use it to change your name on your passport and other personal documents, at your bank, work and at the GP surgery. Once the GP has a copy of your deed poll, they should contact Primary Care Support ...

  7. PDF Vaginoplasty Feminising Surgery

    The NHS funded feminising genital surgery is available for people aged 18 and above and could include some or all the following: Vaginoplasty- creation of a vagina Clitoroplasty - creation of a clitoris Vulvoplasty - creation of a vulva (please refer to Vulvoplasty patient leaflet) Labiaplasty - creation of inner and outer labia

  8. Vaginoplasty: Gender Confirmation Surgery Risks and Recovery

    Risks and complications. There are always risks associated with surgery, but vaginoplasty complications are rare. Infections can usually be cleared up with antibiotics. Some immediate postsurgical ...

  9. Gender-affirming surgery (male-to-female)

    Gender-affirming surgery for male-to-female transgender women or transfeminine non-binary people describes a variety of surgical procedures that alter the body to provide physical traits more comfortable and affirming to an individual's gender identity and overall functioning.. Often used to refer to vaginoplasty, sex reassignment surgery can also more broadly refer to other gender-affirming ...

  10. Gender Confirmation Surgery

    The cost of transitioning can often exceed $100,000 in the United States, depending upon the procedures needed. A typical genitoplasty alone averages about $18,000. Rhinoplasty, or a nose job, averaged $5,409 in 2019. Insurance Coverage for Sex Reassignment Surgery.

  11. Gender Affirmation Surgery: What Happens, Benefits & Recovery

    Research consistently shows that people who choose gender affirmation surgery experience reduced gender incongruence and improved quality of life. Depending on the procedure, 94% to 100% of people report satisfaction with their surgery results. Gender-affirming surgery provides long-term mental health benefits, too.

  12. What transgender women can expect after gender-affirming surgery

    Genital sensory detection thresholds and patient satisfaction with vaginoplasty in male-to-female transgender women. ... of the neoclitoris after gender reassignment surgery. https://www.jsm ...

  13. Bottom Surgery: Cost, Recovery, Procedure Details, and More

    Last medically reviewed on May 10, 2018. Bottom surgery generally refers to one of three surgeries. The first, vaginoplasty, is typically pursued by transgender women and AMAB (assigned male at ...

  14. How to find an NHS gender dysphoria clinic

    Devon Partnership NHS Trust West of England Specialist Gender Dysphoria Clinic. The Laurels. 11-15 Dix's Field. Exeter. EX1 1QA. Phone: 01392 677 077. Email: [email protected]. The Laurels' website has information about the types of services on offer and the help available during transition.

  15. Gender Identity Service

    Genital Reconstructive Surgery (GRS) involves reshaping the male genitals to anatomically and, as far as possible, functionally resemble that of female genitalia. Prior to surgery, patients undergo hormone replacement therapy and counselling from recognised gender specialists.

  16. NHS population screening: information for trans and non-binary people

    Trans women and non-binary people assigned male at birth who are registered with a GP as female: are invited for breast screening. are invited for bowel cancer screening. do not need cervical ...

  17. Transgender Surgery: Everything You Need to Know

    Older terms such as gender- or sex-reassignment surgery and male-to-female or female-to-male surgery have fallen out of favor.

  18. What does gender reassignment surgery entail?

    Updated on: 05-04-2023 Edited by: Conor Dunworth What is gender reassignment surgery? Gender reassignment surgery is any surgical procedure involved in facilitating a male-to-female (MtF) or female-to-male (FtM) transition. Gender reassignment surgery is complex and can involve a number of separate procedures, carried out over several operations.

  19. Surgery

    Male-to-Female Gender-Affirming Surgery: 20-Year Review of Technique and Surgical Results. Frontiers in Surgery 8. Males. Medical transition ... Santi, A. & Birkhäuser, M. (2011). Vaginal prolapse, pelvic floor function, and related symptoms 16 years after sex reassignment surgery in transsexuals. Fertil Steril. 95: 2379-82. Females. Males.

  20. What is gender reassignment surgery? Does the NHS offer it, what does

    Gender reassignment surgery is a surgical procedure where a transgender person can alter their existing characteristics to resemble that of their identified gender. Genital surgeries may be...

  21. Gender reversal surgery is more in-demand than ever before

    Gender reassignment surgery has been available on the NHS for more than 17 years. ... It is a much more risky procedure than its male to female counterpart, vaginoplasty, whereby the testicles are ...

  22. Gender Reassignment Surgery

    Gender Reassignment Surgery - Female to Male Breast Surgery | Hull University Teaching Hospitals NHS Trust News Gender Reassignment Surgery - Female to Male Breast Surgery Patient Experience10th December 2021 Reference Number: HEY-434/2021 Departments: Breast Services Last Updated: 10 December 2021

  23. How does female-to-male surgery work?

    Female-to-male surgery is a type of gender-affirmation or gender-affirming surgery. There are multiple forms of gender-affirming surgery, including altering the genital region, known as "bottom ...

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