Gender reassignment surgery: a comprehensive guide

Gender reassignment surgery, also known as gender affirmation surgery, is a significant step for individuals seeking to align their physical appearance with their gender identity. Leading consultant plastic surgeon Mr Alexander Armstrong explores the various aspects of gender reassignment surgery, from the procedures involved to the potential risks and benefits.

Understanding gender dysphoria

Before delving into the details of gender reassignment surgery, it's essential to grasp the concept of gender dysphoria. Gender dysphoria denotes the distress and discomfort felt by those whose gender identity does not align with the sex they were assigned at birth.

Gender reassignment surgery is one of the treatment options available for individuals experiencing gender dysphoria, alongside hormone therapy and psychotherapy. All patients who embark upon surgery require a referral from a gender specialist to ensure surgery is an appropriate step in their gender reassignment. Surgery may not appropriate for every patient. 

Types of gender reassignment surgery

There are several types of gender reassignment surgery, each aimed at altering specific physical characteristics to better align with a person's gender identity. The two primary procedures are:

Female-to-male (FTM) surgery: FTM surgery involves creating male anatomical features from female ones. This may include procedures such as chest masculinisation (removal of breast tissue and skin excess; reducing nipple size and nipple repositioning), genital reconstruction (phalloplasty or metoidioplasty), and facial masculinisation surgery. I specialise in FTM ‘top’ surgery.

Male-to-female (MTF) surgery: This procedure involves transforming male anatomical features into female ones. It typically includes surgeries such as breast augmentation, facial feminisation surgery, and genital reconstruction (vaginoplasty).

Procedure and recovery

Gender reassignment surgery is a complex process that requires careful planning and coordination between the patient and their healthcare team. Prior to surgery, patients undergo a thorough evaluation to assess their readiness and suitability for the procedure. This evaluation may includes medical and psychological assessments, hormone therapy initiation, and consultations with various gender specialists. You may be asked to lose weight or stop smoking, to ensure surgery is as safe and effective as possible.

The surgery itself is performed under general anaesthesia and may involve more than one procedure, depending on the desired outcome. Recovery times vary depending on the extent of surgery and individual healing abilities. Patients can expect to experience some discomfort and swelling following surgery, but this typically resolves over time with proper care and follow-up appointments. It is vital to attend follow up appointments to ensure advice and support can be given throughout the recovery period.

Risks and considerations

As is the case with all surgical procedures, gender reassignment surgery comes with inherent risks and possible complications. These can encompass risks of: infections, bleeding, scarring (which can be red, raised lumpy and stretched) , alterations in sensation, asymmetry, seroma (collections of fluid), lumpiness and irregularities of the soft tissue, the need for further surgery and dissatisfaction with the overall outcome.

It's imperative for patients to engage in a thorough discussion with a surgeon regarding these risks and carefully consider them alongside the potential advantages of undergoing surgery. I will carry out two consultations with you prior to surgery and write to you after each appointment. I will also give you written information about the procedure, risks, aftercare and consent process. This is to ensure that the benefits and risks of surgery are weighed up, and consent for the procedure happens over time, called the ‘cooling off period’. If anything is unclear or you need more information, you should ask for further clarification, more time and a further consultation.

Gender reassignment surgery is a significant decision that can have a profound impact on an individual's life. By providing clear and accurate information, healthcare professionals can support patients in making informed choices about their gender transition journey. If you are considering gender reassignment surgery, we encourage you to consult with a qualified specialist who can guide you through the process with compassion and expertise.

If you are considering gender reassignment surgery and would like to book a consultation with Mr Armstrong, do not hesitate to do so by visiting his Top Doctors profile today.