Do you know that one of the first sex reassignment operations was performed in the USSR? Before her, only four cases were described in the world. In the early 1970s, Riga surgeon Viktor Kalnberz successfully turned a woman named Inna into a man, Innocent. Although the psychiatric commission confirmed the need for such intervention for the patient and there was permission from the Latvian Minister of Health, the surgeon was subsequently reprimanded in Moscow “for carrying out a mutilation operation that does not correspond to the structure and ideology of the state.”
V. Kalnberz with Fidel Castro’s bodyguard, to whom he restored “male health”
These days, according to the Vademecum analytical center, at least 800 gender reassignment operations are performed in Russia annually. In the USA, according to statistics from the American Society of Plastic Surgeons, there are more than 3 thousand. And many times more in Thailand, which is considered a global mecca for transgender people due to more affordable prices.
Queen and finalists of the Pattaya Transgender Beauty Pageant 2015. Reuters
But in any case, these prices are rather high - from several tens to one and a half hundred thousand dollars. But the procedures themselves are difficult and painful. Anews found out what people go through when they decide to change their sex.
Photos before and after gender reassignment of famous personalities
Chastity Bono, the only daughter of singer Cher, has turned into Chaz Bon, which shows how a woman can be turned into a full-fledged man
European pole vault medalist Yvonne Buschbaum had sex reassignment surgery and is now called Balian
Heidi Krieger, European champion in shot put, underwent gender reassignment surgery - this is how Andreas Krieger was born
Reviews of transformations
The overwhelming number of transsexuals who have successfully completed all stages of transformation prefer to disappear into the crowd. And only a few are happy to tell their own biography. It's all about the mixed reaction of the public. Is it really possible that such people can only be helped by changing their gender from female to male?
Reviews about the operation can be found very different and incredible. But for all transsexuals without exception, the operation is a ticket to a new and definitely better life. Many of them, after a complete transformation, get married, successfully engage in creativity and build a career.
Stages of preparation for gender reassignment in women
Preparing a woman for the operation of transformation from female to male occurs both from the physical and moral sides.
The physical side includes:
- Observation by a psychiatrist and sex therapist for 18 months. This is necessary to ensure complete confidence in the need for intervention.
- Collecting a complete medical history with all kinds of tests and tests. The absence of any neoplasms in the reproductive system is especially important.
- Hormone therapy for 12 months. Necessary for primary masculinization.
- The moral side includes being comfortable in the role of a man. To do this, experts advise a woman to live like a man for 6-10 months. This will help you finally decide on your gender.
Preparation
The period of preparation for surgery includes a comprehensive examination of the body and psychological examination. It is important that a person understands how difficult the operation is ahead of him, how many procedures he will have to go through. If the patient expresses strong consent, he is prescribed hormonal therapy.
Before undergoing surgery, it is important to make sure that the body tolerates all prescribed medications well, because after the operation the person will be forced to take them for life.
How does gender reassignment surgery take place from a woman to a man?
Gender reassignment surgery for women is one of the most difficult. Therefore, surgeons divide it into several stages:
- Removal or correction of primary and secondary sexual characteristics. Depending on the woman’s decision, complete or partial removal of the reproductive system organs and mammary glands are removed.
- Reconstruction of male genital organs. A phalloplasty or metoidioplasty operation is performed based on the wishes and physiological capabilities of the patient.
Some clinics offer one-stage gender reassignment surgery. During the operation, 5-7 hours, a vaginectomy is performed along with complete female castration and phalloplasty. The advantage is one rehabilitation period instead of several, lower cost.
The downside is the large load on the body. Guaranteed complications due to the large amount of operated tissue.
The recovery period after a woman is turned into a man will be painful and difficult.
Mammoplasty – removal of mammary glands
Mastectomy during gender reassignment in women is characterized by complete removal of lipid and glandular tissue. If necessary, excess skin is excised.
Depending on the size of the breast, mammoplasty occurs in different ways:
- If you have breasts of size AA, A, the tissue around the nipple is cut. Tissue is removed through this hole.
- If you have a bust of size B, C, an incision is made under the breast, and the mammary gland is removed horizontally through it.
- If you have large breasts of size D or more, the skin is cut vertically. Since it is necessary not only to remove adipose tissue and glands, but also to excise excess skin. As well as the localization of the nipple in the anatomically correct place for the male breast.
Ovariectomy or female castration
Ovariectomy is an operation during which the ovaries are removed. It is possible to additionally remove the fallopian tubes. If a woman does not plan to have children in the future, a hysterectomy is performed. If only the ovaries are removed, closed laparoscopy is performed.
If the uterus is excised along with its appendages, then open abdominal surgery is performed. It lasts about 2 hours. Primary rehabilitation lasts 5-7 days.
During the rehabilitation period at home, it is necessary to adhere to strict hygiene rules, nutritional rules, and not overwork.
Vaginectomy
Another step in making a man out of a woman is the removal or stitching of the vagina.
The operation to completely remove the vagina is performed under general anesthesia or epidural anesthesia. It lasts for several hours. The rehabilitation period is about 2 months . Quite painful. High risk of complications.
An alternative to vaginectomy is vaginal reshaping. Its front and back walls are sewn together. This intervention is less traumatic and rehabilitation time is significantly reduced. This is the correction most often recommended by surgeons.
Phalloplasty: where are organs taken for reconstruction?
Penis reconstruction is a complex operation that is performed by several specialists at once: a plastic surgeon and an andrologist. The most difficult part is the formation of the urethra.
The material for creating the phallus is taken from the forearm area. The skin there is thin, its characteristics are similar to that of the male penis. This method of creating an organ is called radiation.
A tube is formed from the flap and transplanted into the groin area. Next, tissue innervation is restored. All connections of arteries, veins, and nerves are performed manually by an andrologist.
A similar operation is performed using a thoracodorsal flap.
At the same time, it is possible to make a larger neophallus - 18-24 cm. To simulate arousal, an erectile prosthesis is installed.
The installation procedure is carried out separately, after phalloplasty. It takes time for recovery and healing.
Correction of the body and face using silicone
For some women, mammoplasty and changes caused by hormonal therapy are not enough for a more complete masculine appearance. The body and face are corrected using silicone implants. Highlight:
- Chin endoprosthetics. Visually it makes a man out of a woman.
- Biceps endoprosthetics. As an alternative to the gym. The effect is identical.
- Removing Bish's lumps. Necessary for a more structured face. In tandem with the chin it changes the face a lot.
- Prosthetic legs.
For some women, when changing gender, in order to finally feel like a man, only one thing is missing - the presence of a scrotum. It is formed from the outer labia and prosthetic testicles of the required size are inserted.
Liposuction
The distribution of adipose tissue is different in men and women. Men are characterized by abdominal fat deposits, while women are characterized by gynoid fat deposits.
Liposuction helps to quickly get rid of fat accumulations in the buttocks and thighs. This will give a masculine appearance. If, after removing excess fat, you adhere to a certain dietary principle and do not overeat, the results will last for a long time.
Hormone replacement therapy
The female body does not have organs that produce testosterone and other male hormones. It is also unrealistic to recreate them surgically. This is why it is necessary to take hormonal medications.
A qualified endocrinologist selects the necessary medications in individual dosages before and after surgery. They make the voice rougher and lower, increase hair growth on the face and chest, and the hands and feet increase in size. However, this is necessary not only for a comfortable existence in a male form.
Without the proper amount of hormones, after a woman is turned into a man, processes of physiological attenuation begin in the body , which can lead to serious illnesses and death.
This is why, after removal of the ovaries, a transgender person does not stop taking hormones. The doctor only adjusts the dosage. Androgens are taken for life after surgery.
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Hormone replacement therapy
If a guy decides for himself that he wants to become a girl, then his transformation begins with hormone therapy. It is based on female sex hormones. They are taken in different forms: capsules, injections, patches, gels.
First of all, these are those that interfere with the production of testosterone, as well as analogues of female hormones - estrogens and gastrogens. Among the antiandrogens (which block testosterone), the most well-known are cyproperone acetate and spironolactone. Of the estrogens, preference is given to estradiol, which is similar to the natural hormone and its artificial analogues: ethinyl estradiol and estradiol valearate.
Artificial drugs are much more powerful and safer than natural ones. For example, ethinyl estradiol at a dose of 0.035 mg can replace 2 mg estradiol, but it has a narrower spectrum of action than natural estrogens. Therefore, it is recommended to use them together. In addition, they enhance each other's effects.
Among estrogens, utrozhestan in capsules and estrogel in the form of a gel are also used, therapy for which lasts several months. It is then replaced with estradiol valearate.
Taking gastrogens is mandatory. They affect the enlargement of the mammary glands, and also smooth out the psycho-emotional consequences of decreased testosterone. Most gastrogens are produced in combination with estrogens, combining them in one preparation.
As for the well-known progesterone, its use has already been practically abandoned. This is due to the fact that it involves the administration of fairly large doses and causes a number of side effects.
It must be said that all natural hormones are more aggressive than their artificial counterparts. And before, when HRT was based exclusively on them, it caused great health problems and even caused death. Modern drugs are softer and harmless.
It is preferable to start HRT before the onset of puberty. In this case, the body will more organically “mature” according to the female type. This is exactly what model Andrea Pejic did. Her masculine features were minimally expressed.
In adolescence, therapy begins with small doses, gradually increasing them. In adults, the opposite is true: they start with shock dosages, gradually reducing them.
In parallel with hormones, vitamins are also taken, for example, folic acid, ideally multivitamins.
What organs look like and how they work after gender reassignment
Modern surgery in the field of sex reassignment has reached certain heights. When the operation is performed by an experienced and highly qualified surgeon, the penis will look completely natural, with a visually distinguishable head and shaft.
The sensitivity of the penis will be low. However, everything depends on the individual characteristics of the body and the location of the implanted tissue. The penis formed from a thoracodorsal flap is considered the most sensitive.
Because the nerve is also transplanted along with the skin. The penis reconstructed using the radiation method also has sensitivity. There have been no studies on this issue due to the small number of people who have undergone this operation.
Erection of the neophallus is possible only if a separate operation is performed to install an erection prosthesis. The operation is possible only after the body has fully recovered after phalloplasty. Is very expensive.
Phalloplasty - the final stage of transformation
Interesting fact: in approximately 30% of cases, gender reassignment from female to male is performed without phalloplasty. It turns out that only 70% of people with transsexuality obtain a body with neophalos through surgery. Modern medicine offers several options for phalloplasty.
Metoidioplasty is performed on patients who have achieved clitoral enlargement through hormonal therapy. The operation is relatively simple, after which the sensitivity of the erogenous zones is preserved. However, this type of plastic surgery allows you to create a penis no more than 6 centimeters long, which does not have penetrating ability.
Complete phalloplasty is an operation that takes place in several stages. The main goal of this surgery is to create a fully functioning penis of adequate size. In this case, changing gender from female to male can take a whole year. The results are definitely worth it. After rehabilitation, the penis looks aesthetically pleasing, and the patient can fully participate in traditional sexual intercourse.
How much does gender reassignment surgery cost - cost, price
As you know, plastic surgery costs a lot of money. The transition from woman to man is one of the most expensive. The high cost is due to:
- a small number of specialists capable of performing high-quality sex reassignment,
- complex of operations carried out,
- complex rehabilitation aimed at minimizing complications.
The total cost of gender reassignment surgery depends on the complex of measures that the woman does. Approximate prices of the main ones:
- Ovariectomy – about $1000;
- Mastectomy – $1500-2500;
- Vaginectomy – about $3000;
- Phalloplasty – $6000;
- Endoprosthetics of erectile penile prosthesis – from $1000 to $4000 (depending on the type of prosthesis)
Since some amputations and transformations can be performed in one surgical procedure, the final cost of gender reassignment may be less - up to approximately $7,000.
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What awaits a transsexual after surgery?
Not for all people born out of their body, phalloplasty becomes the last plastic surgery in the process of transformation. Many transsexuals turn to surgeons more than once. The possibilities of aesthetic medicine today are great. Through surgery, you can make your facial features more masculine, remove excess fatty tissue, and shape the shape of your buttocks or calves. You should not expect dramatic changes in appearance immediately after changing gender from female to male.
Many physiological parameters will remain unchanged forever. This is, for example, the size of the hands and feet. You will also have to develop your voice, gait and demeanor yourself. The most important stage in the life of every transsexual is changing the gender in the passport. What is noteworthy is that after receiving new documents, many people who have undergone a complete transformation prefer to move to a new place and begin a full life in the desired body.
Rehabilitation (recovery period) for women who have changed sex
Rehabilitation after a woman is turned into a man is based on several points:
- Maintaining a calm, healthy lifestyle. Includes proper nutrition, minimal physical activity, and self-treatment of stitches
- Scheduled examinations with a specialist, strictly following his recommendations.
- Taking hormonal medications, broad-spectrum antibiotics, painkillers (as needed).
The recovery period lasts from six months or more, depending on the characteristics of the body.
Other procedures
After hormonal therapy and surgical intervention, the process of gender transformation can already be considered complete. But many people prefer to go all the way, improving their body. The list of procedures includes:
- laser hair removal;
- breast augmentation with implants;
- correction of facial areas with fillers.
The course, technique and scope of interventions performed for people who have changed their gender are similar to self-care for people who have never undergone a transgender transition.
Possible complications in women after gender reassignment
The risk of complications after a woman is made into a man is very significant. This is due to the high complexity of ectomies. Common complications are:
- Inflammation of the seams.
- Infectious infection of tissues.
- Rejection of the neophallus.
- Loss of sensation.
- Slow healing and bleeding.
- Tissue necrosis.
Psychological complications may occur. This occurs due to a discrepancy between the expected and received results. There may be a feeling of general discomfort from the new appearance. The desire to return to your original appearance.
This complication is extremely rare, since before undergoing a sex change, a woman strives for several years to achieve a male appearance through hormones, undergoes psychological preparation, living a male life.
Preparation period
It is important to understand that the process of gender reassignment is quite lengthy and normally takes several years. It is useful to start by studying this issue in detail and, if possible, communicating with like-minded people. How does gender change from female to male occur, where to start? The first step towards the desired goal is visiting a psychiatrist. The patient undergoes an examination and regularly visits this specialist.
After some time (usually a period of 6 months to 2 years), a person who considers himself transsexual is asked to undergo a medical examination. Experts experienced in this matter, based on the medical history and an interview with the patient, decide on the need for gender transformation. If transsexuality is confirmed, a corresponding certificate is issued. This document is necessary for carrying out operations.
Life after gender reassignment – social adaptation
Social adaptation is one of the most important in the long process of gender change. It is complicated due to the high level of intolerance of society towards such people. To some extent, it is impossible to understand their internal state.
To make adaptation easier, many change their social circle and move to a new job. This happens due to cruel and harsh communication with a transgender person. Having told those closest to him about his intentions, a person faces manifestations of transphobia. It is expressed in the form of psychological violence, aggressive behavior, and rejection of the stated fact.
According to foreign and domestic studies, only 30% of transgender people observed a neutral or friendly attitude towards themselves after coming out.
Physiological and psychological risks
Physiology:
- hematomas;
- infection;
- scars;
- loss of sensation;
- swelling;
- bleeding.
Psychology:
- non-acceptance of a new gender;
- the desire to return everything back;
- misunderstanding of others;
- ridicule, dismissal, rejection by society;
- depression;
- alienation of loved ones.
The risks in this case are great, but it all depends on the determination and positive attitude of the person himself. If problems arise, you should contact specialists for help.
How to change gender in Russia
In Russia, gender reassignment surgery can only be performed after a diagnosis of transsexualism has been made.
This requires a certain amount of time - from a year to 3 years, during which a visit to a psychiatrist is mandatory.
After making a diagnosis, he refers the woman to a medical commission consisting of 3-5 specialists from different fields of medicine. Only the commission is authorized to provide referrals for gender reassignment operations.
It is possible to undergo a commission for a fee in a private clinic that has permission to do so. This method is faster, but also more expensive.
Next comes a trip to an endocrinologist, who prescribes hormonal therapy. After this, an operation is performed.
In Russia, at the legislative level, changing your passport gender and name is problematic. Since today no sample application has been developed that will be used to issue a new birth certificate and passport without any problems. A medical certificate confirming that you belong to the other gender is also required.
However, this does not guarantee success. In most cases, the civil registry office refuses to change documents and it is necessary to go to court.
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The whole truth about female transsexualism
Modern medicine distinguishes between two forms of transsexualism: male and female. In the first case, we are talking about people who are male from birth, but feel like women. Female transsexualism is a diagnosis given to women who perceive themselves as men. Today, every transsexual has the opportunity to bring his body into alignment with the spiritual world. At the same time, changing gender from female to male is considered the most difficult and dangerous.
At least two surgical interventions are required for complete transformation. Often, 4-5 operations are performed to achieve a high-quality aesthetic result. Each patient, before being seen by a surgeon, must undergo a long course of hormone therapy. All this is quite dangerous even for an absolutely healthy person. The decision to change sex must be balanced and informed. Today in Russia and other developed countries of the world, such operations are performed only for clear medical indications.
Gender reassignment in children
Changing gender in childhood is possible only in a few cases: in case of injury to the genital organs and the impossibility of restoring its function, as well as in congenital pathologies of the reproductive system.
Doctors turned 11-year-old Savarnni from Australia into a boy because they diagnosed him with “gender identity disorder”
In some countries, teenagers who want to change gender are prescribed hormones. They are taken during puberty to prevent the development of secondary sexual characteristics and reduce the development of primary ones. After 18 years of age, such people can undergo sex reassignment surgery.
Mastectomy and hysterectomy
The process of physiological transformation of the female body into a male one begins with hormonal therapy. Initially, a comprehensive diagnosis of the body is carried out. In the absence of categorical contraindications, specific drugs are prescribed based on the test results. One of the most important moments in the transformation of all men born in women's bodies is the first operation. Mastectomy, or removal of the mammary glands, is the first-line surgical procedure for transsexuality. Immediately after this operation, the figure takes on a male outline.
But what does a complete gender change from female to male consist of, what is such an intervention called? Hysterectomy – removal of the female genital organs. After this operation, the patient receives an appropriate certificate. Based on this medical document, in our country you can legally change your gender. But changing this line in the passport is often the goal of a transsexual. When the gender in the passport coincides with the actual psychological one, it is much easier to adapt to society. For many people with transsexuality, this is an opportunity to find their dream job, officially introduce themselves with a new name, and even get married.
Actress and performance artist Candis Cayne
Candis Cayne is the first transgender actress.
She managed to receive this “title” in 2007 for her role as the transgender Carmelita in the TV series “Dirty Wet Money.” Brendan McDaniel began gender reassignment at the age of 25, and today he is a famous American actress and performance artist.
In a man's body
Life with a new gender
Every person who decides to change their gender must understand that not a single operation will help them fully approach those who were born with the set of chromosomes they “need” from birth. Plastic surgery can change external sexual characteristics. However, whether a man from birth who is forced to take hormones in the form of pills for the rest of his days can be considered a woman is a big question.
Gender reassignment does not involve the creation and implantation of internal genital organs, since such operations are currently impossible. Accordingly, the “new woman” will not be able to have offspring and will never know what menstruation is. When it comes to maintaining erotic sensitivity, many people who have changed their sex claim that they enjoy intimacy. Doctors also say that sensitivity in the genital area does not disappear after surgery, but the “woman” created through plastic surgery will never feel what her friend, born with that gender, feels.
There are quite a few disadvantages to surgical gender reassignment, but it is still worth recognizing that for some people this is truly the only path to happiness and harmony. This type of operation should only be performed by those who are confident in the correctness of their decision and are not afraid of possible difficulties.
Politician Anna Grodskaya
Anna Grodskaya is the first transsexual in Poland elected to the Sejm of the Republic.
She is also known as the founder and president of the Trans-Fuzja transgender rights foundation. The final gender change took place in 2010. A psychologist by training, she has been involved in social work and political activities for most of her life. In a man's body
Writer Janet Mock
Today, the transgender activist, TV presenter and writer, who was once born in a male body and lived under the name Charles, leads a completely female life.
In 2014, she received a marriage proposal from her boyfriend Aaron Treadwell, which she happily accepted. To support this, Janet posted on Twitter, highlighting other significant events that year - the publication of the book Redefining Reality: My Journey to Femininity, Identity, Love and More, becoming the editor of Marie Claire and the launch of her television show So Popular. In a man's body
Rehabilitation
During the rehabilitation period, the patient goes through all the hardships of the consequences of the surgical intervention, to which is added the psychological discomfort associated with getting used to the new gender role. If before the operation the patient had no somatic pathologies, he took hormonal medications, eliminated alcoholic beverages and smoking, there will be a minimum of side effects during rehabilitation.
.
If we talk about the risks that transgender surgery can bring, they are divided into psychological and physiological.
Physiological ones include:
- scars on the body;
- numerous hematomas;
- swelling;
- bleeding.
However, after a while, almost all these complications disappear and after rehabilitation, the patient’s health is completely restored.
After the operation, the surgeon explains to the patient how he should behave during recovery, prescribes medications, physical procedures, etc.
Psychological discomfort can bring much more trouble than physiological discomfort. Despite the fact that an operation aimed at gender reassignment is very desirable, after it is performed, the patient is faced with an outside world that finds it difficult to accept such a person.
The realities of life are such that many are prejudiced towards people who have changed their gender. As a result, a person may not get along with the new gender role and come to the conclusion that he wants to return his masculine nature.
Gender reassignment is a very serious decision. Every person who decides to undergo such a surgical intervention must understand that he will have to face psychological problems, as well as a rehabilitation period.
