Shall we talk about gender affirmation surgery?

It's common to have surgery to change the way we look. Some people do it to feel good about their appearance. But for a transgender or nonbinary person, this type of surgery is about more than just making themselves look better. It's a way to express who they are on the inside, their true identity, to the outside world.

What exactly do "Transgender" and "Nonbinary" mean?

Okay, let's put this simply. When a baby is born, we look at its genitals and decide whether it's a girl or a boy, right? We call that " sex assigned at birth."

"Transgender" refers to someone who feels they have a gender identity that is different from the sex they were assigned at birth. For example, someone who was assigned male at birth may identify as a woman. Then that person is a trans woman. And the other way around.

"Nonbinary" refers to someone who feels they cannot be placed exactly in the boxes of "woman" or "man." Their identity may lie somewhere in between, a combination of both, or outside of either entirely.

In this way, there are various ways to change your external appearance to match your inner identity. Some express their identity through things like clothing, hairstyles, and makeup. Others turn to hormone therapy . Still others choose surgery that can permanently change their body. We are talking about this surgery today.

Facial surgery to suit your identity

Facial plastic surgery is a popular procedure among many people today. Many people undergo it to increase their self-confidence and to achieve the appearance they want. Transgender people can also use this surgery to adjust their facial shape to match their gender identity.

Chest surgery (Top Surgery)

Breast surgery is also a very common procedure in the world. This is commonly referred to as "Top Surgery." These surgeries, which are performed to accommodate the identity of transgender people, are very similar to surgeries that are usually performed to enlarge or remove breasts.

For a feminine appearance (Transfeminine Top Surgery)

If a transgender woman wants to have more feminine-looking breasts, this surgery involves breast implants. This is very similar to the surgery that is usually done to enlarge a person's breasts.

For a masculine appearance (Transmasculine Top Surgery)

This surgery is suitable for someone who wants a flat chest with a masculine look. This involves removing breast tissue and flattening the chest. This is usually doneIt is similar to a mastectomy, but here, the doctor reshapes the skin and repositions the nipples so that they look like a normal male chest.

Surgeries related to the genitals (Bottom Surgery)

There are special surgeries for those who want to change their genitals. These are called "Bottom Surgery." These are somewhat complex surgeries and should only be performed by doctors who have extensive experience in gender reassignment surgery .

Transmasculine Bottom Surgery

• Some transgender men choose to have their uterus and ovaries removed. This can be done by having a hysterectomy . This reduces the body's levels of female hormones and stops monthly periods.
• If you want to change the external genitalia, there are surgeries that change the vaginal opening. You can also create a penis. There are several methods for this:
• Metoidioplasty: In this procedure, the clitoris and surrounding skin are used to create a small penis that can be stimulated and used for urination.
• Phalloplasty: This involves creating a penis using skin grafts taken from another part of the body (e.g., the arm or thigh).
• Also, testicles can be artificially created using implants to resemble testicles.

Transfeminine Bottom Surgery

• Men who want to reduce the level of male hormones in their body choose to have their testicles removed. This surgery is called an orchiectomy .
• Vaginoplasty is a surgical procedure that creates a vagina. In this procedure, tissue from the penis is used to create a vagina in the pelvic area. After this surgery, special devices (dilators) must be used continuously to prevent the newly created vagina from closing.

How much do these surgeries cost?

Gender Affirmation surgery is a very expensive procedure. The cost can vary greatly depending on the type of surgery you choose, the hospital, and the number of doctors involved. Although these costs are covered by medical insurance in some countries, the situation in Sri Lanka may be different. Therefore, it is very important to talk to your doctor about this and get a clear understanding of the costs.

There are several documents that may be required to obtain approval for this type of surgery:

• A medical condition called Gender Dysphoria: This refers to severe psychological distress caused by a discrepancy between the sex assigned at birth and one's true gender identity. Your doctor may be able to provide a note about this.
• A letter of support from a mental health professional:You can get this letter from someone like a psychiatrist or a counselor.

Recovery time and mental well-being after surgery

The time it takes for you to recover will vary depending on the type of surgery you have had. For example, while swelling after facial surgery will go down in about 2 weeks, swelling after bottom surgery may last for 4 months or more.

Here's the important thing: Many people who undergo gender affirmation surgery say that it has significantly improved their quality of life and mental well-being . In fact, surveys show that more than 94% of those who undergo the surgery are satisfied with the results.

And, those who receive good mental health support before surgery have even better outcomes. One study found that the need for mental health treatment after this surgery was reduced by 8%.

Not every trans and non-binary person chooses surgery. It's a completely personal decision. If you're considering this type of surgery, first meet with your primary care doctor to discuss what options are best for you.