We all want to be happy with our appearance. For some, it's about showing the world who they really are. In fact, having surgery to change the way they look is something that many people choose to do these days. But for someone who is transgender or nonbinary, it's something much deeper. It's about affirming their true identity, bringing their mind and body into alignment. Today, we're talking about one such surgery, Gender Affirmation Surgery .
How does someone become transgender or nonbinary?
Simply put, it's very simple. Imagine, when a baby is born, we look at its genitals and decide whether it's a boy or a girl. We call that the "sex assigned at birth." But sometimes, as the child grows up, we realize that what he or she feels inside, that is, his or her "gender identity," does not match the sex assigned at birth.
For example, someone who was assigned male at birth may feel deep down that they are actually female. That is what we call transgender .
Nonbinary refers to people who feel they cannot be completely categorized as either "female" or "male." They are people who have an identity that goes beyond these two boxes.
These people have various options to change their appearance to match their inner self. Some change their appearance with clothes, hairstyles, and makeup. Others turn to hormone therapy. Still others choose surgery that can permanently change their body and face.
Facial surgery
Plastic surgery to change the appearance of the face is very common. It can help people improve their self-confidence and feel good about themselves. Transgender people can also use this surgery to adjust their facial shape to match their identity.
| Type of surgery | Explanation |
|---|---|
| Facial Feminization | Giving a more feminine look to a masculine face and neck. This includes changing the shape of the forehead, reducing the size of the jaw and chin bones, giving the cheeks a fuller look, changing the shape of the nose and lips, and reducing the Adam's apple. |
| Facial Masculinization | Giving a feminine face a more masculine look. This includes lengthening the forehead, reshaping the jaw and chin, reshaping the cheekbones, and enlarging the jawline. |
Surgery to change the appearance of the chest (Top Surgery)
Breast surgery is also very common. This is called "top surgery" for short.
- Transfeminine Top Surgery: If a person wants a more feminine-looking chest, breast implants are performed. This is similar to the surgery usually performed to enlarge the breasts.
- For a more masculine appearance (Transmasculine Top Surgery): If a person wants a flatter chest with a more masculine appearance, a breast reduction surgery (similar to a mastectomy) is performed. This involves removing breast tissue and flattening the chest. The nipples can also be repositioned to resemble a normal male chest.
Bottom Surgery
These are quite complex surgeries, and they require the assistance of doctors who have a lot of experience in transplant surgery.
For a masculine appearance (Transmasculine Bottom Surgery)
Some transgender men choose to have their uterus and ovaries removed. This can be done through a hysterectomy. This reduces the body's levels of female hormones and stops monthly periods.
If you want to change the external genitalia, you can create a penis. There are several ways to do this:
- Metoidioplasty: Here, the clitoris and surrounding skin are used to create a small penis (phallus) that can be stimulated and used for urination.
- Phalloplasty: This involves taking skin from another part of the body (e.g., the arm or thigh) and grafting it to create a penis.
- Additionally, a scrotum can be created using implants that look like testicles.
For a feminine appearance (Transfeminine Bottom Surgery)
Those who want to reduce the level of male hormones in the body can undergo surgery to remove the testicles (orchiectomy) .
The surgery to create a vagina is called vaginoplasty . In this procedure, tissue from the penis is used and inserted into the pelvic cavity to create a vagina. After this surgery, special devices (dilators) must be used to prevent the newly created vagina from closing.
The most important thing is that all of these surgeries are very personal decisions. Not everyone wants to have all of these. It's important for them to decide for themselves what suits them and what they want.
How much does this surgery cost?
Some insurance companies cover these surgeries. However, in many cases, insurance policies may have clauses that exclude things like "services related to sex change." So, it's best to call your insurance company and ask them about this.
If you are covered by insurance, they may ask for some documentation before approving it.
- A medical report stating that you have been diagnosed with Gender Dysphoria: Gender Dysphoria is the psychological distress and discomfort caused by a discrepancy between the gender identity you were assigned at birth and the gender you actually feel you are. Your doctor can provide a note for this.
- A letter of support from a mental health professional (e.g., psychiatrist, counselor).
These surgeries can cost a lot of money. Therefore, if you are doing it out of your own pocket, it is important to be aware of the fees of everyone involved, including surgeons, anesthesiologists, psychiatrists, and counselors, in advance.
Post-surgery recovery and mental well-being
The recovery time varies depending on the type of surgery you had. While swelling after facial surgery usually goes down in about two weeks, swelling after genital surgery can last for 4 months or more.
Talk to your doctor about when you can return to normal activities. Also, be sure to attend follow-up appointments after surgery so your doctor can check that you are healing properly.
Here's the most important part: Many people who undergo Gender Affirmation Surgery say that it has greatly improved their quality of life and mental health. In fact, more than 94% of those who undergo the surgery are satisfied with the results.
Those who receive good psychological support before surgery have even better outcomes. One study found that the need for mental health treatment after surgery was reduced by 8%.
If you are considering this type of surgery, the first step is to talk to your primary care doctor about it. They can discuss the options that are best for you and provide you with the right guidance.
Take-Home Message
- Gender Affirmation Surgery is a very personal surgical procedure that is performed to adjust a person's body to match their true identity.
- There are different types of surgeries for the face, chest, and genitals. Not everyone needs to have all of them.
- This is not a decision to be taken lightly. It is a decision that should be carefully considered and discussed with a trusted doctor and mental health counselor .
- Although it takes time to heal, studies show that these surgeries significantly improve the mental health and happiness in life for many people.
- This journey is unique to each person. What works for one person may not work for another. The most important thing is that you feel good about yourself.
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