What you need to know about Gender confirmation surgeries?

Gender confirmation surgeries are a boon for transgender people to affirm their process of transition. However, many of us are still confused about the surgical procedures available for gender non-conforming patients. Notably, multi-specialty teams perform such surgeries under the supervision of certified plastic surgeons. Gender reassignment surgeries are essential as they help the concerned patients to cope up with the feeling of seclusion. It also enables them to navigate easily throughout the world.

Gender dysphoria : A quick review

This medical condition occurs when you witness a strong feeling that the gender assigned to you at the time of your birth is different from your identification gender. This feeling of gender dysphoria or gender identity disorder makes you prone to anxiety and dissatisfaction about your own gender.


Characteristic features of gender dysphoria

If you feel one or more of these traits, then probably you are a victim of gender dysphoria
You have a strong desire to acquire the body of the opposite gender.
You have a strong desire for possessing primary or secondary sex characteristics associated with the opposite gender.
You feel dissatisfied with the primary or secondary characteristic features assigned to your own gender.
You start experiencing a sense of detachment from assigned primary or secondary sex characteristics.
Your gut feeling says that your personality and behavior associates well with the other gender.
Finally, you have a clear desire to receive social treatment as the opposite gender.

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Transmasculine Surgeries

TOP PROCEDURES: The top surgical procedure helps in the removal of chest tissue, thereby restricting it to give a masculine appearance. Here, you have three different options to choose from:
1.Horizontal incision:
Under double incision surgery, your surgeon shall make incisions on the top and bottom portions of your breastss for the removal of breast .. This results in pulling down of your skin and reconnecting it at the lower incision site, along with removal of nipples and a graft creation (with a nipple-like appearance).
2. Periareolar
Under this process, your surgeon shall make an incision around the region of your areola, which he will again encircle by a larger incision. After this, the steps the surgeon proceeds with the removal of breast tissue and pulling down of your skin surrounding your nipple to make it intact.
3. Keyhole
The Keyhole process, on he other hand, involves a single incision that goes underneath your nipple and facilitates removal of your chest tissue.
In the transmasculine bottom surgical procedure, genitals undergo a reconstruction for the creation of a phallus. These are inclusive of the following:
Metoidioplasty: It results in the release of your enlarged clitoris from your clitoral hood and aid in the process of phallus creation. Here, the urethra is rerouted by using a cheek graft or a graft from an internal vaginal wall. This grafting aids in the urination process through the newly developed phallus.
Phalloplasty: Under this process, a graft is taken usually from the regions of forearm, thigh or back to facilitate the creation of a new penis.
Hysterectomy, oophorectomy, and vaginectomy: Hysterectomy aids in the process of vagina removal, oophorectomy aids in the process of ovaries removal (one or both), and vaginectomy aids in vagina removal.
3. Transfeminine Surgeries These are also called female to Male (FTM ) surgery
TOP SURGERY:people assigned with masculine primary or secondary sex characteristics at the time of birth, may exhibit a strong desire for breast tissue.
Breast Augmentation: Under this surgical procedure, the surgeon creates an incision around the areola, at a point where your chest and breast tissues meet or underneath your armpit. After this, the implantation of a custom-sized silicone or saline implant and finally suture of an incision take place. Although silicone implants tend to be more expensive than the saline ones, they are softer and realistic.
Bottom surgery:
There are two types of bottom surgical procedure meant for people born with masculine sexual characteristics in their lower regions:
Penectomy and Vaginoplasty: Under this process, your surgeon shall create a functional vagina out of whatever tissue is available. He uses the method of penile inversion to perform this treatment. The surgeon inverts your penis to create a vagina. In this way, your penis tip shall function as a clitoris and your scrotal skin as your labia.
Orchiectomy: This is relatively an inexpensive surgical procedure, which involves removal of your testes. In this way, your body shall create less count of endogenous testosterone. This is essential for those who are on their hormone replacement therapy.


Things to know before opting for Gender confirmation surgeries

Surgical transitions are not the only options available for those who wish to undergo a medical transformation. For alleviating gender dysphoria, there is an alternative option called hormonal shift.
It is important to note that the results of surgical transitions will inevitably be differing from individual to individual.

Cost of different gender confirmation surgeries

Here is an approximate idea of the charges of various surgeries performed for gender confirmation.
Transmasculine Surgeries
For Top: Anything between 3000 to 11000 US dollars
For Bottom: Begins from 4000 US dollars
Transfeminine Surgeries
For Top: Anything between 3000 to 11000 US dollars
For Bottom: Begins from 4000 US dollars


The goal of gender reassignment surgeries is to alleviate the feelings associated with gender dysphoria. Although it is not advisable for everyone but proves to be a great help to assign your sexual characteristics to fall in line with your internal sense of self.

Dr. Tejinder Bhatti, Plastic Surgeon
Dr. Kulwant S Bhangoo, Plastic Surgeon

The information is being provided by and have no intention to replace the medical advice of your doctor. Please consult your doctor directly for advice about a specific medical condition. This document was last reviewed by Dr. Tejinder Bhatti, Plastic Surgeon on: 20-JUN-2020