Sex reassignment, transgenitalization, or neophaloplasty surgery, popularly known as gender change surgery, is done with the aim of adapting the physical characteristics and genital organs of the transgender person, so that this person can have the appropriate body to what considers suitable for you.
This surgery is performed on female or male people, and involves complex and long surgical procedures, which involve both the construction of a new genitalia, called neopenis or neovagina, as well as the removal of other organs, such as the penis, breast, uterus. and ovaries.
In addition, for this type of procedure to be done, it is necessary that the person undergo a hormonal treatment to adapt the characteristics, in addition to psychological monitoring, so that it is possible to determine that that new physical identity fits the person and there is no regrets. Learn all about gender dysphoria.
Where it is made
Gender change surgery can be performed by SUS since 2008, however, as waiting in line can last for years, many people choose to do the procedure with private plastic surgeons.
How it is done
Before undergoing transgenitalization surgery, some important steps must be followed:
- Accompaniment with psychologist, psychiatrist and social worker; Socially assume the gender you want to adopt; Hormonal treatment to acquire female or male characteristics, guided by the endocrinologist for each case.
These steps prior to surgery last about 2 years, and are very necessary, as they are a step towards the person's physical, social and emotional adaptation to this new reality, since it is recommended to be sure of the decision before the surgery, which is definitive.
The surgery is preceded by general anesthesia, and lasts about 3 to 7 hours, depending on the type and technique used by the surgeon.
Change from female to male
There are 2 types of surgical techniques for transforming the female sexual organ into a male one:
Methoidioplasty
It is the most used and available technique, and consists of:
- Hormonal treatment with testosterone causes the clitoris to grow, becoming larger than the common female clitoris; Incisions are made around the clitoris, which is detached from the pubis, making it more free to move around; Tissue is used the vagina to increase the length of the urethra, which will remain inside the neopenis; the tissue of the vagina and the labia minora are also used to coat and shape the neopenis; the scrotal sac is made from the labia majora and implants of silicone prostheses to simulate the testicles.
The resulting penis is small, reaching about 6 to 8 cm, however this method is quick and capable of preserving the natural sensitivity of the genitalia.
Phalloplasty
It is a more complex, expensive and poorly available method, which is why many people looking for this method end up looking for professionals abroad. In this technique, grafts of skin, muscles, blood vessels and nerves from another part of the body, such as the forearm or thigh, are used to create the new genital organ with greater size and volume.
- Care after surgery: to complement the masculinization process, it is necessary to remove the uterus, ovaries and breasts, which can be done already during the procedure or can be scheduled for another time. Generally, the sensitivity of the region is maintained, and intimate contact is released after about 3 months.
Change from male to female
For the transformation of male to female genitalia, the technique commonly used is the modified penile inversion, which consists of:
- Incisions are made around the penis and scrotal sac, defining the region where the neovagina will be made; Part of the penis is removed, preserving the urethra, the skin and the nerves that give sensitivity to the region; The testicles are removed, preserving the skin of the scrotum; a space is opened to fight the neovagina, with about 12 to 15 cm, using the skin of the penis and scrotum to cover the region. Hair follicles are cauterized to prevent hair growth in the region; The rest of the skin of the scrotum and foreskin are used for the formation of the vaginal lips; The urethra and urinary tract are adapted so that the urine comes out through an orifice and the person can urinate seated; the glans is used to form the clitoris, so that the sensation of pleasure can be maintained.
To allow the new vaginal canal to remain viable and not to close, a vaginal mold is used, which can be exchanged for larger sizes over the weeks for the neovagina dilation.
- Care after surgery: Physical activities and sexual life are usually released after about 3 to 4 months after surgery. It is usually necessary to use lubricants specific to the region during sexual intercourse. In addition, it is possible that the person has follow-up with a gynecologist, for guidance and skin evaluations of the neovagina and urethra, however, as the prostate remains, it may also be necessary to consult with the urologist.
In addition, after any plastic surgery, it is recommended to eat light meals, respect the rest period recommended by the doctor, in addition to using prescription drugs to relieve pain, such as anti-inflammatories or analgesics, to facilitate recovery. Check the essential care after a plastic surgery.
