Some do nothing at all and keep their gender identity and expression private. Some aspire to social transition — telling others about their gender identity — without medical intervention. Many only pursue hormone replacement therapy HRT. Others will pursue HRT as well as various degrees of surgery, including chest reconstruction or facial feminization surgery FFS.
They may also decide that bottom surgery — also known as genital surgery, sex reassignment surgery SRSor preferably, gender confirmation surgery GCS — is the right choice for them. Vaginoplasty is typically pursued by "Transsexual surgery cost" women and AMAB assigned male at birth nonbinary people, while phalloplasty or metoidioplastyis typically pursued by transgender men and AFAM assigned female at birth nonbinary people.
Leading transgender healthcare providers will either follow an informed consent model or the WPATH standards of care. The informed consent model allows the physician to inform you of the risks of a certain decision.
Then, Transsexual surgery cost decide for yourself whether to proceed without any input from any other healthcare professional. They believe it takes control out of the hands of the person Transsexual surgery cost implies that the transgender person deserves less personal authority than a cisgender person. Requiring letters from therapists and physicians appeals "Transsexual surgery cost" some hospitals, surgeons, and care providers, who may look at this system as legally defensible if necessary.
Both of these methods are considered by some in the transgender community to be an improvement of the previous and widespread gatekeeper model. Some argued that this presumes transgender identity to be
Transsexual surgery cost or less legitimate than cisgender identity. They also believe that RLE is a mentally traumatic, socially impractical, and physically dangerous period of time in which a transgender person must out themselves to their community — without the benefit of the physical transformations that hormones or surgeries bring.
The gatekeeper model also tends to use heteronormative, cisnormative criteria for qualifying the real-life experience.
This poses a significant challenge to transgender people with same-sex attractions or gender expressions outside a stereotypical norm dresses and makeup for women, hyper-masculine presentation for menand essentially erases the experience of nonbinary trans people.
In Canada and the UK, bottom surgery is covered under nationalized healthcare, with varying levels of supervision and wait times depending on the region.
When choosing a surgeon, pursue in-person or skype interviews with as many surgeons as possible. Many surgeons give presentations or consultations in major cities throughout the year and may make appearances at transgender conferences. It also helps to reach out to former patients of the surgeons that interest you, via online forums, support groups, or mutual friends.
Penile inversion involves using the penile skin to form the neovagina. The labia major and minora are primarily made from scrotal tissue. This results in a sensate vagina and labia.
One main drawback is the lack of self-lubrication by the vaginal wall. Common variations include using the remaining Transsexual surgery cost tissue as a graft for additional vaginal Transsexual surgery cost, and using the intact mucosal urethra recovered "Transsexual surgery cost" the penis to line part of the vagina, creating some self-lubrication. Rectosigmoid vaginoplasty involves the use of intestinal tissue to form the vaginal wall.
This technique is sometimes used in conjunction with penile inversion. Intestinal tissue helps when penile and scrotal tissue is scarce. This method is often used for transgender women who began hormone therapy at puberty and were never exposed to testosterone. Intestinal tissue has the added benefit of being mucosal, and therefore self-lubricating. This technique is also used to reconstruct vaginas for cisgender women who developed atypically short vaginal canals.
Non-penile inversion is also known as the Suporn technique after Dr. Suporn who invented it or the Chonburi Flap.
This method uses perforated scrotal tissue graft for the vaginal lining, and intact scrotal tissue for the labia majora same as a penile The penile tissue is used for the labia minora and clitoral hood.
Surgeons who use this technique purport greater vaginal depth, more sensate inner labia, and improved cosmetic appearance. Scrotoplasty may be performed with either surgery, which modifies the major labia into a scrotum.
Testicular implants usually require waiting for a follow-up surgery. Metoidioplasty is a much simpler and quicker procedure than phalloplasty. In this procedure, the clitoris, already elongated to centimeters by HRT, is released from the surrounding tissue, and repositioned to match the positioning of a penis. You may also choose to do a urethral lengthening with your metoidioplasty, also known as a full metoidioplasty.
This method uses donor tissue from the cheek or from the vagina to connect the urethra to the new neopenis, allowing you to urinate while standing. You "Transsexual surgery cost" also pursue a Centurion procedure, wherein the ligaments underneath the major labia are repositioned to add girth to the neopenis. Removal of the vagina may be performed at Transsexual surgery cost time, depending on your goals. After these procedures, the neopenis may or may not maintain an erection on its own and is unlikely to provide meaningful penetrative sex.
Phalloplasty involves using a skin graft to elongate the neopenis to inches. The common donor sites for the graft are the forearm, thigh, abdomen, and upper back. There are pros and cons to each donor site.