39 Therefore, it is suggested that psychological support is crucial for patients after sex reassignment surgery, which helps them feel accepted and have confidence in the outcome of the surgery; also, psychological support will become increasingly important for patients with lengthier sex reassignment surgery process. 39 Sexual satisfaction edit The majority of the transsexual individuals have reported enjoying better sex lives and improved sexual satisfaction after sex reassignment surgery. 5 The enhancement of sexual satisfaction was positively related to the satisfaction of new primary sex characteristics. 5 Before undergoing srs, transsexual patients possessed unwanted sex organs which they were eager to remove. Hence, they were frigid and not enthusiastic about engaging in sexual activity. In consequence, transsexuals individuals who have undergone srs are more satisfied with their bodies and experienced less stress when participating in sexual activity.
32 Many studies have been carried out to investigate satisfaction levels of patients after your sex nikki reassignment surgery. In these studies, most of the patients have reported being very happy with the results and very few of the patients have expressed regret for undergoing sex reassignment surgery. 34 Although studies have suggested that the positive consequences of sex reassignment surgery outweigh the negative consequences, 35 it has been suggested that most studies investigating the outcomes of sex reassignment surgery are flawed as they have only included a small percentage of sex reassignment. 36 These methodological limitations such as lack of double-blind randomised controls, small number of participants due to the rarity of transsexualism, high drop-out rates and low follow-up rates, 37 which would indicate need for continued study. Persistent regret can occur after sex reassignment surgery. Regret may be due to unresolved gender dysphoria, or a weak and fluctuating sense of identity, and may even lead to suicide. 38 During the process of sex reassignment surgery, transsexuals may become victims of different social obstacles such as discrimination, prejudice and stigmatising behaviours. 39 The rejection faced by transsexuals is much more severe than what is experienced by lgb individuals. 40 The hostile environment may trigger or worsen internalised transphobia, depression, anxiety and post-traumatic stress. 41 Many patients perceive the outcome of the surgery as not only medically but also psychologically important. Social support can help them to relate to their minority identity, ascertain their trans identity and reduce minority stress.
30 31 Moreover, studies have also found that the critical procedure for genital summary sensitivity maintenance and achieving orgasms after phalloplasty is to preserve both the clitoris hood and the clitoris underneath the reconstructed phallus. 30 31 Erogenous sensitivity is measured by the capabilities to reach orgasms in genital sexual activities, like masturbation and intercourse. 30 Many studies reviewed that both trans men and trans women have reported an increase of orgasms in both sexual activities, 32 5 implying the possibilities to maintain or even enhance genital sensitivity after srs. Psychological and social consequences edit After sex reassignment surgery, transsexuals (people who underwent cross-sex hormone therapy and sex reassignment surgery) tend to be less gender dysphoric. They also normally function well both socially and psychologically. Anxiety, depression and hostility levels were lower after sex reassignment surgery. 33 They also tend to score well for self-perceived mental health, which is independent from sexual satisfaction.
Overall, transsexual people have rated their self-perceived quality of life as normal or quite good, however, their overall score was still lower than the control group. 26 Another study showed a similar level of quality of life in transsexual individuals and the control group. 27 Nonetheless, a study with long-term data suggested that albeit quality of life of patients 15 years after sex reassignment surgery is similar to controls, their scores in the domains of physical and personal limitations were significantly lower. 5 28 On the other hand, research has found that quality of life of transsexual patients could be enhanced by other variables. For instance, trans men obtained a higher self-perceived health score than women because they had a higher level of testosterone than them. Trans women who had undergone face feminization surgery have reported higher satisfaction in different aspects of their quality of life, including their general physical health. 29 looking specifically at transsexual people's genital sensitivities, trans men and trans women are capable of maintaining their genital sensitivities after srs. However, these are counted upon the procedures and surgical tricks which are used to preserve the sensitivity. Considering the importance of genital sensitivity in helping transsexual individuals to avoid unnecessary harm or injuries to the genitals, allowing trans men to obtain an erection and perform the insertion of the erect penile prosthesis after phalloplasty, 30 the ability for transsexual to experience erogenous.
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The criteria of many of those socs are stricter than the latest revision of the wpath-soc. Many qualified surgeons in North America and many in Europe adhere almost unswervingly to the wpath-soc or other socs. However, in the United States many experienced surgeons are able to apply the wpath soc in ways which respond to an individual's medical circumstances, as is consistent with the soc. Most surgeons require two letters of recommendation for sex reassignment surgery. At least one of these letters must be from a mental health professional experienced in diagnosing gender identity disorder, who has known the patient for over a year. Letters must state that sex reassignment surgery is the correct course of treatment for the patient.
23 24 Many medical professionals and numerous professional associations have stated that surgical interventions should not be required in order for transsexual individuals to change sex designation on identity documents. 25 However, depending on the legal requirements of many jurisdictions, transsexual and transgender people are often unable to change the listing of their sex in public records unless business they can furnish a physician's letter attesting that sex reassignment surgery has been performed. In some jurisdictions legal gender change is prohibited in any circumstances, even after genital or other surgery or treatment. Quality of life and physical health edit patients of sex reassignment surgery may experience changes in their physical health and quality of life, the side effects of sex steroid treatment. Hence, transgender people should be well informed of these risks before choosing to undergo srs. 5 several studies tried to measure the quality of life and self-perceive physical health using different scales.
Standards of care edit see also: Transgender rights Sex reassignment surgery can be difficult to obtain, due to a combination of financial barriers and lack of providers. An increasing number of surgeons are now training to perform such surgeries. In many regions, an individual's pursuit of srs is often governed, or at least guided, by documents called Standards of Care for the health of Transsexual, Transgender, and Gender Nonconforming people (SOC). The most widespread soc in this field is published and frequently revised by the world Professional Association for Transgender health (wpath, formerly the harry benjamin International Gender Dysphoria association or hbigda). Many jurisdictions and medical boards in the United States and other countries recognize the wpath standards of Care for the treatment of transsexualism.
For many individuals, these may require a minimum duration of psychological evaluation and living as a member of the target gender full-time, sometimes called the real life experience (RLE) (sometimes mistakenly referred to as the real life test (RLT) before genital reconstruction or other sex. Standards of Care usually give certain very specific "minimum" requirements as guidelines for progressing with treatment for transsexualism, including accessing cross-gender hormone replacement or many surgical interventions. For this and many other reasons, both the wpath-soc and other socs are highly controversial and often maligned documents among transgender patients seeking surgery. Alternative local standards of care exist, such as in the netherlands, germany, and Italy. Much of the criticism surrounding the wpath/hbigda-soc applies to these as well, and some of these socs (mostly european soc) are actually based on much older versions of the wpath-soc. Other socs are entirely independent of the wpath.
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Some surgeons charge higher fees for hiv and hepatitis C-positive patients; other medical professionals assert that it is unethical to deny surgical or hormonal treatments to transgender people solely on the basis of their hiv or hepatitis status. 18 Other health conditions such as diabetes, abnormal blood clotting, ostomies, and obesity do not usually present a problem to experienced surgeons. The conditions do increase the anesthetic risk and the rate of post-operative complications. Surgeons may write require overweight patients to reduce their weight before surgery, any patients to refrain from hormone replacement before surgery, and smoking patients to refrain from smoking before and after surgery. Surgeons commonly stipulate the latter regardless of the type of operation. Potential future advances edit see also: Transgender pregnancy, uterus transplantation Application on transgender women, and Male pregnancy Humans Medical advances may eventually make childbearing possible by using a donor uterus long enough to carry a child to term as anti-rejection drugs do not seem. The dna in a donated ovum can be removed and replaced with the dna of the receiver. Further in the future, stem cell biotechnology may also make this possible, with no need for anti-rejection drugs.
Complications of penile inversion vaginoplasty are mostly minor; however, rectoneovaginal fistulas (abnormal connections between the neovagina and the rectum) can occur in about 1-3 of patients. These require additional surgery to fix and are often fixed by colorectal surgeons. 17 As underscored by wpath, a medically assisted transition from one sex to another may entail any of a variety of non-genital surgical procedures, any of which are considered "sex reassignment surgery" when performed as part of treatment for gender dysphoria. For trans men, these may include mastectomy (removal of the breasts) and chest reconstruction (the shaping of a male-contoured chest or hysterectomy and bilateral salpingo-oophorectomy (removal of ovaries and Fallopian tubes ). For some trans women, facial feminization surgery, hair implants, and breast augmentation are also aesthetic components of their surgical treatment. Medical considerations edit people with hiv or hepatitis language C may have difficulty finding a surgeon able to perform successful surgery. Many surgeons operate in small private clinics that cannot treat potential complications in these populations.
In addition, other non-surgical procedures are also considered medically necessary treatments by wpath, including facial electrolysis. A growing number of public and commercial health insurance plans in the United States now contain defined benefits covering sex reassignment-related procedures, usually including genital reconstruction surgery (mtf and ftm chest reconstruction (ftm breast augmentation (mtf and hysterectomy (FTM)., the American Medical Association (AMA) house. 16 Different srs procedures edit The array of medically indicated surgeries differs between trans women (male to female) and trans men (female to male). For trans women, genital reconstruction usually involves the surgical construction of a vagina, by means of penile inversion or the sigmoid colon neovagina technique; or, more recently, non-penile inversion techniques that make use of scrotal tissue to construct the vaginal canal. For trans men, genital reconstruction may involve construction of a penis through either phalloplasty or metoidioplasty. For both trans women and trans men, genital surgery may also involve other medically necessary ancillary procedures, such as orchiectomy, penectomy, mastectomy or vaginectomy. Penile inversion vaginoplasty is one of the most common procedures performed in the United States. It is a relatively safe procedure.
3 4, another term for srs includes sex reconstruction surgery, and more clinical terms, such as feminizing genitoplasty or business penectomy, orchiectomy, and vaginoplasty, are used medically for trans women, with masculinizing genitoplasty, metoidioplasty or phalloplasty often similarly used for trans men. People who pursue sex reassignment surgery are usually referred to as transsexual (derived from "trans meaning "across "through or "change and "sexual pertaining to the sexual characteristics —but not necessarily sexual actions—of a person). While individuals who have undergone and completed srs are sometimes referred to as transsexed individuals, 5 the term transsexed is not to be confused with the term transsexual, which may also refer to individuals who have not undergone srs, yet whose anatomical sex may not. Sex reassignment surgery performed on unconsenting minors (babies and children) may result in catastrophic outcomes (including ptsd and suicide—such as in the david reimer case, following a botched circumcision) when the individual's sexual identity (determined by neuroanatomical brain wiring) is discrepant with the surgical reassignment. 6 7 8 Milton diamond at the john. Burns School of Medicine, university of Hawaii recommended that physicians do not perform surgery on children until they are old enough to give informed consent, assign such infants in the gender to which they will probably best adjust, and refrain from adding shame, stigma and. Diamond considered the intersex condition as a difference of sex development, not as a disorder. 9 10 Contents Scope and procedures edit The best known of these surgeries are those that reshape the genitals, which are also known as genital reassignment surgery or genital reconstruction surgery (GRS)- or bottom surgery (the latter is named in contrast to top surgery, which. However, the meaning of "sex reassignment surgery" has been clarified by the medical subspecialty organization, the world Professional Association for Transgender health (wpath to include any of a larger number of surgical procedures performed as part of a medical treatment for "gender dysphoria" or "transsexualism".
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For specialized articles on surgical procedures, see. Sex reassignment surgery (male-to-female) and, sex reassignment surgery (female-to-male). Sex reassignment surgery or, sRS (also known as gender reassignment surgery, gender confirmation surgery, genital reconstruction surgery, gender-affirming surgery, or sex realignment surgery ) is the surgical procedure (or procedures) by which a transgender person's physical appearance and function of their existing sexual characteristics are. It is part of a treatment for gender dysphoria in london transgender people. Related genital surgeries may also be performed on intersex people, often in infancy. A 2013 statement by the. United Nations, special Rapporteur on Torture condemns the nonconsensual use of normalization surgery on intersex people. 1 2, the American Society of Plastic Surgeons (asps) calls this procedure gender Confirmation Surgery or gcs.