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surgery.md

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% Surgery

TODO: add information about intersex people.

For facial feminization surgery, we have a separate page.

Table of contents

We oppose penile inversion technique (MtF vaginoplasty) {#penile-inversion}

Transit recommends not having surgery done using the penile inversion technique, for these reasons:

  • Requires expensive genital hair removal, which can damage the genital area (the skin is much more sensitive). This also makes penile inversion more cost prohibitive for trans people, who are more likely to be poor than other groups of people
  • Does not result in self-lubrication (you need to use lube when having sex)
  • Inferior in terms of depth, sensation, etc, and doesn't look as good in terms of cosmetic appearance

There are other, superior methods

Recovery

No matter where you get your surgery, make sure that you have decent care after surgery, to help you recover. If you're doing it overseas, you might need to stay in that foreign country for a few weeks before returning home (in some cases, it could be just 1 week or a few days before being able to continue recovery at home). After surgery (any surgery) you need time for your body to heal, and you will be in pain for a while.

Stimulation (assigned male at birth) {#stimulation}

Some people say that, prior to surgery, you should flex/stimulate your penis regularly. This means making it become erect, and stretching it when it's not erect. Some people believe that this is necessary, otherwise the penis would eventually become not as flexible and would make surgery less effective. Basically pull your penis and stretch it as much as possible, and make it erect a few times each week at minimum.

If this is true, it's important to mention, because a lot of people assigned male at birth (trans women and non-binary) don't like touching or handling their penis. This is especially important while on HRT, which makes it less easy to get erect (it's common for trans women on HRT for even a few months, to stop getting spontaneous erections, where they go days or even a whole week or more without becoming erect).

We're not sure about this, it's just word of mouth. We need to research this, to confirm.

New Zealand {#nz}

Read this article. New Zealand has no surgeons at all at the moment, for MtF, FtM on non-binary surgeries. If you live in New Zealand, you will have to travel overseas and use a foreign surgeon. We're adding more surgeons to this page, as and when we find good ones.

You *can* get surgery done in Australia or Thailand. These countries are within easy travel distance to you. TODO: add information about surgery in Thailand and Australia. Thailand in particular has good services, some of the best in the world.

New Zealand needs surgeons for transgender surgeries! It is unacceptable that it does not have any qualified surgeons! If you are studying to be a surgeon, you should definitely consider studying this and becoming qualified. You will literally be saving lives.

Surgery for trans women {#mtf}

List of surgeries available:

  • Bottom surgery (vaginoplasty. Construction of a vagina. Also labiaplasty and clitoroplasty)
  • Facial reconstruction surgery
  • Adams apple removal/trimming (trachea shave)
  • Breast augmentation (don't do this until after a few years HRT when your breasts are fully grown)
  • orchiectomy (removal of testicles. Done during GRS or can be done before)
  • Voice feminization surgery
  • TODO: research other surgeries, if they exist.
  • TODO: medical/scientific names of each surgery

List of surgeons

Note for trans women: none of these surgeons perform penile inversion technique, for vaginoplasty. They use other, superior methods which result in better depth, sensation and, most importantly, ability to self-lubricate, without the need for external lubricant liquids. You also don't need genital hair removal, for the surgeries that these surgeons perform.

This is why we don't list any UK surgeons, or indeed most European surgeons, because we are not currently aware of any that use non-penile inversion techniques. See #penile-inversion for an explanation of why we are against the penile inversion technique.

TSSurgeryGuide.com

TSSurgeryGuide.com has their own lists of surgeons, including other advice like how to afford surgery, etc - they might recommend surgeons that perform penile inversion there, so do beware. Integrate info from that site, onto the Transit site

Brazil

Portugal

Thailand (Bangkok)

  • The Suporn Clinic - one of the best surgeons on earth, basically. Highly recommended for Male to Female vaginoplasty surgery. Also provides decent aftercare, for recovery after surgery. Also offers other surgeries.
  • Chettawut Plastic Surgery Center - also very good

Trachea shave (adams apple size reduction)

Cis women also have adams apples, but they're usually not as large. Some people AMAB who transition decide to have their trachea reduced in size. Not all people need this.

TODO: add more information about this, including information about surgeons.

Orchiectomy

The testicles are what product testosterone. People who are AMAB might take antiandrogens before GRS. It's possible to have the testicles removed, even before GRS. It's advisable to use a surgeon who will remove the testicles themselves but leave the scrotum skin intact so that it can be used for surgery.

With testicles removed, someone who is AMAB will stop taking antiandrogens, since their body is no longer naturally producing high levels of testosterone.

This type of surgery should be available at most hospitals, but do do your research before having it done. TODO: add information about surgeons here.

You need to maintain a minimal level of estradiol after orchi, to prevent oesteoporosis. Make sure to take estradiol (as HRT) but without an antiandrogen (avoid spiro, cypro, GnRH, etc) after having an orchi. Estradiol (as HRT) is also required for preventing menopause symptoms.

Voice feminization surgery

The larynx (voice box) increases in size during male puberty and vibrates at a much lower pitch (when your voice breaks during puberty). Voice feminization surgery aims to increase natural voice pitch by reversing some of this. Voice training is still required, even with voice surgery, and voice surgery is optional. You can still get to a high female pitch in every day conversations, without surgery. Some people get surgery anyway, and it can benefit some people.

Stories of trans women who have had bottom surgery

https://laurakbuzz.com/2017/04/12/transition-vagina-ownership-and-post-lower-surgery-life/

Surgery for trans men {#ftm}

List of surgeries available:

  • Top surgery (remove breasts)
  • Bottom surgery (construction of a penis)
  • TODO: research other surgeries, if they exist.
  • TODO: medical/scientific names of each surgery

Surgeons

For construction of a penis.

TODO: add info about top surgeons, for removing breasts

Surgery for non-binary trans people {#nonbinary}

TODO: research

Some people have gender nullification surgery to make their genitals genderless.