Sex change surgery aka genital reconstruction is a medical procedure that converts genital organs from one gender to another. There are many reasons behind a person's decision to undergo a sex change operation. So, what is the procedure like?
Why does someone want to change sex?
There are two main reasons why most doctors give the go-ahead for patients undergoing sex change surgery. First, for newborns diagnosed as having an penis and vagina, aka intersexual. Double sex is a condition of birth defects that can affect growth in the future, so a double-sex baby should be given as soon as possible, one of the sexes.
However, a statement issued by the United Nations in 2013 on the Special Rapporteur on Torture stated that the implementation of sex change operations without the owner's consent is illegal . So for babies born with two different genitalia, genital surgery must and can only be done after he is 18 years old. At that age, children already have the freedom and responsibility to be able to choose their own sex according to their beliefs.
Sex change surgery can also be done as part of therapy for gender dysphoria which is commonly experienced by transgender people. This operation aims to change the physical appearance and function of sexual characteristics in a person's body to adjust the anatomical characteristics of the body like the gender they believe in.
What are the stages of starting a sex change operation?
Reported from The Washington Post, the first step before carrying out a sex change operation is usually a consultation session with a professional mental health counselor to carry out a diagnosis and psychotherapy. A diagnosis of a gender identity disorder or gender dysphoria and an official letter of recommendation from the therapist concerned allows the individual to start hormone therapy under the supervision of a doctor.
Androgen hormones are given to transgender men (from women to men) to help them develop male secondary sex characteristics, such as beards and body hair, as well as heavier sounds. Conversely, estrogen and anti-androgen hormones are given to transgender women (from male to female) to help them change the sound of muscle mass, skin, distribution of body fat, and widening the hips. A number of these things will make their physical appearance more feminine. The typical men's body hair will also disappear.
Hormone therapy will then be followed by a test of adjusting the patient's life for activities as usual in the real world, not with the 'old' gender but as someone with the gender he believes in, for about one year - going to school , work, monthly shopping, and change their first name. This is done to prove to the surgeon that other people around him, besides the therapist, admit that he has managed to live life as a 'new' person.
After that, the doctor will carry out a number of procedures to change the genitalia and other body parts.
What is the sex change operation procedure?
From male to female
Sex-to-female sex change surgery involves the procedure of removing the penis and testicles, and cutting the urethra shorter. Some of the rest of the skin will be used to graft the supporting tissues of the vagina and form a functional intact vagina. A "neoclitoris" that allows transgender women to feel the sensation of orgasm can be made from the penis. Transgender women will maintain their prostate.
After the procedure is over, the patient will continue to use hormones to reshape the body's contours and stimulate breast growth or breast enlargement. Plastic surgery to 'beautify' the face, such as changing the shape of the eyes, cheekbones, nose, eyebrows, chin, hair, and removing Adam's apple can also be done.
From woman to man
In female to male sex change operations are divided into three stages. First, a subcutaneous mastectomy will be performed. Then, the uterus and ovaries will be removed, in two separate procedures. The last procedure involves genital transformation, scrotoplasty, and the making of the penis using tissue from the clitoris or vulva or other body tissue that allows sexual sensation.
Women who want to change their identity to men may also undergo removal of the vagina as well as lengthening the urethra (vaginectomy) to allow it to urinate standing. Prolongation of the urethra is the most difficult procedure of the whole process. After one year, the penis (erection) and artificial testes can be grafted when sexual sensations have returned to the tip of the penis.
In addition to the sex-making procedure, plastic surgery will be performed to make the chest look more masculine - no longer look like a breast.
Even so, the success rate of female-male sex change surgery is low. The reason is, the procedure for making a new penis that works optimally is fairly difficult when it is only built from a much less clitoral tissue.
Are there any risks and side effects from a sex change operation?
Like other medical procedures, sex change surgery carries the risk of infection, bleeding, and possibly other medical examinations to repair damage. Sex change surgery is permanent and cannot be changed again. Then you must be absolutely sure before you undergo this operation. Even so, many people are satisfied with the results they have gotten.
The most common complication of male to female sex change surgery is a narrowing of the new vaginal pathway. However, this can be treated with dilation (widening) or using part of the large intestinal tissue to make the vagina. Meanwhile, complications from a female to male procedure are penile dysfunction. Artificial penis grafts are a difficult procedure and will not produce a uniform appearance.
Sex change surgery is vulnerable to causing psychological and social problems
Noteworthy, regardless of physical complications, sex change surgery can also affect the new quality of life of the person. Transgender people who have new identities often lose partners, family, friends, and even work. They may even find it difficult if they are required to move and start a new life.
A 2011 journal published by PLOS ONE about a follow-up study of 324 Swedish people who had undergone sex change surgery showed that they had a higher risk of mortality, suicidal behavior, and psychiatric disorders than the general population.
The conclusion of the study outlines that although sex change surgery can overcome symptoms of gender dysphoria, but this may not be effective enough as a whole therapy. That is why a therapy session with a psychologist must be carried out before and after undergoing this procedure to overcome the possibility of gender dysphoria recurrence, even after changing identity.