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What Is Gender Reassignment Surgery?

Reviewed by Dan Brennan, MD on April 08, 2021

Surgery to change the appearance of your body is a common choice for all kinds of people. There are many reasons that people might want to alter their appearance. For transgender or gender non-conforming people, making changes to their bodies is a way of affirming their identity. 

A trans person can choose from multiple procedures to make their appearance match their gender identity. These are often called gender "reassignment" procedures by the general public. However, trans persons and their doctors typically refer to them as gender confirmation surgeries.

Trans people might decide to have surgery on their chest, genitals, or face. These surgeries are personal decisions, and each person makes their own choices about what is right for them.

Learn more about gender reassignment surgery and how it helps trans people. 

What Does It Mean to Be Transgender?

Transgender is a word to describe people whose gender identity or gender expression doesn't match the sex they were assigned at birth. Typically, parents and doctors assume a baby's gender based on the appearance of their genitals. However, some people grow up and realize that their sense of who they are isn't aligned with how their bodies look. These people are considered transgender. 

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Trans people may identify as the opposite gender of what they were assigned at birth. For example, a child assigned male at birth may identify as female. Other people don't identify as either male or female. They may refer to themselves as "non-binary" or "genderqueer". 

There are many options for trans people to change their appearance so that how they look reflects who they are inside. Many trans people use clothing, hairstyles, or make-up to present a particular look. Some use hormone therapy to refine their secondary sex characteristics. Some people choose surgery that can change their bodies and faces permanently.

Facial Surgery

Facial plastic surgery is popular and accessible for all kinds of people in the United States. Nearly everyone knows someone who has had a nose job or a facelift. Cosmetic surgery is great for improving self-esteem and making people feel more like themselves. Trans people can use plastic surgery to adjust the shape of their faces to better reflect their gender identity. 

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Facial feminization. A person with a masculine face can have surgeries to make their face and neck look more feminine. These can be done in one procedure or through multiple operations. They might ask for:

  • Forehead contouring 
  • Jaw reduction 
  • Chin surgery 
  • Hairline advancement 
  • Cheek augmentation
  • Rhinoplasty
  • Lip augmentation 
  • Adam's apple reduction

Facial masculinization: Someone with a feminine face can have surgery to make their face look more masculine. The doctor may do all the procedures at one time or plan multiple surgeries. Doctors usually offer:

  • Forehead lengthening 
  • Jaw reshaping 
  • Chin contouring 
  • Cheek augmentation 
  • Rhinoplasty 
  • Adam's apple enhancement

Top Surgery

Breast surgeries are very common in America. The shorthand for breast surgeries is "top surgery." All kinds of people have operations on their breasts, and there are a lot of doctors who can do them. The surgeries that trans people have to change their chests are very similar to typical breast enhancement or breast removal operations.

Transfeminine. When a trans person wants a more feminine bustline, that's called transfeminine top surgery. It involves placing breast implants in a person's chest. It's the same operation that a doctor might do to enlarge someone's breasts or for breast reconstruction. 

Transmasculine. Transmasculine top surgery is when a person wants a more masculine chest shape. It is similar to a mastectomy. The doctor removes the breast tissue to flatten the whole chest. The doctor can also contour the skin and reposition the nipples to look like a typical man's chest.

Bottom Surgery

For people who want to change their genitals, some operations can do that. That is sometimes called bottom surgery. Those are complicated procedures that require doctors with a lot of experience with trans surgeries. 

Transmasculine bottom surgery. Some transmasculine people want to remove their uterus and ovaries. They can choose to have a hysterectomy to do that. This reduces the level of female hormones in their bodies and stops their menstrual cycles.

If a person wants to change their external genitals, they can ask for surgery to alter the vaginal opening. A surgeon can also construct a penis for them. There are several techniques for doing this.

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Metoidioplasty uses the clitoris and surrounding skin to create a phallus that can become erect and pass urine. A phalloplasty requires grafting skin from another part of the body into the genital region to create a phallus. People can also have surgery to make a scrotum with implants that mimic testicles.

Transfeminine bottom surgery. People who want to reduce the level of male hormones in their bodies may choose to have their testicles removed. This is called an orchiectomy and can be done as an outpatient operation. 

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Vaginoplasty is the operation to construct a vagina. Doctors use the tissue from the penis and invert it into a person's pelvic area. The follow-up after a vaginoplasty involves using dilators to prevent the new vaginal opening from closing back up. 

Not all trans people choose to have gender reassignment surgery, or they may only have some of the procedures available. If you are considering trans surgery, speak with your primary doctor to discuss what operations might be best for you. 

WebMD Medical Reference

Sources

SOURCES: 

AMERICAN PSYCHOLOGICAL ASSOCIATION: "What does transgender mean?"

AMERICAN SOCIETY OF PLASTIC SURGEONS: "What are the steps of facial feminization surgery,"  "What are the steps of facial masculinization surgery," "What are the steps of transfeminine top surgery,"  "What are the steps of transmasculine top surgery?"

Journal of sexual medicine: "Gender Confirmation Surgery: Guiding Principles."

Mount Sinai: "Trans-feminine (Male to Female) Surgeries," "Trans-masculine (Female to Male) Surgeries."

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