Feminizing surgery

Feminizing surgery, also called gender-affirming surgery, involves procedures that help better align the body with a person's gender identity. Research has found that gender-affirming surgery can have a positive impact on well-being and sexual function. Feminizing surgery includes several options, such as top surgery to increase the size of the breasts. That procedure also is called breast augmentation. Bottom surgery can involve removal of the testicles, or removal of the testicles and penis and the creation of a vagina, labia and clitoris. Facial procedures or body-contouring procedures can be used as well.

Many people seek feminizing surgery as a step in the process of treating discomfort or distress because their gender identity differs from their sex assigned at birth. This is called gender dysphoria. For some people, having feminizing surgery feels like a natural step. It's important to their sense of self. Others choose not to have surgery. All people relate to their bodies differently and should make individual choices that best suit their needs. Feminizing surgery may include: Removal of the testicles alone. This is called orchiectomy. Vaginoplasty. This is a procedure that may include: Removal of the penis, called penectomy. Removal of the testicles. Creation of a vagina, called vaginoplasty. Creation of a clitoris, called clitoroplasty. Creation of labia, called labioplasty. Breast surgery. Surgery to increase breast size is called top surgery or breast augmentation. It can be done through implants, the placement of tissue expanders under breast tissue, or the transplantation of fat from other parts of the body into the breast. Plastic surgery on the face. This is called facial feminization surgery. It involves plastic surgery techniques in which the jaw, chin, cheeks, forehead, nose, and areas surrounding the eyes, ears or lips are changed to create a more feminine appearance. Body-contouring. These procedures may include: Tummy tuck, called abdominoplasty. Buttock lift, called gluteal augmentation. Liposuction, a surgical procedure that uses a suction technique to remove fat from specific areas of the body. Voice feminizing therapy and surgery. These are techniques used to raise voice pitch. Tracheal shave. This surgery reduces the thyroid cartilage, also called the Adam's apple. Scalp hair transplant. This procedure removes hair follicles from the back and side of the head and transplants them to balding areas. Hair removal. A laser can be used to remove unwanted hair. Another option is electrolysis. It involves inserting a tiny needle into each hair follicle. The needle emits a pulse of electric current that damages and eventually destroys the follicle.

Like any other type of major surgery, many types of feminizing surgery pose a risk of bleeding, infection and a reaction to anesthetic. Depending on the procedures, other health concerns that might happen due to feminizing surgery include: Delayed wound healing. Fluid buildup beneath the skin, called seroma. Bruising, also called hematoma. Changes in skin sensation such as pain that doesn't go away, tingling, reduced sensation or numbness. Damaged or dead body tissue — a condition known as tissue necrosis — such as in the surgically created vagina or labia. A blood clot in a deep vein, called deep vein thrombosis, or a blood clot in the lung, called pulmonary embolism. Development of an irregular connection between two body parts, called a fistula, such as between the bladder or bowel into the vagina. Urinary problems, such as incontinence. Pelvic floor problems. Permanent scarring. Loss of sexual pleasure or function. Worsening of a behavioral health problem.

Before surgery, you meet with your surgeon. Work with a surgeon who is board certified and experienced in the procedures you want. Your surgeon talks with you about your options and the potential results. The surgeon also may provide information on details such as the type of anesthesia that will be used during surgery and the kind of follow-up care that you may need. Follow your healthcare team's directions on preparing for your procedures. This may include guidelines on eating and drinking. You may need to make changes in the medicine you take. Before surgery, you also may need to stop using nicotine, including vaping, smoking and chewing tobacco.