Many people face internal conflicts regarding their gender. Some continue living in the same manner, whereas many others choose to undergo gender reassignment surgery for a transition into their desired gender. Recent reports suggest that each year the number of surgeries for gender reassignment range from 100 to 500 in US alone, while the world figures are 2-5 times higher. So what is this surgery and what are the steps involved?
What Is Gender Reassignment Surgery?
Also known as sex reassignment surgery (SRS) or simply sex change, it involves physical and functional changes in the sexual nature of a transgender person from their existing sex to their new sex. In simple words, in this surgery the genitals of the transgender person are transformed to that of the opposite sex, which is usually the desired sex. It is also performed to treat gender dysphoria or gender identity disorder in transgender people. Besides, this surgery is also performed in many intersex people, especially in their infancy.
SRS is also known as feminizing genitoplasty or vaginoplasty when transgender women undergo the surgery. It is referred to masculinizing genitoplasty or phalloplasty when transgender men undergo the surgery. The people undergoing this surgery are usually called transsexuals, wherein; “trans” means a change or across; “sexual” refers to the sexual traits of a person. These people are also referred to as transgender.
After the surgery, these people are identified as transsexed and differ from the transsexuals. Transsexuals usually are those who have not undergone the surgery but whose physical and sexual traits do not match the gender with which they identify themselves.
What Happens During Gender Reassignment Surgery?
Usually male to female surgeries are more successful, easier and affordable to perform than female to male surgeries. The procedure involves the removal of testicles along with a major portion of the penis and shortening of urethra. Some of the skin is then used to create a large functioning vagina. Also, a neoclitoris which has sensations is created from the penis, but prostrates are kept intact.
In the female to male surgeries, the breasts, ovaries and the uterus are removed in two separate operations. Then a neophallus is constructed with the tissues from the forearms or any other body part that allows sexually stimulated sensations. Another major step involves the extension of the urethra to allow urination while standing.
Let Hormones Help
After the surgical procedures are completed, hormonal therapy is started to alter the secondary sexual characteristics of the person. The hormonal therapy is continued for a few years and helps the people tremendously.
Many women are given androgens to help them develop male secondary traits like breads and body hair. Males are given estrogen and anti-androgen hormones to change their physical musculature, fat distribution and skin. Their body hair also reduces by the hormone therapy, making them more feminine in appearance. What's more, hormonal therapy also helps these individuals get more aligned with their physical changes and cope with the feelings of dysphoria.
Medical Considerations of Gender Reassignment Surgery
Transgender individuals with HIV or Hepatitis C have a hard time finding surgeons who can operate on them. Also, these people are charged higher fees. People with diabetes, obesity or blood clotting issues wish to undergo the surgery are at an increased anesthetic risk and post-operative complications. Many surgeons request the overweight individuals to reduce weight and also require them to stop any hormonal therapy before surgery. They need to refrain from smoking before and post-surgery.
How to Cover the Surgery
Women who choose the complete range of surgical procedures to change to a male need to spend around $75, 000. Converting from a male to a female body needs about $40,000 to $50,000. It is big money, but you may secure insurance through one of the below means:
1. Employer-Provided Plans
Many of the private sector employers help the transgender individuals get all possible help for healthcare through their employer plans. Additionally, many of the state or federal transgender employees get covered by the group benefit plans for their transition-related health care.
2. Medicare/Medicaid
Many individuals benefit from Medicare for hormonal therapy, gender reassignment surgery and other medical care. Refer to National Center for Transgender Equality's for more details.
State and federal funded Medicaid program for low income groups provides transition related health care.
3. State Health Insurance Exchanges
Many states have covered transition related health care plans in their state's health insurance exchange policies. However they are individually purchased and are commercial plans that can vary according to each of the states.