By Juniper
Gender reassignment, known casually as a sex change, is any procedure performed to give a patient sexual characteristics that differ from those of the patient's biological sex. The vast majority of sex reassignment surgical procedures are sought by male-to-female transgender individuals, but an increasing number of female-to-male transsexuals, sometimes called transsexual men, are seeking gender reassignment.
Transitioning from a biologically female state to a male identity can be a very complicated or very simple procedure. Depending on the preferences of the individual patient, it can involve simply cross dressing to appear as the opposite sex or include hormone replacement, chest reconstruction and, in the most extreme cases, a full genital sex change.
Hormone Replacement Therapy for Female-to-Male Transsexuals
In general, transitioning from a biologically female state to a male appearance involves the use of extensive hormone therapy. This procedure, which must be performed with the careful supervision of a physician, is similar to traditional male hormone replacement therapy (HRT) and is one of the biggest steps that can be taken to transition to a male appearance that matches the patient's gender identity.
Hormone replacement therapy for transsexual men generally involves shots, patches, pills or skin implants. These treatments, which vary widely in their cost, generally increase the amount of testosterone in the body. Other forms of female-to-male HRT do not use testosterone, instead relying on steroid-like compounds or "ando pro-hormones," which encourage the patient's body to produce its own testosterone.
This process produces a male-like appearance, often leading to the growth of more facial and body hair and increased muscle mass. In general, it also causes menstruation to stop within five months and the clitoris to enlarge. This transition is usually the first, and sometimes the only, step taken when undergoing a female-to-male sex change.
Hormone replacement therapy for transsexual men has some drawbacks, including the tendency to aggravate cardiovascular disease and cause psychological disruptions. Many transsexual men undergoing HRT report mood swings and aggressive outbursts. Unless a hysterectomy is also performed, many are also at risk of developing endometrial, ovarian or uterine cancers.
Chest Reconstruction for Female-to-Male Transsexuals
Because genital surgery is often prohibitively expensive, complicated or unsuccessful, many transsexual men opt to have "top" surgery only, which usually involves the removal and reshaping of the breasts. Cosmetic breast surgery performed on female-to-male transsexuals usually involves a full mastectomy. Although care is taken to prevent scarring, many transsexual men experience scarring on both sides of the chest.
During chest reconstruction surgery, fatty tissue is removed from a single incision on each breast. The areola (the dark part of the breast) is then shrunk and placed as a graft on a different part of the chest, where it is dressed carefully with sterile bandages. Usually, the surgery is not particularly painful and daily activities can be resumed within a week.
In general, chest reconstruction surgery is the easiest and most successful part of a female-to-male sex change. The chests of transsexual men are usually almost identical to the chests of biological men, with the only key difference being mild scarring on each side of the chest. The majority of transsexual men are very satisfied with the results of this surgery.
Genital Modification for Female-to-Male Transsexuals
The most complicated step in a female-to-male sex change, genital modification, can occur in a variety of forms, with varying degrees of complexity and complication. The simplest form of female-to-male sex change surgery includes the removal of the vaginal canal (by sewing it shut), which is a procedure that usually takes place only if the patient has already had a full hysterectomy. Hysterectomies that involve the removal of the uterus and ovaries are also often performed to eliminate female hormones.
Phalloplasty, or a penis construction, is also a common procedure for female-to-male sex reassignment. With all forms of phalloplasty, the labia are joined together to form the appearance of a scrotum. Implants, which are designed to look and feel like testicles, are sometimes placed inside this new scrotum. A new penis is then constructed using a variety of different methods.
Another method known as metoidioplasty creates a new penis from the clitoris. Tissue from the labia or another part of the body can then be used to make it slightly larger. This usually results in a small penis when compared to the penis of a biological man.
Another popular genital modification used to create a penis involves the insertion of a tissue graft from the leg, arm or abdomen. This can incorporate unneeded muscles or even small bones, from other parts of the body, to create a relatively large phallus. This surgery is quite complicated in some cases but can create a penis up to seven inches in length of surprisingly normal appearance.
Phalloplasties can also involve the additional use of an erectile implant to enable erection and sexual penetration. These implants can be simple, rod-like prosthetics or very complex pumping mechanisms. The urethra can also be directed, often in a separate surgery, to flow into the new penis. While this adds complexity to the procedure, it is an important aspect of a sex change for many transsexual men.
Other surgical alterations undergone by transsexual men include facial implants, pectoral-muscle chest implants and body contouring with liposuction. These procedures, often far more simple than the others involved in the transition, can contribute to the patient's male appearance.
Depending on the patient's own circumstances, a female-to-male transsexual might choose to undergo most, many, a few or none of the procedures described. While some transsexual men are content and satisfied without any surgical or hormonal alteration, others may be willing to undergo the risks associated with gender reassignment treatments in order to confirm and experience the physical sensations of male biology.
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