TABLE OF CONTENTS:
- What is a sex change?
- Why is it performed?
- What does it consist of?
- Preparation for the surgery
- Care after the operation
What is a sex change?
It is an operation with a radical purpose: to convert the genitals of one sex to the opposite sex. If the sex change is from male to female, a vagineplasty is performed and if it is a sex change from female to male, the technique used is known as phalloplasty.
This is a complicated and delicate issue due to the number of implications it entails, both physically and psychologically.
The operation requires general anesthesia and its intervention time can exceed twelve hours. It is a non-return operation and the results are immediate.
Why is a sex change performed?
Sex reassignment surgery was created to provide a physical and psychological solution to those people who do not feel identified with the sex they were born with. It is a long procedure, which requires different operations and treatments such as hormonal.
This surgery is not indicated in patients with psychiatric or psychological disorders, nor in those with circulatory, systemic, urological or cardiovascular problems.
Weeks before the sex change is performed, the hormonal treatment is abandoned.
What does sex change surgery consist of?
It is necessary to make a distinction between the sex to be changed, that is to say, the procedure will not be the same from male to female as from female to male. However, in both cases the hormonal treatment will be abandoned weeks before the operation.
In the case of a sex change from male to female -vagineplasty- the surgeon will open the penis by separating the corpora cavernosa that compose it as well as the vasculonervous pedicle. The remaining skin is used to shape the vaginal walls and the glans is used to create the clitoris. On the other hand, the scrotum is used to shape the vaginal lips and deepen the vagina, which will be placed in a space between the bladder and the rectum. In turn, the urethra is trimmed and placed in front of the new vagina, placing a dressing so that the skin of the vagina does not move.
After this procedure, other complementary procedures will be performed, such as an augmentation mammoplasty with breast implants, a thyroplasty or a chondrolaryngoplasty to reduce the size of the male nut, a Wendler glottoplasty to feminize the voice…
In the case of a sex change from female to male, the technique used is known as phalloplasty, in which a penis is reconstructed using tissues from other parts of the body such as the skin, abdomen, thighs or arms. The new penis allows urinating standing up and is tactilely and erogenously sensitive, although in order to be able to have sexual intercourse a prosthesis will need to be implanted. Once the penis has been modeled with the chosen tissues, it is transported to its final position and veins and arteries are sutured and nerves from the clitoris are connected to those of the penis, while the clitoris itself will remain hidden inside the penis. The urethra will be extended with a skin graft from the inner wall of the vagina. On the other hand, the labia majora form the new scrotum, and once the scrotal pouch is obtained, silicone testicular implants are placed.
Preparation for sex change surgery
Before undergoing the sex change, it is necessary to have obtained the psychological certification of a psychiatrist that there is no transient psychological alteration that certifies that it is a real process of transsexuality.
At the same time, the patient must have followed a hormonal treatment directed by an endocrinologist for at least nine months.
Care after the operation
The patient must be immobilized for the first two days after the operation. However, the patient will be discharged seven to ten days after the operation and will have to wear a bladder catheter for 21 days.
At the surgeon’s discretion, a suprapubic catheter may also be placed to allow emptying of the bladder while keeping the urethra clean and dry for the first few days.