Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and, as far as possible, the function of female genitalia. Before any surgery, patients usually undergo hormone replacement therapy HRTand, depending on the age at which HRT begins, facial hair removal.
There are associated surgeries patients may elect to, including facial feminization surgerybreast augmentationand various other procedures. Lili Elbe was the first known recipient of male-to-female sex reassignment surgery, in Germany in She was the subject of four surgeries: However, she died three months after her last operation.
She was a strong advocate for the rights of transgender people. She transitioned and had surgery in the mids, and successfully fought to have transgender people recognized in their new sex. Inthe United States Defense Health Agency for the first time approved payment for sex reassignment surgery for an active-duty U.
The patient, an infantry soldier who identifies as a woman, had already begun a course of treatment for gender reassignment.
The procedure, which the treating doctor deemed medically necessary, was performed on November 14 at a private hospital, since U. When changing anatomical sex from male to female, the testicles are removed, and the skin of foreskin and penis is usually inverted, as a flap preserving blood and nerve supplies a pioneered by Sir Harold Gillies into form a fully sensitive vagina vaginoplasty. A clitoris fully supplied with nerve endings innervated can be formed from part of the glans of the penis.
If the patient has been circumcised removal of the foreskinor if the surgeon's technique uses more skin in the formation of the labia minorathe pubic hair follicles are removed from some of the scrotal tissue, which is then incorporated by the surgeon within the vagina. Other scrotal tissue forms the labia majora. In extreme cases of shortage of skin, or when a vaginoplasty has failed, a vaginal lining can be created from skin grafts from the thighs or hips, or a section of colon may be grafted in colovaginoplasty.
Surgeon's requirements, procedures, and recommendations vary enormously in the days before and after, and the months following, these procedures. Plastic surgery
Male to female post operative transsexuals it involves skin, is never an exact procedure, and cosmetic refining to the outer vulva is sometimes required. Some surgeons prefer to do most of the crafting of the outer vulva as a second surgery, when other tissues, blood and nerve supplies have recovered from the first surgery.
This relatively minor surgery, which is performed only under local anaesthetic, is called labiaplasty. The aesthetic, sensational, and functional results of vaginoplasty vary greatly.
Surgeons vary considerably in their techniques and skills, patients' skin varies in elasticity and healing ability which is affected by age, nutrition, physical activity and smokingany previous surgery in the area can impact results, and surgery can be complicated by problems such as infections, blood loss, or nerve damage.
Supporters of colovaginoplasty state that this method is better than use of skin grafts for the reason that colon is already mucosal, whereas skin is not.
Lubrication is needed when having sex and occasional douching is advised so that bacteria do not start to grow and give off odors. Because of the risk of vaginal stenosis the narrowing or loss of flexibility of the vagina  any current technique of vaginoplasty requires some long-term maintenance of volume vaginal dilationby the patient, using medical graduated dilators to keep the vagina open.
Daily dilation of the vagina for six months in order to prevent stenosis is recommended among health professionals. Regular application of estrogen into the vagina [ citation needed ]for which there are several standard products, may help, but this must be calculated into total estrogen dose. Some surgeons Male to female post operative transsexuals techniques to ensure continued depth, but extended periods without dilation will still often result in reduced diameter vaginal stenosis to some degree, which would require stretching again, either gradually, or, in extreme cases, under anaesthetic.
With current procedures, trans women do not have ovaries or uteri. This means that they are unable to bear children or menstruate until a uterus transplant is performed, and that they will need to remain on hormone therapy after their surgery to maintain female hormonal status. Occasionally these basic procedures are complemented further with feminizing cosmetic surgeries or procedures that modify bone or cartilage structures, typically in the jaw, brow, forehead, nose and cheek areas.
These are known as facial feminization surgery or FFS. Breast augmentation is the enlargement of the breasts. Some trans women choose to undergo this procedure if hormone Male to female post operative transsexuals does not yield satisfactory results. Usually, typical growth for trans women is one to two cup sizes below closely related females such as the mother or sisters.
Progesterone also rounds out the breast to an adult Tanner stage -5 shape and matures and darkens the areola. Some MTF individuals may elect to have voice surgery, altering the range or pitch of the person's vocal cords.
However, this procedure carries the risk of impairing a trans woman's voice forever, as happened to transgender economist and author Deirdre McCloskey. Because estrogens by themselves are not able to alter a person's voice range or pitch, some people proceed to seek treatment.
Other options are available to people wishing to speak in a less Male to female post operative transsexuals tone. Voice feminization lessons are available to train trans women to practice feminization of their speech.
A tracheal shave procedure is also sometimes used to reduce the cartilage in the area of the throat and minimize the appearance of the Adam's applein order to conform to more feminine dimensions. Because anatomically masculine hips and buttocks are generally smaller than those that are anatomically feminine, some MTF individuals will choose to undergo buttock augmentation.
If, however, efficient hormone therapy is conducted before the Male to female post operative transsexuals is past puberty, the pelvis will broaden slightly, and even if the patient is past their teen years, a layer of subcutaneous fat will be distributed over the body rounding contours.
Trans women usually end up with a waist to hip ratio of around 0. From Wikipedia, the free encyclopedia. Part of a series on Transgender topics Gender identities. Health care and medicine. This article needs additional citations for verification.
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January Learn how and when to remove this template message. Archived from the original on Retrieved January 8, Retrieved February 29, Van Trostenburg stresses the need to maintain dilation and hygiene for the newly created vagina and tissues left vulnerable to Male to female post operative transsexuals that may result from surgery.
He further notes that transgender women and their male sexual partners have to be advised about vaginal intercourse, since the newly created vagina is physiologically different than a biological vagina. Vaginoplasty surgery increases the size of the vagina, though not without surgical complications, and often requires repeated dilation of the vaginal opening so that it remains open.
Trans Bodies, Trans Selves: A Resource for the Transgender Community. The surgeon will also provide a set of vaginal dilators, used to maintain, lengthen, and stretch the size of the vagina.
Dilators of increasing size are regularly inserted into the vagina at time intervals according to the surgeon's instructions.
Dilation is required less often over time, but it may be recommended indefinitely. Gender dysphoria In children Health care Pregnancy Sex reassignment therapy surgery to female male.
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