Sex-reimbursement surgery for male-to-male transgender women includes various surgical procedures that alter the features of female anatomy to provide physical features more suited to the identity and function of male trans men.
Many trans men consider the choice of not opting for genital change surgery; More frequent surgical options include bilateral mastectomy (breast removal) and chest contour (giving a more male-specific chest shape), and hysterectomy (removal of internal sex organs).
Surgical genital surgery is usually preceded by initiating hormone therapy with testosterone.
Video Sex reassignment surgery (female-to-male)
Mastectomi
Many trans men look for bilateral mastectomy, also called "peak surgery", breast removal and chest forming contoured men.
Trans men with moderate to large breasts usually require a formal bilateral mastectomy by grafting and nipple-areola reconstruction. This will produce two horizontal scars on the lower edge of the pectoralis muscle, but it is possible to change the size of the nipple and its placement more easily in the male position.
By some doctors, surgery is done in two steps, first the contents of the breast are removed through cuts in the areola or surrounding areas, and then let the skin be pulled back for about a year, in which in the second operation the excess skin is removed. This technique produces far fewer scars, and the nipples are not necessarily removed and grafted. Completely removing and grafting often results in a loss of sensation from the area that may take months to more than a year to return, or may never return at all; and in rare cases in the loss of this network. In this rare case, the nipple may be reconstructed due to surgical candidates whose nipples are removed as part of treatment for breast cancer.
For trans men with smaller breasts, a peri-areolar or "keyhole" procedure can be performed in which a mastectomy is performed through an incision made around the areola. This avoids a scar larger than a traditional mastectomy, but the nipple may be larger and may not be in perfect male orientation on the chest wall. In addition, there is less denervation (nerve damage that supplies the skin) from the chest wall with a peri-areolar mastectomy, and less time required for the sensation to return. See Male Chest Reconstruction.
Maps Sex reassignment surgery (female-to-male)
Hysterectomy and bilateral salpingo-oophorectomy
Hysterectomy is the removal of the uterus. Bilateral salpingo-oophorectomy (BSO) is the removal of both ovaries and fallopian tubes. Hysterectomy without BSO in women is sometimes mistakenly referred to as 'partial hysterectomy' and is performed to treat uterine disease while maintaining the female hormone environment until natural menopause occurs. 'Partial hysterectomy' is actually when the uterus is removed, but the cervix is ââleft intact. If the cervix is ââremoved, it is called 'total hysterectomy.'
Some trans men want to have a hysterectomy/BSO because of the discomfort with having internal female reproductive organs despite the fact that menstruation usually stops with hormonal therapy. Some people go through this as their only gender identity that justifies 'under operation'.
However, for many trans men, hysterectomy/BSO is performed to reduce the risk of developing cervical, endometrial, and ovarian cancers. (Though breast cancer-like, the risk does not become zero, but drastically decreases.) It is not known whether the risk of ovarian cancer increases, decreases, or does not change in transgender men. The risk may never be known because the transgender male population as a whole is very small; even in the transgender male population in hormone therapy, many patients had significantly reduced risk due to previous oophorectomy (removal of the ovaries). While overall endometrial and cervical cancer rates are higher than ovarian cancer, and this malignancy occurs in younger people, it is still highly unlikely that this question will be answered with certainty.
However, reducing the risk of cancer is very important because trans men often feel uncomfortable seeking gynecological treatments, and many do not have access to adequate care and are culturally sensitive. Although ideally, even after hysterectomy/BSO, trans men should visit obstetricians for examination at least every three years. This is especially true for trans men who:
- maintain their vagina (either before or after further genital reconstruction,)
- have a strong family history or breast, ovarian, or uterine cancer (endometrium,)
- have a personal history of gynecologic cancer or significant dysplasia in the Pap smear.
One important consideration is that any trans men who experience vaginal bleeding after successfully stopping menstruation on testosterone should be evaluated by a gynecologist. This is equivalent to postmenopausal bleeding in a woman and can mark the development of gynecological cancer.
Genital redirection
The genital reconstruction procedure (GRT) uses a clitoris, enlarged by androgenic hormone (metoidioplasty), or depends on free tissue grafts of the arms, thighs or stomach and prosthetic erections (phalloplasty). In both cases, the urethra can be diverted through the phallus to allow urination through a newly constructed penis. The labia majora are united to form the scrotum, where prosthetic testes can be inserted.
See also
- Scrotoplasty
- List of transgender related topics
- Genital (male-to-female) surgery
Notes and references
Source
- Factors Affecting Individual Decisions When Considering Women's Genital Reconstructive-For-Male Operations by Katherine Rachlin of International Journal of Transgenderism . Genital Female-Male Reconstructive Surgery. Factors, Benefits and Risks by Dr. Preecha Tiewtranon This article also discusses some common female-to-male GRT issues.
External links
- FemaletoMale.org FTM Bilateral Mastectomy, Key Holes, Phalloplasty, Metoidioplasty, and Hysterectomy Information
- FTM Surgery Info Patient education and support forum for trans men, list of surgeons performing FTM surgery.
- The Top Furgures Guide TopSurgery.net FTM includes information on procedures, tips, and surgeons.
- Hysterectomy
- Hysterectomy and Related Risks
- Everything you want to know about... Total Abdominal Hysterectomy with Bilateral Salpingo Oophorectomy
Source of the article : Wikipedia