Sex Reassignment Surgery is performed to transition individuals with gender dysphoria to their desired gender. The primary surgical option, Genital Reassignment Surgery, involves reshaping the penis and scrotum to form the appearance of, and, as far as possible, the function of a vulva.

It is important to note that Sex Reassignment Surgery (also known as: Gender Confirmation Surgery, Sex Confirmation Surgery, Gender Reassignment Surgery, Gender Realignment Surgery, Sex Realignment Surgery) is the umbrella term for a number of procedures that transform the anatomical sex of an individual.

This term can also include:

  • Tracheal Shave: surgical procedure to reduce cartilage in the throat to make the appearance more feminine (also known as Adam’s Apple Removal)
  • Breast Augmentation: a set of surgical procedures using implants and/or fat grafting to create female breasts, optimizing for size, shape, and texture
  • Buttock Augmentation: a set of surgical procedures using implants and/or fat grafting to alter the size, shape, and texture of the buttocks
  • Facial Feminization Surgery (FFS): is a set of surgical procedures that, in conjunction with hormone therapy, change the masculine features of a male face to be more feminine.
  • Body Sculpting: a set of surgical procedures that aim to enhance the appearance of the body, which includes evening fatty tissue deposits, reducing localized excess, and providing the desired feminization of the body
  • Hair Grafting: surgical procedure to augment female-pattern body hair developed with hormone therapy
quick details
  • People with gender dysphoria, looking to surgically transition to their identified gender
  • People who have begun their medical transition, at a minimum through hormone therapy, or combined with other Sex Reassignment Surgery procedures
  • People who have been living in their assigned gender role for a minimum of 12 months
  • As a surgical procedure, Genital Reassignment Surgery has very high rates of success when it is performed by responsible and experienced surgeons. However, as a procedure where body dysmorphia is involved, there is a risk of regret or dissatisfaction. It is highly recommended patients seek post-operative support from a trusted professional and/or personal network to minimise this risk.
  • Short term: 3-7 days in the hospital.
  • Mid-term: 7-10 days after surgery the sutures are removed.
  • Long term: 5-8 weeks before resuming physical activity/returning to work
  • Generally, 5-6 hours, depending on complexity.
  • Typical surgery risk of infection, bleeding, pain, and scarring
  • General anesthetic associated risk
  • Fistula (opening between the rectum and vagina)
  • Decreased sexual sensation, or ability to have orgasm
  • Partial or total death of the tissue used to create the new vagina, labia, or clitoris
  • Narrowing or closure of the new vagina or urethra
  • Prolapse
  • Hair growth in the vagina
  • Unsatisfactory size or shape of the new vagina, clitoris, or labia


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  • Thailand

  • Mexico


How can I access Sex Reassignment Surgery?

Before pursuing Genital Reassignment Surgery, it is recommended that you reflect on whether the procedure is right for you, and the right time to pursue it.

The World Professional Association for Transgender Health (WPATH) (WPATH) suggests the following prerequisites:

  • You have been diagnosed with gender dysphoria
  • Surgery has been recommended by 2 mental health specialists trained in gender identity issues, preferably who have known the patient for more than a year
  • Hormone treatment for at least one year.
  • Living as your gender identity for a minimum of one year.
  • Emotionally stable
  • Medically healthy with any medical conditions being treated and under control.

Your physical and mental wellbeing prior to surgery are vital to preparing for the changes that you will go through in the lead up to and recovery from surgery.

Physical readiness means you have considered the following and consulted a health professional throughout the process:

  • Health condition: You should be healthy overall, but if you have any pre-existing conditions, they need to be discussed with your surgeon and healthcare provider to ensure they can be managed before and after surgery (for example diabetes, HIV can impact surgery, but not necessarily prevent you)
  • Pre-surgery physical requirements: You will need to have undergone hormone therapy for a minimum of 12 months prior to surgery, but will also need to taper off estrogen use in the lead up to surgery. It is also recommended to undergo electrolysis before vaginoplasty to avoid hair growth in future.
  • Post surgery requirements: Do you have a safe, supportive space to recover post surgery? This includes access to understanding healthcare professionals and a support network (friends, family, community and mental health professionals) who can help you through the process.

Mental wellbeing means you have the following:

  • A solid sense of your gender identity: This is not a procedure for people who have just started to explore issues around gender identity. Medical professionals recommend you have lived as your chosen gender identity for a minimum of a year.
  • Understanding of the mental journey ahead: While it is common to feel liberated after Genital Reassignment Surgery, this is not always an immediate feeling. It is important to consider your readiness for the emotional ups and downs after surgery. It can be difficult to adjust to changes to how your body looks and feels, to cope with pain or other physical complications, or other people’s reactions. While the negative emotions are not guaranteed, if you don’t feel you have the emotional resilience to deal with these possibilities, now might not the right time to pursue this procedure.

If you are sure that this is the option for you, but not right now, you don’t have to abandon Genital Reassignment Surgery altogether.

You can still work towards the procedure by considering what might help you get to the point where you are ready – counselling, medical treatment, peer support, etc. – and slowly but surely making life changes to move closer to readiness.

In fact, there are even clinics who specialise in Genital Reassignment Surgery who can also help you locate and access these resources.

The most important thing is ensuring you are pursuing surgery on the terms that are best for you and your journey.

What questions should I ask my doctor before surgery?

Each person’s reasons for Genital Reassignment Change are highly personal with varied ideal outcomes for each person.

Overall, it is important to understand the surgeon’s goals (based on best practice) and assess if and how they align with your own.

The surgeon will aim to:

  • Create a vagina that looks and functions as naturally possible. For example, shape, sensitivity, form for sexual penetration
  • Create a clitoris, labia, and opening to the vagina (introitus) that look realistic and maintain good touch sensation (i.e., you can feel it when they are touched)
  • Preserve the ability to have orgasms
  • Alter the structures of the urinary tract

If any of these goals are particularly important, or if you have other outcomes in mind it is best to thoroughly discuss this with your surgeon to ensure that by surgery day, you feel comfortable about your own realistic post-operative goals.

How does Sex Reassignment Surgery work?

Generally you will be admitted to hospital the day before your surgery, so that your doctors can assess your your overall health.

Due to the length of surgery time and the area operated on, you will also likely have a “bowel prep” to clean out your intestines. This helps to prevent problems during surgery and also reduces discomfort going to the bathroom after surgery.

You will be unable to eat or drink after midnight the night before you have surgery and will be shaved in preparation.

What procedures are involved in Sex Reassignment Surgery?

Genital Reassignment Surgery has three key parts:

  • Removal of the testicles (orchiectomy)
  • Removal of the penis (penectomy)
  • Creation of a vagina (vaginoplasty), labia (labiaplasty), and clitoris (clitoroplasty)

After the testicles are removed, the penile skin, glans, blood vessels, nerves and urethra are separated from the penile shaft, and the erectile tissue of the penis is removed as close to the body as possible.

The most common technique for creating a vagina is the penile inversion. The penis skin is turned inside out so that the outer skin becomes the inner lining of the vagina.

Penile skin or scrotal tissue is then also used to form the labia. In some cases, extra skin is required to make the vagina longer or wider; this is usually taken from the lower abdomen or the scrotal sac. A segment of your large intestine may be used to create the vagina if the penile inversion fails or is not possible.

As part of the penile inversion, a small section of the head of the penis – the part that is most sensitive – is used to create a new clitoris.

The blood supply and nerves of the glans or head of the penis are kept intact and it is transformed into a functional clitoris, and the urethra is shortened and positioned like it would be in a female.

Finally, incisions are then made to expose the new urethra and the clitoris in their correct positions.

How long will I stay in the hospital after Sex Reassignment Surgery?

After surgery, patients will generally stay in hospital for 3 to 7 days to minimise risk of infection and ensure your doctor can check your general health and healing process.

For example, you will be asked questions about your bowel and bladder function, and the surgical incisions will be checked for infection and scarring.

Most importantly - the body will treat the new vagina as a wound, so after the surgery, in order to maintain the width and depth of the new vagina, it must be kept dilated using medical graduated dilators.

Your surgeon and nurse will be able to monitor this process to ensure you feel confident managing this process on your own outside of their care.

Additionally, if you had a graft as a part of the procedure, you will have an incision on your abdomen, just above the pubic bone. Hospital staff will check this incision and change your dressings on a regular basis.

The stitches from your surgery will dissolve or be removed 7-10 days after surgery and you will be able to leave the hospital once your surgeon is confident that you are healing well.

How long will it take to fully recover from Sex Reassignment Surgery?

After you go home, it is important to have appointments scheduled with your trusted GP and mental health professionals to ensure you are supported in this stage of your recovery.

You can go back to your usual routine when you feel well enough to do so, which is typically 4–6 weeks but can also be longer in some cases.

Most importantly, for the first 8 weeks you will continue to wear a prosthesis inside your vagina most of the time, ensuring it doesn’t heal too narrow or shallow.

The amount of time the prosthesis is left out will gradually be increased as per your surgeon’s advice, but as a reference, you can consider the following timeline:

  • Week 1 – 3: 4 times a day
  • Week 4 – Week 6: 3 times a day
  • Week 7 – Week 9: 2 times a day
  • Week 10 – Week 12: 1 times a day
  • Week 13 forward: Dilation or intercourse at least once or twice a week for the rest of your life.

Qunomedical Health Managers have an all-round knowledge to find the right specialist for you. Learn more about Qunomedical.

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