Surgical Options There are several guidelines dictated by the Harry Benjamin Standards of Care regarding eligibility for surgery for transgender people. If you are considering surgery, it would be a good idea to read over these guidelines and speak to your therapist regarding their particular interpretation of these guidelines. The following information and links provide a brief overview of some of the surgical procedures used by some transgenderpeople in physically transitioning. This list does not cover all of thepossibilities, nor should it be considered official medical advice. Formore information, one should consult with a licensed doctor.
To have surgery or not to have surgery . . . Choosing whether or not to pursue various surgical procedures is a very personal thing. Not all transgender people desire to have surgery, and having surgery or not having surgery does not make a person more or less transgender. Surgery is also a very costly endeavor. Although constantly improving and advancing, results are not always entirely satisfactory for transgender people. Functionality, sensation, appearance, and good results are not guaranteed.
There are also health risks involved with whether or not to pursue surgery. It is important to be aware of all of these factors and to have several conversations with your doctor before going into surgery to get an idea of what to expect.
Undergoing Gender Reassignment Surgery allows people in most states to officially change their sex with driver’s licenses and birth certificates.
Covering the Cost of Surgery The biggest obstacle for many to overcome in pursuing GRS is covering the cost. A majority of health insurance companies consider transgender-related surgeries to be “elective” and thus refuse to cover the costs. However, some companies will cover particular procedures, especially if they can be deemed medically necessary (suchas a hysterectomy for FTMs due to an increased risk for ovarian cancer). Being aware of all this and your insurance company's policies, as well as finding a doctor willing to work withyour insurance situation, you can save on the cost of surgery.
Some people choose to travel to other countries where surgery is significantly cheaper and there are different guidelines regulating who can have surgery and who cannot. The best ways to investigate these options are through searching online and speaking with other transgender people who have had surgery abroad.
Transsexual Veterans
The VA has performed GRS procedures in certain areas of the country, however, there is no national policy on the treatment of transegendered patients from the VA. Talk to your local VA healthcare provider, as well as other TG vets in your area.
MTF:
Breast Implants –Breast growth for MTFs on hormones rarely exceeds a B cup. Once aperson’s breasts reach their full size (after about two years of hormones), some transwomen choose to increase their size with breast implants.
Dr. Daniel A. Medalie: Dr.Daniel A. Medalie, University Plastic Surgery in Cleveland, OH. Photos of results and descriptions of his procedures are listed on hiswebsite. Medalie does chest reconstruction surgery for FTM patients and breast implants for MTF patients.
Vaginoplasty – A Vaginoplasty involves inverting the penis to create a vagina. Transsexual Sex Reassignment Surgery (Male to Female): Anin-depth description of SRS for MTF individuals, including the historyof the procedure and stories of some of the most famous transsexualwomen. This site contains many images of completed vaginoplastysurgeries and some graphic illustrations.
Vocal Surgery –Since hormone therapy leaves the MTF’s voice unchanged and voice therapy has its limits, some transwomen choose to pursue surgery toalter their voices. International Journal on Transgenderism: Satisfaction of MTF Transsexuals with Operative Voice Therapy: This study compares the voice ranges of transwomen before and after surgery.It also contains basic information about the procedure and thesatisfaction of people that have undergone vocal surgery.
FTM:
Chest Surgery (‘Top Surgery’) –There are several procedures available for chest reconstruction, anddifferent doctors have their own ways of performing these procedures.The type of surgery used depends greatly on personal preference and specific body type.
Transster: Transster is a great resource for photos of FTM chest and genital surgery results. Surgeries are indexed by type of surgery, surgeon, location ofsurgeon, and price.
Dr. Daniel A. Medalie: Dr.Daniel A. Medalie, University Plastic Surgery in Cleveland, OH. Photosof results and descriptions of his procedures are listed on hiswebsite. Medalie does chest reconstruction surgery for FTM patients andbreast implants for MTF patients.
Yahoo group ftmsurgeryinfo: Inorder to access any of the group’s files, one must be a member of Yahoogroups and be admitted into this group. There are tens of thousands ofposts, and there is an extensive catalog of photos and informationabout different surgical procedures and photos of results. The archivesare a great resource for commentary about surgeons and other issuesrelating to surgery.
Genital Surgery (‘Bottom Surgery’) –The most common forms of genital surgery for FTMs are metoidioplasty(the freeing of the enlarged clitoris and typically testicularimplants) and phalloplasty (the creation of a penis from a roll of skinfrom the forearm or abdomen). These surgeries are extremely expensive,and many transmen opt to not have surgery due to dissatisfaction withthe results of any of the available surgeries. For some, however,having bottom surgery is a very important part of becoming happier withtheir bodies.
