Both male-to-female (MTF) and female-to-male (FTM) transgender surgeries can have complications, just like any other surgical procedures. These complications can vary based on the specific surgery being undertaken. Here are potential complications for some of the main gender-affirming surgeries:

Male-to-Female (MTF) Surgeries:

1. Vaginoplasty:
   • Vaginal Stenosis: The vaginal canal can narrow and shorten if post-operative dilation is not regularly and correctly done.
   • Necrosis of the Neoclitoris: The tissue used to form the neoclitoris can die.
   • Vaginal Fistula: An abnormal hole between the vaginal canal and another organ, such as the bladder or rectum.
   • Granulation Tissue: Painful, red, raw tissue that can form in the vaginal canal.
   • Wound Separation or Dehiscence: Where the surgical wound reopens.
   • Loss of Depth: The neovagina may lose depth if not dilated consistently post-operatively.
   • Urinary Complications: Including urinary tract infections, strictures, and misdirected urine stream.
2. Breast Augmentation:
   • Capsular Contracture: Scar tissue forms around the breast implant, causing pain and hardening.
   • Implant Leakage or Rupture.
   • Asymmetry: Breasts may not be symmetrical post-surgery.
   • Scarring.
3. Facial Feminization Surgery:
   • Scarring: Especially in hairline procedures or tracheal shaves.
   • Nerve Damage: Leading to numbness or tingling.
   • Asymmetry: One side of the face might look different from the other.
   • Hair Loss: In incision areas.

Female-to-Male (FTM) Surgeries:

1. Mastectomy (Top Surgery):
   • Scarring: Especially with the double incision technique.
   • Loss of Nipple Sensation.
   • Asymmetry: The chest may not be perfectly symmetrical post-surgery.
   • Nipple Necrosis: In procedures where the nipple is resized and repositioned.
2. Phalloplasty or Metoidioplasty:
   • Urethral Strictures or Fistulas: An abnormal narrowing of the urethra or an unwanted hole between the urethra and the skin.
   • Flap Failure: The tissue used to construct the neophallus can fail.
   • Scarring.
   • Loss of Sensation.
   • Complications related to Implants: If implants are used to facilitate erections.
3. Hysterectomy:
   • Bleeding.
   • Infection.
   • Organ Damage: Injury to nearby organs such as the bladder or bowel.
   • Scarring.

General Complications for All Surgeries:

• Anesthetic Risks: All surgeries that require anesthesia carry risks like allergic reactions or breathing difficulties.
• Blood Clots: Deep vein thrombosis or pulmonary embolism.
• Infection.
• Poor Wound Healing.

It’s vital for anyone considering gender-affirming surgeries to discuss potential risks with their surgeons and understand the post-operative care required to minimize complications. Proper surgical aftercare, prompt recognition of complications, and immediate medical attention when necessary can help mitigate some of these risks.