There are two main types of gender reassignment surgery (GRS), also known as sex reassignment surgery (SRS): top surgery and bottom surgery.
⦁ Top surgery refers to any surgical procedure that alters the chest to create a more feminine or masculine appearance. For female-to-male (FTM) individuals, top surgery typically involves a mastectomy (removal of the breasts) and chest masculinization. For male-to-female (MTF) individuals, top surgery typically involves breast augmentation.
⦁ Bottom surgery refers to any surgical procedure that alters the genitals to create a more feminine or masculine appearance. For FTM individuals, bottom surgery typically involves metoidioplasty (enlargement of the clitoris to create a penis-like structure) or phalloplasty (creation of a penis from other body tissue). For MTF individuals, bottom surgery typically involves vaginoplasty (creation of a vagina).

There are also a number of other procedures that can be performed as part of GRS, such as facial feminization surgery, voice surgery, and hair removal.
The specific type of GRS that a person chooses will depend on their individual needs and goals. Some people may choose to have all of these procedures, while others may only have one or two.
GRS is a major medical procedure and should only be undertaken after careful consideration. It is important to work with a qualified surgeon who has experience in performing gender-affirming surgery.

Here are some additional resources that you may find helpful:
⦁ World Professional Association for Transgender Health (WPATH) Standards of Care: https://www.wpath.org/publications/soc
⦁ Transgender Surgery: What Happens, Risks & Benefits: https://my.clevelandclinic.org/health/treatments/21526-gender-affirmation-confirmation-or-sex-reassignment-surgery
⦁ The Trans Center: Transgender Surgery for Transmen: https://thetranscenter.com/transmen/

Sex reassignment surgery (SRS), also known as gender confirmation surgery or gender reassignment surgery, encompasses a variety of surgical procedures that are performed to align an individual’s physical characteristics with their gender identity. The specific procedures chosen depend on the individual’s goals, preferences, overall health, and anatomical considerations.

Here are some common types of SRS surgeries:
⦁ Male-to-Female (MTF) Surgery:
⦁ Vaginoplasty: This procedure involves the creation of a neovagina using various techniques, such as penile inversion, sigmoid colon, or non-penile skin graft. The goal is to create functional and aesthetic female genitalia.
⦁ Orchiectomy: This procedure involves the removal of the testes, reducing testosterone production.
⦁ Breast Augmentation: This surgery involves the placement of breast implants to enhance the size and shape of the breasts.

⦁ Female-to-Male (FTM) Surgery:
⦁ Metoidioplasty: This procedure involves releasing the clitoral tissue to create a small phallus that can become erect when sexually aroused. It may also involve additional procedures such as scrotoplasty (creation of a scrotum) and urethroplasty (lengthening of the urethra).
⦁ Phalloplasty: This surgery involves the construction of a neophallus using tissue grafts from other parts of the body, such as the forearm, thigh, or abdomen. It may involve multiple stages and additional procedures to create a functional penis.
⦁ Hysterectomy and Oophorectomy: Removal of the uterus (hysterectomy) and ovaries (oophorectomy) may be performed as part of FTM surgery.

⦁ Non-Binary or Genderqueer Surgery:
⦁ Chest Reconstruction: This surgery, commonly known as top surgery, involves the removal of breast tissue and reshaping the chest to achieve a more masculine or non-binary appearance.
⦁ Other Procedures: Some individuals who identify as non-binary or genderqueer may undergo specific procedures based on their desired physical changes, such as facial feminization surgery, masculinization surgery, or body contouring.

It is important to note that the specific procedures chosen for SRS are highly individualized, and the timeline and combination of surgeries may vary from person to person. The decision to pursue SRS should be made in consultation with experienced healthcare professionals who specialize in transgender healthcare. They can provide personalized guidance, assess individual suitability for surgery, discuss potential risks, expected outcomes, and post-operative care specific to the individual’s circumstances and goals.

Vaginoplasty

Vaginoplasty is a surgical procedure that involves the creation or reconstruction of the vagina. It is a gender-affirming surgery commonly performed as part of gender confirmation or affirmation for transgender women or individuals assigned male at birth who desire a female anatomy. Vaginoplasty aims to create a neovagina, providing a functional and aesthetically pleasing result. Here are some details on vaginoplasty:

Procedure:

1. Penile Inversion Technique:
   • In this widely used technique, the surgeon creates the neovagina by inverting the penile skin to form the vaginal lining. The testicular tissue may be used to create labia.
2. Scrotal Graft Technique:
   • Some surgeons use scrotal tissue, in addition to penile skin, to construct the neovagina. This technique may be employed when additional tissue is needed for optimal results.
3. Intestinal Graft Technique:
   • In some cases, a segment of the intestine (usually the sigmoid colon) may be used to create the neovagina. This technique is less common and typically reserved for cases where other methods may not be feasible.

Stages of the Procedure:

1. Preparation:
   • Patients typically undergo a thorough evaluation by a multidisciplinary team, including mental health professionals, before being deemed eligible for vaginoplasty.
2. Anesthesia:
   • The surgery is performed under general anesthesia, ensuring the patient remains unconscious and pain-free during the procedure.
3. Penile and Scrotal Disassembly:
   • The penile skin and sometimes scrotal tissue are dissected and prepared for inversion or use in the neovaginal construction.
4. Vaginal Cavity Creation:
   • The neovagina is created by carefully shaping and suturing the inverted penile or scrotal skin. The depth and width of the neovagina are customized based on the patient’s preferences and anatomy.
5. Labia Formation:
   • Labiaplasty involves the creation of labia minora and, if desired, labia majora using the available tissue.
6. Clitoroplasty:
   • Clitoroplasty involves the creation of a clitoral hood and, in some cases, the construction of a clitoral glans using sensitive penile or scrotal tissue.
7. Urethral Lengthening (Optional):
   • Some patients may opt for urethral lengthening to enable urination while seated. This involves extending the urethra to the neovaginal introitus.
8. Closure:
   • The surgical sites are closed with dissolvable stitches, and dressings are applied to aid in healing.

Postoperative Care:

• Patients typically stay in the hospital for several days after surgery.
• Dilators may be prescribed to maintain neovaginal depth and prevent contraction.
• Patients are advised to avoid strenuous activities and sexual intercourse during the initial recovery period.

Risks and Considerations:

• As with any surgical procedure, there are risks, including bleeding, infection, scarring, and complications related to anesthesia.
• Sensation in the neovagina may vary, and patients should have realistic expectations about the outcomes.

Vaginoplasty is a complex and specialized surgical procedure that requires expertise in transgender healthcare. Patients considering this surgery should consult with experienced surgeons and undergo a thorough evaluation to ensure that they are well-informed and prepared for the process and recovery.

Labiaplasty

Labiaplasty is a surgical procedure that involves the alteration or reshaping of the labia minora (the inner folds of the external female genitalia). This procedure is commonly performed for aesthetic reasons or to address functional concerns, and it may be part of a larger genital gender-affirming surgery for transgender women. Here are details on labiaplasty:

Types of Labiaplasty:

1. Reduction Labiaplasty:

1. • Purpose: To reduce the size or length of the labia minora.
   • Procedure: Excess tissue is removed, and the remaining tissue is reshaped to achieve the desired size and appearance.

1. Augmentation Labiaplasty:

1. • Purpose: To enhance the size or volume of the labia minora.
   • Procedure: Autologous fat grafting or filler injections may be used to augment the labia minora.

Procedure:

1. Preparation:

1. • Patients undergo a preoperative consultation with the surgeon to discuss their goals, expectations, and medical history.

1. Anesthesia:

1. • Labiaplasty is typically performed under local anesthesia with sedation or general anesthesia, depending on the extent of the procedure.

1. Marking and Incisions:

1. • The surgeon marks the areas of excess tissue to be removed. Incisions are made to excise the unwanted tissue while preserving a natural contour.

1. Tissue Removal and Reshaping:

1. • Excess tissue is carefully removed, and the remaining labial tissue is reshaped to achieve a symmetrical and aesthetically pleasing appearance.

1. Closure:

1. • The incisions are closed with dissolvable stitches or sutures. The surgeon pays attention to achieving symmetry and a natural contour.

Postoperative Care:

• Patients may experience swelling and discomfort for a few days, which can be managed with pain medication.
• Keeping the surgical area clean and avoiding strenuous activities is advised during the initial recovery period.
• Sexual activity and the use of tampons are often restricted during the early stages of recovery.
• Follow-up appointments with the surgeon are scheduled to monitor healing and address any concerns.

Risks and Considerations:

• As with any surgical procedure, there are risks, including bleeding, infection, scarring, and changes in sensation.
• Patients should have realistic expectations about the outcomes, as individual anatomy and healing can vary.

Labiaplasty in Gender-Affirming Surgery:

• Labiaplasty may be performed as part of gender-affirming surgery for transgender women to achieve a more feminine genital appearance.
• The specific approach and goals of labiaplasty in transgender women may vary based on individual preferences and surgical plans.

It’s essential for individuals considering labiaplasty to consult with an experienced and qualified surgeon who specializes in this procedure. Open communication with the surgeon about expectations, potential risks, and the desired outcome is crucial for a successful surgical experience.

 

Penectomy

Penectomy is a surgical procedure involving the partial or complete removal of the penis. This procedure can be performed for various medical reasons or as part of gender-affirming surgery for transgender women. Here are details on penectomy:

Medical Reasons for Penectomy:

1. Penile Cancer Treatment:

1. • Penectomy may be recommended as a treatment for penile cancer. The extent of the procedure depends on the stage and location of the cancer. Partial or total penectomy may be performed.

1. Genital Trauma:

1. • Severe genital trauma, such as injuries from accidents or other traumatic events, may necessitate partial or complete penectomy to address the damage.

1. Gender-Affirming Surgery:

1. • Transgender women may choose penectomy as part of their gender-affirming surgery to align their physical characteristics with their gender identity. Penectomy may be performed in conjunction with other procedures like vaginoplasty.

Types of Penectomy:

1. Partial Penectomy:

1. • In a partial penectomy, only a portion of the penis is removed, leaving a part of the organ intact. This type is often performed for medical reasons, such as cancer treatment.

1. Total Penectomy:

1. • Total penectomy involves the complete removal of the penis. The surgeon may close the urethra and create a neovaginal opening if the procedure is part of gender-affirming surgery.

Procedure:

1. Preoperative Evaluation:

1. • Patients undergo a thorough evaluation, including medical history, physical examination, and discussions with the surgical team about the reasons for the penectomy and expected outcomes.

1. Anesthesia:

1. • Penectomy is typically performed under general anesthesia, ensuring that the patient is unconscious and pain-free during the surgery.

1. Surgical Technique:

1. • The specific surgical approach depends on the underlying reasons for the penectomy:

1. • • For cancer treatment, the surgeon aims to remove cancerous tissue while preserving as much healthy tissue as possible.
     • In gender-affirming surgery, the surgeon follows a planned approach to create the desired genital appearance.

1. Closure:

1. • After the removal of the penis, the surgical site is closed using sutures or dissolvable stitches. In gender-affirming surgery, the surgeon may create a neovaginal opening.

Postoperative Care:

• Recovery after penectomy varies based on the extent of the procedure and the underlying reasons.
• Patients may need pain management, wound care, and follow-up appointments to monitor healing and address any concerns.

Risks and Considerations:

• Risks associated with penectomy include bleeding, infection, changes in sensation, and psychological effects.
• For transgender individuals, the decision to undergo penectomy is deeply personal and may involve comprehensive discussions with mental health professionals.

It’s crucial for individuals considering penectomy to consult with experienced healthcare professionals who specialize in the specific procedure. Clear communication with the surgical team, including discussions about expected outcomes and potential risks, is essential for informed decision-making.

 

Clitoroplasty

Clitoroplasty is a surgical procedure that involves the creation or enhancement of the clitoris, typically performed as part of gender-affirming surgery for transgender women or individuals assigned male at birth (AMAB) who desire a more feminine genital appearance. The procedure aims to create a neoclitoris, which can contribute to a more natural and feminine genital contour. Here are details on clitoroplasty:

Purpose:

1. Gender-Affirming Surgery:
   • Clitoroplasty is commonly performed as part of a comprehensive gender-affirming surgery, which may include other procedures such as vaginoplasty and labiaplasty.
2. Enhancement or Creation:
   • Depending on the individual’s anatomy and surgical goals, clitoroplasty may involve enhancing the existing clitoral tissue or creating a neoclitoris using sensitive penile or scrotal tissue.

Types of Clitoroplasty:

1. Augmentation Clitoroplasty:
   • In this procedure, the surgeon enhances the size and visibility of the existing clitoral tissue without creating a new clitoris. This can involve using autologous fat grafting or other techniques.
2. Neoclitoroplasty:
   • Neoclitoroplasty involves the creation of a new clitoris, typically using penile or scrotal tissue. The surgeon carefully shapes and sutures the tissue to achieve a natural appearance and sensitivity.

Procedure:

1. Preoperative Assessment:
   • Before undergoing clitoroplasty, patients typically have a comprehensive preoperative assessment, including discussions about their goals, medical history, and physical examination.
2. Anesthesia:
   • Clitoroplasty is performed under general anesthesia to ensure the patient is unconscious and pain-free during the surgery.
3. Surgical Technique:
   • The specific technique used depends on whether it is an augmentation or neoclitoroplasty:
     • For augmentation, the surgeon may use autologous fat grafting or other techniques to enhance the existing clitoral tissue.
     • For neoclitoroplasty, the surgeon may use sensitive penile or scrotal tissue to create a new clitoris. Careful shaping and suturing are performed to achieve the desired appearance.

4. Sensitivity Preservation:
   • Efforts are made to preserve or enhance sensitivity in the clitoral region to contribute to sexual satisfaction and function.

Postoperative Care:

• Recovery after clitoroplasty involves postoperative care, including pain management, wound care, and monitoring for any complications.
• Patients are typically advised to refrain from sexual activity and strenuous physical activities during the initial recovery period.

Risks and Considerations:

• Risks associated with clitoroplasty may include bleeding, infection, changes in sensation, and dissatisfaction with the aesthetic outcome.
• Sensitive aftercare and follow-up appointments are important to address any concerns during the recovery period.

Clitoroplasty is a specialized procedure that requires expertise in transgender healthcare. Individuals considering this surgery should consult with experienced surgeons who have a thorough understanding of gender-affirming procedures. Open communication with the surgical team is crucial to ensure that the procedure aligns with the individual’s goals and expectations.

Scrotoplasty

Scrotoplasty is a surgical procedure that involves the creation or reconstruction of the scrotum, often performed as part of gender-affirming surgery for transgender men or individuals assigned female at birth (AFAB) seeking a more masculine genital appearance. The procedure aims to create a scrotal sac, which may include the insertion of testicular implants to provide a more natural and aesthetically masculine appearance. Here are details on scrotoplasty:

Purpose:

1. Gender-Affirming Surgery:

1. • Scrotoplasty is commonly performed as part of a comprehensive gender-affirming surgery, which may include other procedures such as metoidioplasty or phalloplasty.

1. Creation of Scrotal Sac:

1. • The primary goal of scrotoplasty is to create a scrotal sac using the patient’s own tissues. The surgeon carefully shapes and sutures the tissue to achieve a natural and aesthetically pleasing appearance.

1. Testicular Implants (Optional):

1. • In some cases, patients may choose to have testicular implants inserted into the scrotum to mimic the appearance of testicles. This can contribute to a more authentic and masculine genital contour.

Procedure:

1. Preoperative Assessment:

1. • Before undergoing scrotoplasty, patients typically have a comprehensive preoperative assessment, including discussions about their goals, medical history, and physical examination.

1. Anesthesia:

1. • Scrotoplasty is performed under general anesthesia to ensure the patient is unconscious and pain-free during the surgery.

1. Surgical Technique:

1. • The surgeon uses the patient’s own tissue, often from the labia majora or other available areas, to create the scrotal sac. Careful shaping and suturing are performed to achieve the desired appearance.

1. Insertion of Testicular Implants (Optional):

1. • If the patient chooses, testicular implants may be inserted into the scrotum to provide a more complete and natural-looking result.

1. Closure:

1. • The surgical site is closed with dissolvable stitches or sutures. The surgeon pays attention to achieving symmetry and a natural contour.

Postoperative Care:

• Recovery after scrotoplasty involves postoperative care, including pain management, wound care, and monitoring for any complications.
• Patients are typically advised to refrain from strenuous physical activities during the initial recovery period.

Risks and Considerations:

• Risks associated with scrotoplasty may include bleeding, infection, changes in sensation, and dissatisfaction with the aesthetic outcome.
• The decision to insert testicular implants is optional and depends on the patient’s preferences.

Scrotoplasty is a specialized procedure that requires expertise in transgender healthcare. Individuals considering this surgery should consult with experienced surgeons who have a thorough understanding of gender-affirming procedures. Open communication with the surgical team is crucial to ensure that the procedure aligns with the individual’s goals and expectations.

 

Phalloplasty

Phalloplasty is a surgical procedure that involves the construction or reconstruction of a penis, typically performed as part of gender-affirming surgery for transgender men or individuals assigned female at birth (AFAB) seeking a more masculine genital appearance. The procedure aims to create a neophallus using various surgical techniques and may include the incorporation of erectile devices. Phalloplasty is a complex surgery that often involves multiple stages. Here are details on phalloplasty:

Purpose:

1. Gender-Affirming Surgery:

1. • Phalloplasty is a major component of gender-affirming surgery for transgender men seeking to align their physical characteristics with their gender identity.

1. Genital Reconstruction:

1. • The primary goal of phalloplasty is to construct a neophallus that resembles a natural penis in appearance and, to the extent possible, in function.

Types of Phalloplasty:

1. Radial Forearm Phalloplasty (RFF):

1. • In RFF phalloplasty, the surgeon uses a flap of skin, typically from the forearm, to create the neophallus. This technique is known for providing a well-vascularized and sensate flap.

1. Anterolateral Thigh Phalloplasty (ALT):

1. • ALT phalloplasty involves using a flap of skin and fat from the anterolateral thigh to construct the neophallus. This technique may be preferred in cases where the forearm is not suitable.

1. Musculocutaneous Latissimus Dorsi (MLD) Phalloplasty:

1. • MLD phalloplasty utilizes a musculocutaneous flap from the latissimus dorsi muscle in the back. This technique is less common but may be chosen based on individual anatomy.

Stages of Phalloplasty:

1. Preoperative Assessment:

1. • Patients undergo a thorough preoperative assessment, including discussions about their goals, medical history, and physical examination.

1. First Stage (Flap Harvesting):

1. • The first stage involves harvesting the skin and tissues for the neophallus from the chosen donor site (forearm, thigh, or back).

1. Second Stage (Neophallus Construction):

1. • The harvested flap is then shaped and sutured to create the neophallus. Nerve and blood vessel connections are performed to provide sensation and vascularization.

1. Urethral Lengthening (Optional):

1. • Urethral lengthening may be performed to enable standing urination. The surgeon extends the urethra through the neophallus.

1. Glansplasty:

1. • The glans (head of the penis) is sculpted and sutured to provide a natural appearance.

1. Erectile Device Implantation (Optional):

1. • Some individuals opt for the insertion of erectile devices (penile implants) to facilitate erections.

Postoperative Care:

• Recovery after phalloplasty involves postoperative care, including pain management, wound care, and monitoring for any complications.
• Multiple stages of surgery may be spaced apart to allow for optimal healing.

Risks and Considerations:

• Risks associated with phalloplasty include bleeding, infection, changes in sensation, scarring, and potential complications related to erectile device implantation.
• The decision to include urethral lengthening and erectile devices is based on individual preferences.

Phalloplasty is a complex and specialized procedure that requires expertise in transgender healthcare. Individuals considering this surgery should consult with experienced surgeons who have a thorough understanding of gender-affirming procedures. Open communication with the surgical team is crucial to ensure that the procedure aligns with the individual’s goals and expectations.

 

Metoidioplasty

Metoidioplasty is a gender-affirming surgical procedure designed for transgender men or individuals assigned female at birth (AFAB) seeking masculinization of the genitalia. The procedure involves the release of the clitoral ligaments, which allows the naturally enlarged clitoris (resulting from hormonal therapy) to extend further. Metoidioplasty may also include procedures such as urethral lengthening for standing urination and the creation of a scrotum. It is important to note that metoidioplasty is a less complex procedure compared to phalloplasty, and it does not involve the creation of a neophallus.

Key Components of Metoidioplasty:

1. Clitoral Release:
   • The clitoral ligaments are released to allow the clitoris, which has typically enlarged due to testosterone therapy, to extend and achieve a more prominent appearance.
2. Urethral Lengthening (Optional):
   • Urethral lengthening may be performed to allow the individual to urinate while standing. This involves extending the urethra through the neophallus.
3. Scrotoplasty:
   • Scrotoplasty involves the creation or reconstruction of the scrotum, providing a more masculine genital appearance.

Procedure:

1. Preoperative Assessment:
   • Patients undergo a thorough preoperative assessment, including discussions about their goals, medical history, and physical examination.
2. Clitoral Release:
   • The surgeon releases the clitoral ligaments, allowing the enlarged clitoris to extend and become more prominent.
3. Urethral Lengthening (Optional):
   • If desired, the surgeon may perform urethral lengthening to enable standing urination. This involves extending the urethra through the neophallus.
4. Scrotoplasty:
   • Scrotoplasty involves creating or reconstructing the scrotum using available tissue. The surgeon shapes and sutures the tissue to achieve a natural and aesthetically pleasing appearance.
5. Testicular Implants (Optional):
   • Some individuals may opt for the insertion of testicular implants into the scrotum to provide a more complete and natural-looking result.

Postoperative Care:

• Recovery after metoidioplasty involves postoperative care, including pain management, wound care, and monitoring for any complications.
• Patients are typically advised to refrain from strenuous physical activities during the initial recovery period.

Risks and Considerations:

• Risks associated with metoidioplasty may include bleeding, infection, changes in sensation, and dissatisfaction with the aesthetic outcome.
• The decision to include urethral lengthening and testicular implants is based on individual preferences.

Metoidioplasty is a surgical option that offers a less complex alternative to phalloplasty, and it is suitable for individuals who prioritize less invasive procedures. As with any gender-affirming surgery, individuals considering metoidioplasty should consult with experienced surgeons who have expertise in transgender healthcare. Open communication with the surgical team is crucial to ensure that the procedure aligns with the individual’s goals and expectations.

Urethroplasty

Urethroplasty is a surgical procedure focused on the reconstruction or repair of the urethra, which is the tube that carries urine from the bladder to the external body. Urethroplasty can be performed for various reasons, including addressing congenital abnormalities, treating urethral strictures (narrowing of the urethra), or as part of gender-affirming surgeries for transgender individuals seeking urethral lengthening. Here are some details about urethroplasty:

Purpose:

1. Urethral Stricture Repair:
   • Urethroplasty is commonly performed to correct urethral strictures, which can result from scarring or narrowing of the urethra, leading to difficulties in urination.
2. Gender-Affirming Surgery:
   • In gender-affirming surgeries for transgender individuals, urethroplasty may be part of procedures like metoidioplasty or phalloplasty to lengthen the urethra, allowing for standing urination.

Types of Urethroplasty:

1. Substitution Urethroplasty:
   • Substitution urethroplasty involves using tissue from other parts of the body, such as the buccal mucosa (inner cheek lining) or a graft from the bladder, to replace the damaged or narrowed section of the urethra.
2. Augmentation Urethroplasty:
   • Augmentation urethroplasty involves enlarging the narrowed section of the urethra without replacing it. This may include using grafts or flaps to widen the existing urethra.

Procedure:

1. Preoperative Assessment:
   • Patients undergo a thorough preoperative assessment, including discussions about the specific reason for urethroplasty and the potential techniques involved.
2. Anesthesia:
   • Urethroplasty is performed under general anesthesia to ensure the patient is unconscious and pain-free during the surgery.
3. Surgical Technique:
   • The specific surgical technique depends on the type of urethroplasty being performed:
     • For substitution urethroplasty, tissue from another part of the body is used to replace the damaged or narrowed section of the urethra.
     • For augmentation urethroplasty, techniques may involve widening the urethra using grafts or flaps without complete substitution.

4. Urethral Lengthening (Gender-Affirming):
   • In gender-affirming surgeries, urethroplasty may involve lengthening the urethra to enable standing urination. This often accompanies procedures like metoidioplasty or phalloplasty.

Postoperative Care:

• Recovery after urethroplasty involves postoperative care, including pain management, monitoring for complications, and follow-up appointments to ensure proper healing.

Risks and Considerations:

• Risks associated with urethroplasty may include bleeding, infection, changes in sensation, and potential complications related to the specific procedure.
• In gender-affirming surgeries, the success of urethroplasty contributes to functional and aesthetic outcomes.

Urethroplasty is a specialized procedure that requires the expertise of urological and reconstructive surgeons. Individuals undergoing urethroplasty for gender-affirming purposes should consult with experienced surgeons who have expertise in transgender healthcare. Open communication with the surgical team is essential to ensure that the procedure aligns with the individual’s goals and expectations.

Colovaginoplasty

Colovaginoplasty is a surgical procedure that involves the creation of a neovagina using a segment of the colon (large intestine). It is a form of vaginoplasty and is often performed as part of gender-affirming surgery for transgender women or individuals assigned male at birth (AMAB) who desire a more feminine genital appearance. Colovaginoplasty aims to create a functional and aesthetically pleasing neovagina. Here are details on colovaginoplasty:

Purpose:

1. Gender-Affirming Surgery:

1. • Colovaginoplasty is performed to align the physical characteristics of transgender women with their gender identity, providing them with a neovagina.

1. Vaginal Reconstruction:

1. • In cases where other vaginoplasty techniques may not be feasible due to factors like insufficient penile or scrotal tissue, colovaginoplasty can be an alternative for creating a neovagina.

Procedure:

1. Preoperative Assessment:

1. • Patients undergo a thorough preoperative assessment, including discussions about their goals, medical history, and physical examination.

1. Anesthesia:

1. • Colovaginoplasty is performed under general anesthesia to ensure the patient is unconscious and pain-free during the surgery.

1. Surgical Technique:

1. • The surgeon typically uses a segment of the colon, often the sigmoid colon, to create the neovagina. The chosen segment is isolated, and its blood supply is maintained. The remaining portion of the colon is reconnected.

1. Vaginal Canal Creation:

1. • The isolated segment of the colon is fashioned into a tubular structure to create the vaginal canal. The surgeon carefully shapes and sutures the tissue to achieve a natural and functional appearance.

1. Closure:

1. • The surgical site is closed with dissolvable stitches or sutures. The surgeon pays attention to achieving symmetry and a natural contour.

Postoperative Care:

• Recovery after colovaginoplasty involves postoperative care, including pain management, wound care, and monitoring for any complications.
• Patients are typically advised to refrain from sexual activity and strenuous physical activities during the initial recovery period.

Risks and Considerations:

• Risks associated with colovaginoplasty may include bleeding, infection, changes in sensation, and potential complications related to the use of colonic tissue.
• Regular follow-up appointments are important to monitor healing and address any concerns.

It’s crucial for individuals considering colovaginoplasty to consult with experienced surgeons who specialize in gender-affirming procedures. Clear communication with the surgical team, including discussions about expected outcomes and potential risks, is essential for informed decision-making. As with any surgical procedure, the appropriateness of colovaginoplasty depends on individual factors and should be discussed thoroughly with healthcare professionals.