Sex reassignment surgery, or also known as gender reassignment surgery, sex affirmation surgery, sex realignment surgery, genital reconstruction surgery, or sex change operation, is a medical procedures to change the existing sexual characteristics from physical appearance and function of a person into opposite sex. Sex reassignment surgery is sometimes undergone to treat people with gender identity disorder, transsexual or transgender people, and intersex people (mostly in infancy). The people who undergone a sex reassignment surgery are usually addressed as transsexual, meaning literally as “person who change his or her sexual characteristics”. Trans women are former men who perform specific sex reassignment surgery to change male to female sexual characteristics, while trans men are former women who perform specific sex reassignment surgery to change female to male sexual characteristics.
Definition
Although people mostly imagine a sex reassignment surgery as a procedure to reshape the genitals of a person, the World Professional Association for Transgender Health (WPATH) has included larger scope to the procedures defined as sex reassignment surgery. Some of these medical procedures are chest and breast reconstruction or augmentation, genital reconstruction, and certain facial plastic reconstruction. This larger definiton also includes some medically non-surgical procedures like facial electrolysis.
To protect patients with gender identity disorder who needs to perform sex reassignment procedure, the American Medical Association House of Delegates declared that the denial to these patients is a form of discrimination and supported public and private health insurance to cover sex reassignment surgery as a treatment recommended by physician. This statements are also issued by other organizations like American Psychological Association and the National Association of Social Workers.
Male to Female or Female to Male Sex Change Difference
Male to female sex reassignment procedure for trans women is different with female to male for trans men. Sex reassignment procedure for trans women includes medical construction of a vagina, facial feminization surgery, and breast augmentation. For trans men, besides medical construction of a penis, several other procedures like mastectomy (breast removal procedure) and hysterectomy or male chest reconstruction are necessary. But, in both cases, sex surgery also includes several necessary ancilliary procedures like orchiectomy or vaginectomy.
In trans women, medical advancement has made it possible to childbearing, by using a donor uterus from other natural women that is strong enought to carry an infant without having any implication from the anti-rejection drugs. A DNA transfer is also possible by removing DNA from the donated ovum to be replaced by the DNA of the receiver.
Not all people could undergo a sex reassignment surgery. There are several health considerations to pass before performing the surgery. For example, the patient with HIV or hepatitis C may find it difficult to do a sex reassignment surgery. Many surgeons avoid these kinds of patient due to the safety problem. Although some medical experts agree that avoiding patients with HIV or hepatitis C to undergo a sex reassignment surgery is a form of discrimination, the patients themselves are willing to pay higher fees in order to recruit a surgeon to perform the surgery safely.
Not only HIV and hepatitis C, other health conditions like diabetes, abnormal blood clotting, and obesity must be considered by the patient. Obese patient, for example, is suggested to lose weight before performing surgery. Meanwhile, smoking patient is suggested to quit before and after surgery. This is necessary to avoid any problems after the surgeons.
Standards of Care
While sex reassignment surgery sometimes feels so difficult to be performed due to financial difficulties or minimum experienced surgeons, a document called Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People becomes a guidance or a governance by some individuals who wants to perform the surgeries. With an increasing number of surgeons in this field in many regions, Standard of Care is widely spread and sometimes revised by the World Professional Association for Transgender Health. The Standard of Care is also becomes a guidance by many countries, including the United States, to treat transsexualism. Standard of Care includes a period of full time life as a member of the target sex before performing the sex reassignment surgery.
Beside that, Standards of Care lists several minimum requirements as guidelines for treating transsexualism. Some of these requirements is accessing hormone replacement from the opposite sex and other surgical interventions. Here then comes the controversy. Many countries do not follow the right Standards of Care, some of them insert their local standards of care in it, like Netherlands, Germany, and Italy. Some European Standards of Care are even based on older versions of the standards. That makes some standards are stricted than other standards, mostly the latest revision of Standards of Care. However, in the United States, many professional sex reassignment surgeons apply the Standards of Care in a more flexible term, regarding to how the patient’s condition is, as long as it is consistent to the Standards.
Surgeons require at least one suggestion from an experienced mental health professional who works in diagnosing sex identity disorder for a patient more than a year. This suggestion is compulsory because it becomes a sign that sex reassignment surgery is the one and only treatment to be performed. Moreover, many medical professionals and associations stated that no surgical interventions are required during performing the sex reassignment surgery procedures. But, laws in many countries are still unable to list transsexual and transgender people as the opposite sex in the public records, except if they attach a testimonial letter from a physician or medical experts that said that the sex reassignment surgery has been undergone. Several strict countries do not even allow any kind of sex change, even after sex reassignment surgery has been performed.
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Unknown - Wednesday, February 20, 2013
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