Medical treatment options for gender variant adults

Surgeries for those assigned male, who identify as trans women, trans feminine, non-binary or non-gender

Surgery Purpose
Orchidectomy removal of testicles
Penectomy removal of penis
Vaginoplasty creation of vagina
Clitoroplasty creation of clitoris
Labioplasty creation of labia
Mammoplasty breast enlargement
Thyroid chondroplasty reduction of Adam’s apple
Facial feminising especially reshaping nose and chin
Body reshaping achieve feminine shape
Crico-thyroid approximation raising the pitch of the voice
Hair removal donor site as well as facial and body
Hair transplant to mitigate male pattern baldness

Document: Lower surgery for those assigned male, who identify as trans women, trans feminine, non-binary or non-gender (PDF, 2MB)

Genital surgery is frequently regarded as a necessary step and an end-point to the journey from living as a man to living as a woman.

However, this surgery is irreversible and you should give yourself enough time to be sure that this is what you want. Although some level of reversal surgery is possible, you can never have your functioning male genital anatomy fully restored once it has been removed. Bear in mind that this surgery will not make a change to your everyday dressed appearance. In your public life, people will not behave differently towards you because you have undertaken this step. Successful social transition can be made without recourse to genital surgery, and there is no requirement to have any of the available surgical options in order to obtain full legal recognition by way of a Gender Recognition Certificate. So, genital surgery should not be regarded as inevitable.

Although living one’s life as a woman with a penis is certainly possible, it does raise issues such as use of changing facilities, toilets and taking the kids swimming. These are all potentially public matters which can make for difficulties for those who have not had surgery to refashion the external genitalia. Clearly, and for some, more importantly, there is also an impact on intimate sexual relationships: what effect will surgery have on erotic possibilities; does this mark the end of your present relationship; will you be seeking new relationships; should you reveal your trans history to a new partner, if so, how and when?

Surgeries for those assigned female, identifying as men, trans masculine, non-binary or non-gender

Surgery Purpose
Mastectomy chest reconstruction
Hysterectomy removal of uterus
Salpingo-oophorectomy removal of fallopian tubes
Vaginectomy removal of vagina
Metoidioplasty creation of micro-penis, using the clitoris
Phalloplasty creation of penis, with or without urethra
Urethroplasty creation of urethra within the penis
Scrotoplasty creation of scrotum
Testicular prostheses penile prosthesis implant – making erection possible
Hair removal donor site

Document: A guide to lower surgery for those assigned female, identifying as men, trans masculine, non-binary or non-gender (PDF, 1MB)

This publication provides information about the various options for ‘lower’ surgery , including genital surgery, for trans men and trans masculine people.

These individuals have gender identities that are partially, or completely, at odds with the female sex assigned at birth. Those who experience a partial mismatch between gender identity and assigned sex, may describe themselves as non-binary, non-gender and/or many other terms. Pronouns, names and titles should be used in accordance with the wishes of the people concerned, regardless of their legal sex or gender status. The aim of lower surgery is to improve their lives, both psychologically and physically, by achieving a closer match between their genital appearance, their sexual function, and their self-identification

It is a guide to what can, and what cannot, be achieved through surgery. This information will also help sexual partners of trans men, by giving them an understanding of the range of possible outcomes, and the impact that these may have on their shared lives. The information is not aimed at surgeons themselves, although it may be helpful to those medical staff who are providing other aspects of care for trans men. The text also provides information and advice about sexual behaviours, and sexually transmitted diseases and how to avoid them.

This publication is written by the GIRES’ team that includes doctors and trans people. All the team members have specialist knowledge and experience in the transgender field. The team preparing the text, and the group involved in the consultation process, included trans men.

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