Gender affirming surgery involves a multi-disciplinary approach that can include urologic procedures along with top surgery, facial surgery, and urogynecologic surgery. The purpose of this care is to assist patients in transitioning to the gender they identify with; this approach contributes to a higher quality of life for the patient.
The surgery that is needed for transgender care varies from one person to the next. What one patient needs is different from another, so choosing a doctor with a personalized approach is important. It’s common for one patient to undergo more than one procedure for gender affirming care.
Types of Surgeries: AMAB
Transgender women (assigned male at birth, or AMAB) may have procedures such as:
- Orchiectomy: Removal of the scrotum
- Clitoroplasty: Surgical construction of a clitoris (from existing tissue)
Other procedures for transitioning women can include a penectomy, which is removal of the penis, and feminizing genitoplasty, which is construction of a vagina and labia.
Types of Surgeries: AFAB
Transgender men (assigned female at birth, or AFAB) may have procedures such as:
- Hysterectomy: Removal of the uterus
- Salpingo-oophorectomy: Removal of the fallopian tubes and ovaries
- Complete vaginectomy: Removal of the entire vagina
Other procedures for transitioning men can include metoidioplasty, phalloplasty, and scrotoplasty (construction of a penis and scrotum).
Risks & Recovery
After bottom surgery, many patients are advised to wait four to six weeks to resume all typical activities. Follow-up appointments are very important during the recovery phase.
There are risks with gender affirming surgery, similar to the risks associated with any medical procedure, like bleeding and infection. Additional risks can include trouble emptying the bladder, urethral stricture, urethral fistulas, recurrent urinary tract infections, and changes to sexual sensation. Be sure to contact your doctor if you are experiencing persistent pain or bleeding for more than a few weeks after the procedure.
Realistic Expectations
It’s important for patients to understand that surgery is only one aspect of transitioning. Hormonal therapy and social transitioning are also factors, so be sure to communicate with your healthcare team for complete and multifaceted care.