MALE TO FEMALE GENDER CHANGE · 2019. 10. 15. · GENDER CHANGE SURGICAL/PROCEDURE NAME Male to female Gender Re-assignment Surgery (GRS) Male to female Sexual Re-assignment Surgery

MALE TO FEMALEGENDER CHANGE

SURGICAL/PROCEDURE NAMEMale to female Gender Re-assignment Surgery (GRS)

Male to female Sexual Re-assignment Surgery (SRS)

COMMON NAMESex Change

Gender Change

SURGICAL PROCEDUREThis operation is complex staged procedures composed of resection of male genital organ and construction

of the new female genital organ instead. The first stage is composed of dissection of penile skin out of the

penile shaft, amputation of penile shaft, removal of testes from the scrotal sac, construction of sensate clitoris

from the portion of tissue around the gland penis that has blood and nerve pedicle attached, shortening and

redirection of the urethra, construction of neovaginal canal, construction of labia majora and labia minora.

The neovaginal canal depth is approximately 5-6 inches and lined with scrotal skin graft. The skin graft is

delayed for 6 days before using on the second stage procedure for optimal survival and taking. After the first

stage operation, the raw vaginal canal is packed with a Polyurethane foam tube connected with negative

pressure generator device or VAC (Vacuum Assisted Closure) instead of conventional dressing. The packing

foam is changed once, 3 days after the surgery. The patient is allowed to walk freely before the second stage

procedure. Then 6 days after the first surgery, the patient receives the final operation: scrotal skin graft

vaginoplasty. The subcutaneous fat, fibrous tissue and hair follicle will be scraped from the scrotal skin so

there will be no hair growing in the neovagina. The patient needs to stay in bed strictly for 3 days after scrotal

skin graft. After that, the surgeon will remove the vaginal packing at bedside without difficulty. Vaginal dilation

will be started on the next day and continued 3 times a day,every day for 6 months.

With all the above revolution, colorectal vaginoplasty will be limited to a handful of new patients who are really

obsessive with the vaginal function or the patients who fail from previous GRS and have no good donor for

full thickness skin graft.

HOSPITAL ADMISSION14 nights admission

DURATION OF OPERATIONStaged procedures:

1st stage 5-6 hours

2nd stage 1 hour

ANAESTHETICGeneral anesthesia

CRITERIA Patients must be at least 18 years old. Patients under 20 years old will require parental permission. Patients

must also have approval from a psychiatrist (MD), psychiatric social worker (PhD),or clinical psychologist

(PhD), and must provide a referral letter.

PRE-OPERATIVE CAREPatients must complete a health checkup within 3 months prior to SRS. Patients must also be confirmed by

a private physician to be free from serious medical diseases and must pass the following blood tests: CBC,

Electrolytes, FBS, Creatinine, Urinalysis, Alkaline Phosphatase, Chest X-ray, SGOT,LDH,EKG

Patients must discontinue hormone treatment at least 14 days prior to surgery.

Hormones should not be used to reduce the risk of thrombosis (blood clots.) Oral tablets should not be used

2 weeks prior to surgery and injectional medication should not be used for 4 weeks prior to surgery. Oral and

androgens should not be used 3 days prior to surgery (4 weeks if injectables.)

Inform your surgeon of any allergies, all medical conditions, and any medication that you are taking (both

prescription and non-prescription). Avoid aspirin and brufen-containing medication for 2 weeks prior to surgery

to eliminate the chance of post op. bleeding. You should not smoke for 2 weeks prior to surgery as this may

affect your reaction to the anesthetic and prolong the healing process. Patients who suffer from hypertension

must inform the surgeon prior to surgery.

MALE TO FEMALEGENDER CHANGE

Tel: +66 (0) 76 361 888 Ext. 5498, 5499 Fax: +66 (0) 76 210 936Email: [email protected]

Website: www.phuketpsi.com

POST-OPERATIVE CAREBefore being discharged from the hospital to hotel, a nurse will teach you how to take care of your vagina and

how to perform vaginal dilation 3 times a day for 6 months, and prescribe more medications. The stitches

will be removed after 7-10 days. You will then be able to return home. After 6 months, the patient might dilate

the vagina once or twice a week.

RECOVERYThe neovagina can function within 8 weeks.

RESULTSAfter 8 weeks, the patient should be able-to engage in neovaginalintercourse. There will be no self-lubrication

in the vagina by this technique. Even though the prostrate and seminal gland are preserved, the secretion of

fluid during sexual arousal via urethra is not very much.

Orgasm is dependent on many factors, sensitivity of clitoris and surrounding area, vaginal depth, emotion,

environment, and rectum or prostrate stimulation. Most patients have no troubles from sensation along the

clitoris and surrounding area because the dorsal nerve of penis that is attached to the clitoris and labia minora

is preserved. But it does not mean that all patients will have orgasm. Many patients had their orgasm 1 year later.

LETTER OF RECOMMENDATIONA letter of recommendation is required from foreign patients, and must be from either a psychiatrist or a

clinical behavioral scientist trained to deal specifically with transsexualism that states the person is a candidate

for SRS according to WPATH criteria. The patient will have a follow-up psychiatric evaluation at PPSI.

NOTEIf you are HIV positive, then you are a risk to hospital personnel. For this reason you are asked to pay an

additional 30% of the original charge.

MALE TO FEMALEGENDER CHANGE