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- For specialized articles on surgical procedures see Sex reassignment surgery male-to-female and Sex reassignment surgery female-to-male.
Sex reassignment surgery (SRS) includes the surgical procedures by which a person's physical appearance and function of their existing sexual characteristics are changed to that of the other sex. It is part of a treatment for gender identity disorder in transsexual and transgender people. Other names for SRS include gender reassignment surgery, sex reconstruction surgery, genital reconstruction surgery, gender confirmation surgery, and more recently sex affirmation surgery. The commonly used terms sex change or sex change operation are considered factually inaccurate. The terms feminizing genitoplasty and masculinizing genitoplasty are used medically.
The best known of these surgeries are those that reshape the genitals which is also known as genital reassignment surgery or genital reconstruction surgery (GRS).
The meanings of sexual reassignment surgery usually differs for transwomen (male to female) rather than transmen (female to male). For transwomen, sex reassignment involves the reconstruction of the genitals (though other procedures may occur; indeed, some transwomen decide against genital reconstruction surgery), whereas for transmen this may refer to a range of surgeries, including the removal of female breasts and the shaping of a male contoured chest as well as the reconstruction of the genitals. Chest (or "top") surgery is often the only surgical procedure they undergo.
People who pursue sexual reassignment surgery are usually referred to as transsexual; "trans" - to go or travel between points; "sexual" - pertaining to the sexual characteristics (not sexual actions) of a person. More recently, people pursuing SRS often identify as transgender instead of transsexual.
Those with HIV or Hepatitis C may have trouble finding a surgeon able (many surgeons operate out of small private clinics that cannot adequately treat potential complications in these populations) or even willing to perform surgery. Some surgeons charge higher fees for HIV and Hepatitis C positive patients (some surgeons in developing countries prefer to dispose of surgical instruments used on these populations). Other health concerns, such as diabetes, abnormal blood clotting, reasonably overweight patients, etc. are generally not a problem with experienced surgeons.
As a result of SRS, the person will have the apparent anatomical structures and function typical of the new sex. They are unable to reproduce due to the lack of actual sex glands (testes or ovaries), except through prior sperm banking or embryonic freezing, which still require a genetic woman as the birth mother (See Reproductive technology.).
Additionally, for trans men, continuing hormone replacement therapy is necessary to maintain muscle and bone integrity and characteristic form.
Transsexual people who cannot have or do not want to have SRS and particularly genital reassignment surgery are often called non-op, while "gender refusenik" is a slang term among transgender people. Possible reasons for not having SRS include financial, legal, medical, and other considerations.
Standards of care
It can be extremely difficult to get sexual reassignment surgery. There are very few surgeons willing to perform SRS. Most jurisdictions and medical boards require a minimum duration of psychological evaluation and living as a member of the target gender full time, sometimes called the Real Life Experience (RLE) or Real Life Test (RLT) before SRS is permitted. However, transsexual and transgendered people are often not allowed to change the listing of their sex in public records until SRS is completed. (See legal aspects of transsexualism.)
In many countries or areas, an individual's pursuit of SRS is often governed, or at least guided, by documents called Standards of Care for Gender Identity Disorders (SOC). This most widespread SOC in this field is published and frequently revised by the Harry Benjamin International Gender Dysphoria Association (HBIGDA). Standards of Care usually give certain very specific "minimum" requirements as prerequisites to SRS. For this and many other reasons, both the HBIGDA-SOC and other SOCs are highly controversial and often maligned documents among transgender patients seeking surgery. Some alternative local standards of care exist, such as in the Netherlands, Germany and Italy. Much of the criticism about the HBIGDA-SOC applies to these as well, and some of these SOCs (mostly European SOC) are actually based on much older versions of the HBIGDA-SOC. Other SOCs are entirely independent of the HBIGDA. The criteria of those SOCs are even more strict than the latest revision of the HBIGDA-SOC. The majority of qualified surgeons in North America and many in Europe adhere almost unswervingly to the HBIGDA-SOC or other SOCs.
Male-to-female SRS information
Female-to-male SRS information
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