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Male to Female Operation
Who is the candidate for sex change MTF surgery?
What are the requirements prior to sex change MTF surgery?
Why do I need to have hormone therapy?
Why do I need to have 12 months of successful continuous full time real-life?
What are the effects of estrogen hormone?
How is the sexual life after the surgery?
How long should I stay in Thailand for sex change surgery?
What is the preparation tip prior to the surgery?
What is the post-surgical care?
What are the possible risks and complications?
Patients must be diagnosed with at least one of the following disorders: gender identity disorder, gender dysphoria, or associated conditions (anxiety, depression).
Patients are required to have continuous 12 months of hormone therapy and provide the written document from a doctor prescribing hormone.
Patients are required to have 12 months of successful continuous full time real-life experience in the cross gender role and provide the identification document from a licensed psychiatrist (MD).
Hormonal treatment plays an important role in the gender transition process not only physically, but also psychologically. These are often medically necessary so patients are able to live as members of their preferred gender.
The real-lift experience is the act of fully adopting a new or evolving gender role or gender presentation in everyday life. This step is important in a person’s transition from one gender to the other. It is a major decision which involves not only the person, but also the immediate family, relatives, friends and colleagues. Because of the immediate personal and social repercussions, it is very important that there is an awareness of the familial, vocational, interpersonal, educational, economic, and legal consequences.
Breast growth, some fat redistribution to approximate a female body, decreased upper body strength, softening of skin, some decrease of body hair, slowing or stopping of scalp hair loss, decreased fertility and testicular size, less frequent and less firm erections are the expected results of Genetic males treated with estrogen. Discontinuing of the hormones, every changes are reversible, except for breast growth which may not regress.
Normal sexual sensation is still guaranteed after sex change surgery as please keep in mind that during removal of the penis and testicles, the skin, together with its nerve supply, are retained and used to line the new vagina. Also, a new clitoris will be formed from part of your glans penis (head of the penis) also with its nerve supply intact. In order to have a fulfilling sexual experience, a patient has to be ready both aspects, which are a physical sensation and a psychological experience.
However, Orgasm is very much a psychological experience as it is a physical experience and you are right that to experience it after SRS varies from person to person as it does even in people who have not had SRS.
Gender reassignment surgery from male to female requires approximately 14 nights. For the proper healing, the patient is recommended to stay in Thailand at least 2-3 weeks.
If you plan to have a surgery, please stop smoking tobacco products, consuming alcohol, taking any medications and vitamins at least 2 weeks before the date of the surgery. In addition, you must fast 8 hours before the surgery which means you should not eat anything on the day of the surgery.
First the surgeon will create the vaginal cavity between rectum and the urethra by cutting some of the pelvic floor muscles to insert the neo-vagina. Then he will make an incision to open the penis. The urethra is shortened and re-routed to emerge lower, just above the new vaginal opening. The surgeon cuts the scrotal skin to removes the testicles after the vaginal cavity is created. The external genitalia such as labia minora and labia majora are constructed by the scrotal skin including the surrounding to create a neo-vagina similar to the biological female genitalia.
The technique uses is called the “Penile Inversion Vaginoplasty”, which turns the penile skin inside out to line the vaginal wall. The depth of the vagina is limited depending on the amount of the penile skin available. The surgeon uses the scrotal skin graft in conjunction with the penile skin to increase the vaginal depth, in patients with short or small penis or who have had circumcision, usually 6-7 inches. The clitoris then constructs by retaining a small section of the glans penis with its blood supply and nerves intact, since the nerves of the glans penis is analogous to the nerves of the clitoris in female. This is then positioned above the urethral meatus. The labia minora is created using part of glans penis and prepuce skin at the same time. The surgery takes approximately 4-8 hours. It is quite safe and effective to have sex change surgery in Thailand.
The patient will be under the surgeon’s close supervision after sex change surgery. He will inform you of everything you need to know. The following post-operative care guidelines should be observed:
• The patient will be on a clear liquid diet and must avoid fibers and milky beverages that can induce defecation to avoid infection for the first 2-3 days.
• To prevent the wound being pressed, use the wrap to lie between legs while sleeping at bed time.
Following the surgeon’s advice closely will reduce risks and complications. The main possible risks are swelling, bruising, bleeding, infection, scarring and numbness, or change in sensation.