Exploring the Different Types of Gender Affirmation Surgeries

Gender affirmation surgeries, formerly called sex reassignment surgery, helps transgender people have a physical body that matches their gender identity. It can include top surgeries and bottom surgeries.

These surgeries can include facial feminization, reducing the size of the trachea (the “Adam’s apple”), or vaginoplasty (creating functional female genitalia). These procedures may be helpful for people experiencing gender dysphoria.

Facial Feminization

Gender-affirming facial feminization surgery (FFS) can help create a more feminine face and improve quality of life. A new study of 66 patients from two centers documented improved psychosocial outcomes following FFS, including more feminine-appearing facial features and increased satisfaction with their gender affirmation.

During facial feminization, we can reshape the forehead, jaw, and chin for a more feminine appearance. Changing the shape of these facial features can significantly impact your gender identity and how others perceive you. In addition to reshaping the underlying facial bones, we can lower the hairline and reduce or correct existing facial bone asymmetries to give you a more naturally feminine appearance.

We can feminize your chin by narrowing and softening the angular jawline that typically characterizes masculine faces. We can also reshape the upper lip to make it shorter and more feminine. Facial feminization is not a one-size-fits-all procedure, and each patient may require varying surgeries to achieve their ideal feminine appearance.

Tracheal Feminization

Often, transgender people and non-binary individuals feel self-conscious about a protruding Adam’s apple. This facial feminization surgery, known as a tracheal shave or thyroid cartilage reduction, can reduce the size of your Adam’s apple to make it more feminine.

Tracheal feminization is commonly performed with other facial feminization procedures, such as a chin implant or jaw reshaping. During the process, your Bellevue plastic surgeon will create a small incision under your chin or jaw in a skin crease. They will then use a camera to locate the thyroid cartilage and carefully trim any excess. They will not touch the vocal cords, which are important for voice function.

Research indicates that gender affirmation surgeries can reduce the often harmful effects of GID. They can also help a person better match their internal sense of self with the sex they are assigned at birth. This can increase confidence and self-esteem and result in fewer negative mental health outcomes.

Chest Feminization

Feminizing surgery shifts your body’s appearance to create a more feminine look. It’s often part of a transgender transition journey and can help alleviate gender dysphoria. Many surgical procedures, including face feminization, breast augmentation, bottom surgeries and orchiectomy, fall under this category.

For MTF patients, chest feminization is an important aspect of their journey. This gender affirmation procedure enlarges the areola and creates more defined pectoral muscles using skin flaps from other body areas. The results can be quite dramatic.

Typically, you will undergo male-to-female (FTM) hormone therapy for several months or years before getting this procedure. You may also require psychological counseling to prepare for the changes ahead. In addition, you should be in good physical condition and able to follow certain recovery guidelines. Pain management is critical, and you will likely need to take various medications, including opioids, acetaminophen, ibuprofen and ice packs.

Genital Feminization

Often, gender affirmation surgeries help individuals feel more in line with their internal sense of self. Genital feminization surgery can include:

  • Removing the testicles (orchiectomy).
  • Penectomy.
  • Creating a vagina, labia and clitoris.
  • Other body-contouring operations.

These surgeries can be a critical step in feeling more aligned with your body and helping you experience the life right for you. However, not everyone chooses to have genital feminization or any other surgical procedure.

When considering genital feminization, being well-informed about your options and working closely with your surgeon is important. Be aware that if you decide to have this type of surgery, it can significantly impact your ability to become pregnant. For this reason, it is essential to discuss fertility options with your healthcare provider, including sperm cryopreservation. You will also need to attend regular pelvic floor physical therapy sessions to learn how to dilate your new vagina properly.

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