Gender transition: Top facts on reassignment surgery

A gender reassignment surgery enables people to change biological characteristics associated to their gender, such as breasts, vagina, penis, clitoris, testicles etc. Such changes in the physical form are needed by people who do not associate with the gender assigned to them at birth. To explain this simply, I may have been told since childhood that I am a man, but while growing up I feel that I am a woman.

However, this does not prevent my body from developing physical features of a male – penis, testicles facial hair, coarse voice etc.  So in order to achieve an identity of a woman, I may choose a medical procedure. The two most common options are a Hormone Replacement Therapy (HRT) and Gender Reassignment Surgery (also known as the sex change surgery). The process of moving from one gender identity to another is known as transitioning, and depending on the individual, a person may choose to undergo sex change surgery, HRT or neither and stay as is.

For transwomen (people who are born male but identify as female), this may include getting breast implants, removal of testicles, clitoris construction, and a host of other changes. For transmen (born female but identify as a male), the surgery may involve removal of breasts, removal of the vagina, construction of a penis, etc.

A transgender person may decide to undergo all or only a few changes depending on their choice, level of comfort, cost and availability of surgical options.

The simple answer is no. It is not really necessary. Transgender refers to a broad spectrum where a person may adopt some or many of the characteristics associated with the sex they relate to. This may include cultural traits like changing their habits around dressing up, altering their body language or make physical changes to their biological organs.

Transgender people who wish to undergo a sex change surgery are called transsexuals. Some transgenders do not really have a desire to undergo a sex change operation while few others cannot either afford the surgery or do not undertake it for other reasons.

Several trends suggest that more people are undergoing sex-change operations than ever before. In India, sex change surgeries are fairly accessible, especially in the cities. Both government and private hospitals offer sex change surgeries.

While the availability is not so much of a problem, the high costs (which run into several lakhs of rupees) do pose a problem for people coming from less privileged backgrounds. While it is more economical for foreign nationals to get their surgeries done in India, the story is different for India’s own transgender people, given the gaps in standards of living.

Generally speaking, gender reassignment surgeries help the transsexuals live a fuller and more meaningful life as they feel closer to the gender they associate with. This means less emotional stress and a healthier sex-life too. It prevents a host of other social and emotional problems that come with living in a body you don’t identify with!

Just like any other medical procedure, sex change surgeries too carry risks. These include loss of ability to reproduce and psychological changes that may be difficult to adapt to. Other possible post-surgery complications include hematoma (collection of blood outside blood vessels) and nipple necrosis (death of cells around the nipples) etc.

That is why it is a prescribed protocol to ensure that the patient is indeed someone who cannot identify with their biological sex at all before the doctors go ahead with the surgery. Further, the patients are required to follow strict post-surgery advice to recover from the stress of the surgery.