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Gender reassignment surgery, otherwise called sex reassignment surgery or just a sex change operation is a kind of operation which the sex of a patient is physically changed. The way toward changing one’s sex is rather complicated, and patients are not taking similar steps so as to attain it.
People who desire to live as the converse gender are identified as transgender. Since this current year, nearly a million transgender people live in the USA only.
There are two major kinds of gender reassignment surgery:
● Gender reassignment surgery female to male
● Gender reassignment surgery male to female
Each sex change procedure is unique because it relies intensely upon the wishes and health, both mental and physical, of the patient.
Three major sex change steps should be followed by patients:
● Mental Health Evaluation – in-depth evaluation before hormone therapy
● Hormone Therapy – to masculinize or feminize the characteristics of the patient involving, strength, voice depth, and hair growth
● Gender reassignment surgery – the series of operations so as to turn the patient into the converse gender
Gender reassignment surgery is suggested for transgender people.
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Gender reassignment surgery (also known as sex reassignment surgery, gender-affirming surgery, or sex change surgery) is a complex and life-changing medical procedure. By 2025, new studies and updated guidelines have improved our understanding of eligibility, risks, recovery, and long-term outcomes.
Below you’ll find the most up-to-date overview of who is eligible, what procedures involve, how long recovery takes, and what risks to expect.
Before undergoing gender-affirming surgery, patients must pass strict medical evaluations. Certain health conditions can significantly increase risks and may make surgery unsafe. Contraindications include:
Uncontrolled HIV infection
Unmanaged diabetes (especially with complications)
Severe bleeding disorders (such as hemophilia)
Deep vein thrombosis or high risk of blood clots
Uncontrolled severe hypertension
Chronic Hepatitis C with liver dysfunction
Severe obesity (high BMI)
Important: These conditions do not always mean surgery is impossible, but they require careful multidisciplinary assessment and treatment before proceeding.
Many patients travel internationally for gender reassignment surgery due to specialized centers. In most cases:
Only one trip abroad is needed to complete the procedure.
Patients must stay in the hospital for 5 to 7 nights after surgery.
A total stay of about 2 weeks in the city (e.g., Istanbul) is recommended for safe follow-up and complication monitoring.
The surgery duration depends on whether the patient is transitioning from female-to-male (FtM) or male-to-female (MtF):
Male-to-Female (MtF): Vaginoplasty procedures usually take 5 to 8 hours under general anesthesia.
Female-to-Male (FtM): Surgeries like phalloplasty are performed in multiple stages, each lasting several hours, often separated by 3–6 months.
Before undergoing sex change surgery, patients must go through a structured process:
Mental Health Assessments – Multiple evaluations to ensure patients fully understand the surgery, its risks, and long-term outcomes.
Hormone Therapy – Typically, at least 12 months of gender-affirming hormone therapy (GAHT) is recommended before surgery. Hormones prepare tissues for surgery and improve outcomes.
Medical Tests – Cardiovascular, liver, kidney, and clotting functions are checked carefully.
Informed Consent – Patients must sign a detailed surgical consent after counseling.
WPATH Standards of Care (SOC-8) – Most centers follow international guidelines set by the World Professional Association for Transgender Health.
Procedures may include:
Mastectomy (chest masculinization)
Hysterectomy and oophorectomy (removal of uterus and ovaries)
Vaginectomy (removal of vaginal tissue)
Urethral lengthening
Phalloplasty (creation of a penis using donor tissue)
⚠️ FtM surgeries are usually divided into 3 major stages with several months between them. Because of high costs and complication risks, only about 25% of patients complete all stages.
The two main vaginoplasty techniques are:
Penile inversion vaginoplasty (most common technique)
Colon or intestinal vaginoplasty (for depth and lubrication)
Recovery includes lifelong vaginal dilation to prevent narrowing.
Recovery times vary by procedure and individual health.
Hospital stay: around 7–10 days per major stage.
Complete healing: may take months to years if multiple stages are done.
Urethral complications (fistula, strictures) are common and may require revisions.
Liquid-only diet for the first week.
Gentle walking usually allowed after 1 week.
Sexual activity may resume after about 2 months.
Vaginal dilation required at least twice a day for the first 2 years, and 2–3 times a week afterward.
Like any major surgery, sex change operations carry risks. Common complications include:
Severe infection
Bleeding and hematoma
Loss of sexual sensation or orgasmic function
Tissue necrosis
Fistula (urethral or intestinal)
Urinary incontinence
Blood clots (thrombosis)
FtM Surgery Risks:
Very high complication rates (up to 70–75% for phalloplasty, mostly urethral problems).
MtF Surgery Risks:
Stricture or narrowing (~10%)
Partial tissue loss (~5%)
Reoperation rates of ~15–20% reported in long-term studies.
Satisfaction rates are high: Up to 80–85% of MtF patients report satisfying sexual intercourse and the ability to orgasm.
Mental health impact: While surgery reduces gender dysphoria, some patients may experience anxiety or depression before and after surgery.
Regret rates are very low: Around 1% or less of patients report long-term regret.
Is gender reassignment surgery permanent?
Yes. These procedures are irreversible, which is why multiple psychiatric evaluations are required.
How long do I need to dilate after MtF surgery?
At least 2 years daily, then 2–3 times per week for maintenance. Some surgeons recommend lifelong dilation.
Will my neovagina lubricate naturally?
It depends on the surgical method. Colon vaginoplasty offers better natural lubrication than penile inversion, but many patients still use lubricants for comfort.
Gender reassignment surgery is a life-changing but complex medical process. With proper preparation, experienced surgeons, and adherence to updated 2025 guidelines, most patients experience high satisfaction and improved quality of life.
However, risks remain significant—especially in multi-stage FtM surgeries—so patients must carefully weigh the benefits, risks, and long-term care requirements such as hormone therapy and vaginal dilation.
