Transgender - Sex Reassignment Surgery (SRS)

Transgender literally means 'involving partial or complete reversal of gender'. The term can be applied to any individual or a group having tendencies that diverge from the normal gender role. These are people who are unable to identify with the sex that they have been born with. Some of these people suffer from Gender Identity Disorder (GID) and hence, undergo a sex change operation or, technically speaking, Sex Reassignment Surgery.

What is Sex Reassignment Surgery?

The sex or gender of a person cannot be truly changed. That is the reason why this procedure is known as Sex Reassignment Surgery (SRS), and not 'sex change surgery'. The process of SRS involves changing the physical look of a person's anatomy and making it similar to the anatomy of the opposite sex. The procedure also includes changing the existing sexual characteristics to that of the opposite sex. SRS is also known as gender affirmation surgery, gender reassignment surgery, sex reconstruction surgery, genital reconstruction surgery and gender confirmation surgery. Besides these, the surgery has other scientific names too. People who undergo SRS are usually referred to as transsexuals.

SRS is generally performed between the ages of 18 to 21. This is because the earlier transsexuals undergo the surgery, the more time they have to recover and adjust themselves according to the new gender identity and sexual orientation.

There are two kinds of SRS; one that involves male to female (transwomen) surgery, where genital reconstruction involves surgical construction of the vagina; and the other that involves female to male (transmen) surgery, where genital reconstruction involves surgical construction of the penis.

SRS: Male to Female

Sex Reassignment Surgery from male to female involves operating and reconstructing the male genitals to a form that resembles as well as functions like the female genitalia. The vagina can be successfully constructed surgically from either a skin graft or an isolated loop of intestine. Prior to the surgery, transwomen undergo hormone replacement therapy (HRT) and facial hair removal; to procure and enhance feminine characteristics. Post surgery, female hormones help stimulate the growth of breasts and reshape the body. For transwomen undergoing the SRS, facial feminization surgery and breast augmentation become a medical necessity.

SRS: Female to Male

Sex Reassignment Surgery from female to male involves creating a functioning penis from the tissue available in the female genitals. Penis construction surgery isn't attempted for up to a year after a preliminary surgery, known as hysterectomy is done, in which the female genital organs are removed. Many transmen undergo bilateral mastectomy, the removal of breasts and shaping of masculine chest. Female to male surgery has achieved a lesser level of success due to the less amount of clitoral tissue available in the female genitals which is essential for the construction of a penis.

Drawbacks of SRS

One major drawback of Sex Reassignment Surgery is that male to female transsexuals cannot become pregnant. While research is still on, it will take time for scientists to come out with new techniques that would enable transwomen to become pregnant. Also, some transwomen are dissatisfied with this procedure as they retain some bodily features like large feet and hands, quality of voice, and prominence of the Adam's apple. Also, existing health conditions such as obesity and diabetes can increase the anesthesia risk and post-surgery complications. People suffering from HIV/AIDS and hepatitis C cannot easily find doctors who will willingly perform the surgery on them. This is due to the fact that post-surgery, doctors are forced to dispose the surgical equipment used in the surgery in order to curb the AIDS and hepatitis viruses from spreading. As the cost of surgery is also high, transgender patients from advanced countries like Germany, France and USA opt for SRS in Thailand, where the cost of this surgery is comparatively lower.

While complications do exist, research and the progress in the field of medicine will help scientists come out with a way to solve all the problems that still hinder the success of Sex Reassignment Surgery. However, making transwomen conceive children will be the most demanding and challenging task for scientists and doctors to overcome.